The relationship between malignant mesothelioma and an asbestos cement plant environmental risk: a spatial case–control study in the city of Bari (Italy)

  • Marina Musti
  • Alessio Pollice
  • Domenica CavoneEmail author
  • Silvano Dragonieri
  • Massimo Bilancia
Original Article



To estimate the mesothelioma risk and environmental asbestos exposure (EAE) due to an asbestos-cement plant.


A spatial case–control study including 48 malignant mesothelioma (MM) cases occurred in the period 1993–2003 selected from the regional mesothelioma register (RMR) and 273 controls. The disease risk was estimated by means of a logistic-regression model, in which the probability of disease-occurrence is expressed as a function of the classes of distances. A non-parametric method was applied to estimate the full relative risk surface.


Significant MM odds ratio of 5.29 (95 CI: 1.18–23.74) was found for people living within a range up to 500 m centered on the plant. The non-parametric estimation of relative risk surface unveiled a marked peak near the plant not paralleled by the spatial distribution of controls.


Evidence of an association between mesothelioma risk and EAE is highlighted. The role played by the RMR in increasing the public health local authorities awareness is stressed.


Asbestos-cement plant Environmental-neighborhood exposure Mesothelioma register Spatial case–control study Public health Italy 



We thank Professor Annibale Biggeri for his comments to the manuscript. The authors would like to thank Professor Benedetto Terracini for the ideas on which this paper is based. Conflict of interest statement: None declared by any author.


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Copyright information

© Springer-Verlag 2008

Authors and Affiliations

  • Marina Musti
    • 1
  • Alessio Pollice
    • 2
  • Domenica Cavone
    • 1
    • 4
    Email author
  • Silvano Dragonieri
    • 3
  • Massimo Bilancia
    • 2
  1. 1.Department of Internal Medicine and Public Medicine, Section of Occupational Medicine “Ramazzini”University of Bari, National Register of Mesothelioma, Regional Operative Centre (C.O.R.)ApuliaItaly
  2. 2.Department of Statistical Sciences “Carlo Cecchi”University of BariBariItaly
  3. 3.Respiratory Diseases, Department of Clinical Methodology and Medical-Surgical TechnologiesUniversity of BariBariItaly
  4. 4.Università degli Studi di BariBari (BA)Italy

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