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Corrado Magnani,¹ Paola Dalmasso,¹ Annibale Biggeri,² Cristiana Ivaldi,¹ Dario Mirabelli,¹ and Benedetto Terracini¹

¹Cancer Epidemiology Unit, Centre for Cancer Epidemiology and Prevention, CPO Piemonte, S. Giovanni Hospital and University of Torino, Italy; ²Department of Statistics "G.Parenti," University of Florence, Italy

Abstract

The association of malignant mesothelioma (MM) and nonoccupational asbestos exposure is currently debated. Our study investigates environmental and domestic asbestos exposure in the city where the largest Italian asbestos cement (AC) factory was located. This population-based case-control study included pleural MM (histologically diagnosed) incidents in the area in 1987-1993, matched by age and sex to two controls (four if younger than 60) . Diagnoses were confirmed by a panel of five pathologists. We interviewed 102 cases and 273 controls in 1993-1995, out of 116 and 330 eligible subjects. Information was checked and completed on the basis of factory and Town Office files. We adjusted analyses for occupational exposure in the AC industry. In the town there were no other relevant industrial sources of asbestos exposure. Twenty-three cases and 20 controls lived with an AC worker [odds ratio (OR) = 4.5 ; 95% confidence interval (CI) , 1.8-11.1) ]. The risk was higher for the offspring of AC workers (OR = 7.4 ; 95% CI, 1.9-28.1) . Subjects attending grammar school in Casale also showed an increased risk (OR = 3.3 ; 95% CI, 1.4-7.7) . Living in Casale was associated with a very high risk (after selecting out AC workers: OR = 20.6 ; 95% CI, 6.2-68.6) , with spatial trend with increasing distance from the AC factory. The present work confirms the association of environmental asbestos exposure and pleural MM, controlling for other sources of asbestos exposure, and suggests that environmental exposure caused a greater risk than domestic exposure. Key words: asbestos, asbestos cement, environmental exposure, pleural mesothelioma. Environ Health Perspect 109:915-919 (2001) . [Online 23 August 2001]

http://ehpnet1.niehs.nih.gov/docs/2001/109p915-919magnani/ abstract.html

Address correspondence to C. Magnani, Cancer Epidemiology Unit, Centre for Cancer Epidemiology and Prevention (CPO Piemonte) , Via Santena 7, 10126 Torino, Italy. Telephone: + 39 011-6336965. Fax: + 39 011-6336960. E-mail: corrado.magnani@cpo.it

Preliminary results were presented at the Annual Ramazzini Days, 1996, Carpi, Italy, 27 October 1996 during the seminar "Presentation to the Collegium Ramazzini of Recent Data on the Epidemiology of Asbestos-Related Cancers in Italy."

We are grateful to the staff of the Hospital (M. Botta, B. Castagneto, D. Degiovanni, G. Verrua, E. Piccolini, M. Pavesi, and P. Pastormerlo) , of the Occupational Medicine Unit (A. Mancini) , and of the Town Office of Casale Monferrato, to the pathologists reviewing the cases (A. Andrion, P.G. Betta, P.A. Donna, F. Mollo, and M. Scelsi) , to the research assistants (M. Bertolotti, M. Nonnato, and V. Vittori) , and to the interviewers (D. Solerio and E. Ferretti) .

The study received grants from AIRC, Piemonte Region and European Community (Europe Against Cancer Program) .

Received 23 October 2000 ; accepted 8 March 2001.