Mensi Carolina, Poltronieri Anna, Romano Alessandro, Dallari Barbara, Riboldi Luciano, Bertazzi Pier Alberto, Consonni Dario
Dip Medicina Preventiva, Fondaz IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milano.
Med Lav. 2016 Jan 20;107(1):22-8.
Malignant Mesothelioma (MM) is a rare neoplasm associated with asbestos exposure. In 24,5% of MM cases reported to the Lombardy Mesothelioma Registry (LMR), asbestos exposure has been defined as "unknown".
To evaluate the cases with "unknown exposure to asbestos" diagnosed in 2000-2004 in agreement with new knowledge about source of asbestos exposure.
Information regarding exposure has been reviewed in order to select the cases susceptible of further investigations, including: interview of relatives and/or colleagues; further evaluations by local PSAL (Prevention and Security in workplace) services; contact of industrial hygienists; analysis of production processes. The same procedure has been followed for extra-occupational exposure. These cases have been subjected to the LMR evaluation group.
Fourthy four out of 364 (12,1%) MM have been reclassified. In 47,7% of the cases, a "possible occupational exposure" has been recognized, 15,9% have been attributed a "certain occupational exposure", while 36,4% an extra-occupational (domestic, environmental and leisure-time) exposure. No significant differences between age, sex, cancer site, diagnostic certainty, residence, year of diagnosis, interviewed subjects were detected. The occupational sector with the highest amount of reclassifications was the clothing production.
The detailed reconstruction of clinical and occupational history and of lifestyle habits of patients affected by MM, close cooperation with Local Services of Occupational Medicine and literature review make it possible for previously overlooked asbestos exposure to be acknowledged.
恶性间皮瘤（MM）是一种与石棉暴露相关的罕见肿瘤。在向伦巴第间皮瘤登记处（LMR）报告的MM病例中，24.5%的病例石棉暴露情况被定义为“不明”。
根据关于石棉暴露源的新知识，评估2000年至2004年诊断为“石棉暴露不明”的病例。
对暴露信息进行了审查，以选择可能需要进一步调查的病例，包括：询问亲属和/或同事；由当地职业安全与健康（PSAL）服务部门进行进一步评估；联系工业卫生学家；分析生产过程。对于非职业性暴露也采用了相同的程序。这些病例已提交给LMR评估小组。
364例MM中有44例（12.1%）被重新分类。在47.7%的病例中，确认了“可能的职业暴露”，15.9%的病例被认定为“确定的职业暴露”，而36.4%的病例为非职业性（家庭、环境和休闲时间）暴露。在年龄、性别、癌症部位、诊断确定性、居住地、诊断年份、受访对象方面未发现显著差异。重新分类数量最多的职业部门是服装生产。
对MM患者的临床和职业病史以及生活习惯进行详细重建，与当地职业医学服务部门密切合作并进行文献综述，使得之前被忽视的石棉暴露得以被确认。
