274
Furthermore, there was a clear gradient distribution of incidence rate, with the
highest rates in Northern Italy, as shown in Fig. 29.1. This is particularly evident for
the year 2014 and declines over the time.
Gorizia province had the highest number of ascertained diagnoses every year,
with a peak at 19.9 new cases by 100,000 workers in 2015.
Concerning disease types, mesothelioma, in its different variants (pleura, peritoneum, other sites or unspecified), was the most common one, with 2995 ascertained
cases (35% of the sample). It was followed in the ranking by pleural plaques (2955
cases, 34%), pneumoconiosis (1327 cases, 15%) and lung cancer and cancer of the
respiratory tract (1298 cases, 14%). These disorders together represent almost 99%
of the retrieved cases.
29.5 Discussion and Conclusions
During the last years Italy showed an overall decreasing tendency of asbestosrelated diseases, following the general trend happening in all the high-income countries because of the ban of the asbestos compounds.
Another noticeable feature is the significant difference between northern and
southern Italian provinces. Further studies could be aimed at investigating whether
this gradient is attributable to a real gap in incidence, due to the highest industrialization process affecting Northern Italy, or to an underreporting phenomenon in
the South.
Therefore, a detailed surveillance of the problem, for instance by case finding
methods, could be an effective tool to assess new emerging cases. Identifying workers at risk would indeed allow public health servants to manage large-scale primary,
secondary and tertiary prevention programs targeted on occupational risks.
References
1. Young GJ, Healey FH (1954) The physical structure of asbestos. J Phys Chem 58:881–884
2. International Agency for Research on Cancer (IARC) IARC Monographs. Arsenic, metals,
fibres and dusts. 2012 Volume 100C. A Review of Human Carcinogens. Available online:
http://monographs.iarc.fr/ENG/Monographs/vol100C/mono100C.pdf. Accessed 11 Sep 2019
3. Henley SJ, Peipins LA, Rim SH, Larson TC, Miller JW (2019) Geographic co-occurrence
of mesothelioma and ovarian cancer incidence. J Womens Health (Larchmt). https://doi.
org/10.1089/jwh.2019.7752. [Epub ahead of print]
4. Lin RT, Chien LC, Jimba M, Furuya S, Takahashi K (2019, Aug) Implementation of national
policies for a total asbestos ban: a global comparison. Lancet Planet Health 3(8):e341–e348.
https://doi.org/10.1016/S2542-5196(19)30109-3
5. Frank AL, Joshi TK (2014) The global spread of Asbestos. Ann Glob Health 80(4):257–262.
https://doi.org/10.1016/j.aogh.2014.09.016
6. Walton WH (1982) The nature, hazards and assessment of occupational exposure to airborne asbestos dust: a review. Ann Occup Hyg 25(2):117–119. https://doi.org/10.1093/
annhyg/25.2.117
A. Vinci et al.
Furthermore, there was a clear gradient distribution of incidence rate, with the
highest rates in Northern Italy, as shown in Fig. 29.1. This is particularly evident for
the year 2014 and declines over the time.
Gorizia province had the highest number of ascertained diagnoses every year,
with a peak at 19.9 new cases by 100,000 workers in 2015.
Concerning disease types, mesothelioma, in its different variants (pleura, peritoneum, other sites or unspecified), was the most common one, with 2995 ascertained
cases (35% of the sample). It was followed in the ranking by pleural plaques (2955
cases, 34%), pneumoconiosis (1327 cases, 15%) and lung cancer and cancer of the
respiratory tract (1298 cases, 14%). These disorders together represent almost 99%
of the retrieved cases.
29.5 Discussion and Conclusions
During the last years Italy showed an overall decreasing tendency of asbestosrelated diseases, following the general trend happening in all the high-income countries because of the ban of the asbestos compounds.
Another noticeable feature is the significant difference between northern and
southern Italian provinces. Further studies could be aimed at investigating whether
this gradient is attributable to a real gap in incidence, due to the highest industrialization process affecting Northern Italy, or to an underreporting phenomenon in
the South.
Therefore, a detailed surveillance of the problem, for instance by case finding
methods, could be an effective tool to assess new emerging cases. Identifying workers at risk would indeed allow public health servants to manage large-scale primary,
secondary and tertiary prevention programs targeted on occupational risks.
References
1. Young GJ, Healey FH (1954) The physical structure of asbestos. J Phys Chem 58:881–884
2. International Agency for Research on Cancer (IARC) IARC Monographs. Arsenic, metals,
fibres and dusts. 2012 Volume 100C. A Review of Human Carcinogens. Available online:
http://monographs.iarc.fr/ENG/Monographs/vol100C/mono100C.pdf. Accessed 11 Sep 2019
3. Henley SJ, Peipins LA, Rim SH, Larson TC, Miller JW (2019) Geographic co-occurrence
of mesothelioma and ovarian cancer incidence. J Womens Health (Larchmt). https://doi.
org/10.1089/jwh.2019.7752. [Epub ahead of print]
4. Lin RT, Chien LC, Jimba M, Furuya S, Takahashi K (2019, Aug) Implementation of national
policies for a total asbestos ban: a global comparison. Lancet Planet Health 3(8):e341–e348.
https://doi.org/10.1016/S2542-5196(19)30109-3
5. Frank AL, Joshi TK (2014) The global spread of Asbestos. Ann Glob Health 80(4):257–262.
https://doi.org/10.1016/j.aogh.2014.09.016
6. Walton WH (1982) The nature, hazards and assessment of occupational exposure to airborne asbestos dust: a review. Ann Occup Hyg 25(2):117–119. https://doi.org/10.1093/
annhyg/25.2.117
A. Vinci et al.