Asbestos Exposure in Patients with Malignant Pleural Mesothelioma included in the PRIMATE Study, Lombardy, Italy
Andrea Spinazzè,
Dario Consonni,
Francesca Borghi,
Sabrina Rovelli,
Andrea Cattaneo,
Carolina Zellino,
Barbara Dallari,
Angela Cecilia Pesatori,
Hans Kromhout,
Susan Peters,
Luciano Riboldi,
Domenico Maria Cavallo and
Carolina Mensi
Additional contact information
Andrea Spinazzè: Department of Science and High Technology, University of Insubria, 22100 Como, Italy
Dario Consonni: Occupational Health Unit, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy
Francesca Borghi: Department of Science and High Technology, University of Insubria, 22100 Como, Italy
Sabrina Rovelli: Department of Science and High Technology, University of Insubria, 22100 Como, Italy
Andrea Cattaneo: Department of Science and High Technology, University of Insubria, 22100 Como, Italy
Carolina Zellino: Occupational Health Unit, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy
Barbara Dallari: Occupational Health Unit, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy
Angela Cecilia Pesatori: Occupational Health Unit, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy
Hans Kromhout: Institute for Risk Assessment Sciences, Utrecht University, 3584 CM Utrecht, The Netherlands
Susan Peters: Institute for Risk Assessment Sciences, Utrecht University, 3584 CM Utrecht, The Netherlands
Luciano Riboldi: Occupational Health Unit, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy
Domenico Maria Cavallo: Department of Science and High Technology, University of Insubria, 22100 Como, Italy
Carolina Mensi: Occupational Health Unit, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy
IJERPH, 2022, vol. 19, issue 6, 1-11
Abstract:
The PRIMATE study is an Italian translational research project, which aims to identify personalized biomarkers associated with clinical characteristics of malignant pleural mesothelioma (MPM). For this purpose, characteristics of MPM patients with different degrees of asbestos exposure will be compared to identify somatic mutations, germline polymorphism, and blood inflammatory biomarkers. In this framework, we assessed exposure to asbestos for 562 cases of MPM extracted from the Lombardy region Mesothelioma Registry (RML), for which a complete interview based on a standardized national questionnaire and histopathological specimens were available. Exposure assessment was performed: (1) through experts' evaluation (considered as the gold standard for the purpose of this study), according to the guidelines of the Italian National Mesothelioma Registry (ReNaM) and (2) using a job-exposure matrix (SYN-JEM) to obtain qualitative (ever/never) and quantitative estimates of occupational asbestos exposure (cumulative exposure expressed in fibers per mL (f/mL)). The performance of SYN-JEM was evaluated against the experts' evaluation. According to experts' evaluation, occupational asbestos exposure was recognized in 73.6% of men and 23.6% of women; furthermore, 29 men (7.8%) and 70 women (36.9%) had non-occupational exposure to asbestos. When applying SYN-JEM, 225 men (60.5%) and 25 women (13.2%) were classified as occupationally exposed, with a median cumulative exposure higher for men (1.7 f/mL-years) than for women (1.2 f/mL-years). The concordance between the two methods (Cohen’s kappa) for occupational exposure assessment was 0.46 overall (0.41 in men, and 0.07 in women). Sensitivity was higher in men (0.73) than in women (0.18), while specificity was higher in women (0.88) than in men (0.74). Overall, both methods can be used to reconstruct past occupational exposure to asbestos, each with its own advantages and limitations.
Keywords: mesothelioma; asbestos; occupational exposure; retrospective exposure assessment; job-exposure matrix (JEM); SYN-JEM (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2022
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