Asbestos Fibre Burden in the Lungs of Patients with Mesothelioma Who Lived Near Asbestos-Cement Factories

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Pietro Gino Barbieri1,*, Dario Mirabelli2, Anna Somigliana3, Domenica Cavone4 and Enzo Merler5

1Mesothelioma Registry, Occupational Health Unit, Local Health Authority, 25128 Brescia, Italy

2Unit of Cancer Epidemiology, University of Turin and CPO-Piemonte, 10126 Turin, Italy

3Centre of Electron Microscopy, Lombardy Environmental Protection Agency (ARPA), 20129 Milan, Italy

4Apulia Mesothelioma Registry, Occupational Health Section B. Ramazzini, Department of Internal Medicine and Public Health, University of , Bari, 70121 Bari, Italy

5Venetian Mesothelioma Registry, Occupational Health Unit, Local Health Authority, 35121 Padua, Italy ?* Author to whom correspondence should be addressed. Tel: +39 030 3838677; fax: +39 030 3838540; e-mail: pietro.barbieri{at}aslbrescia.it Received December 8, 2010. Accepted December 2, 2011. Background Epidemics of malignant mesothelioma are occurring among inhabitants of Casale Monferrato and Bari never employed in the local asbestos-cement (AC) factories. The mesothelioma risk increased with proximity of residence to both plants.

Objectives To provide information on the intensity of environmental asbestos exposure, in the general population living around these factories, through the evaluation of the lung fibre burden in mesothelioma patients. Methods We analysed by a scanning electron microscope equipped with X-ray microanalysis wet (formalin-fixed) lung tissue samples from eight mesothelioma patients who lived in Casale Monferrato or Bari and underwent surgery. Their occupational and residential history was obtained during face-to-face interviews. Semi-quantitative and quantitative indices of cumulative environmental exposure to asbestos were computed, based on residential distance from the AC plants and duration of stay. Results The lung fibre burden ranged from 110?000 to 4?300?000 fibres per gram of dry lung (f/g) and was >1?000?000 f/g in three subjects. In four cases, only amphibole fibres were detected. Environmental exposures had ceased at least 10 years before samples were taken. No patient had other definite or probable asbestos exposures. A linear relationship was observed between the lung fibre burden and all three indices of environmental cumulative exposure to asbestos. Conclusions Environmental exposure to a mixture of asbestos fibres may lead to a high lung fibre burden of amphiboles years after exposure cessation. The epidemiological evidence of an increased mesothelioma risk for the general population of Casale Monferrato and Bari, associated with asbestos contamination of the living environment, is corroborated. © The Author 2012. Published by Oxford University Press on behalf of the British Occupational Hygiene SocietyThis ArticleAnn Occup Hyg (2012) 56 (6): 660-670. doi: 10.1093/annhyg/mer126 First published online: January 12, 2012 Current Issue
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Posted in: Asbestos, AsbestosCement, Burden, Factories, Fibre, Lived, Lungs, Mesothelioma, Patients