Marinaccio Alessandro, Binazzi Alessandra, Bonafede Michela, Di Marzio Davide, Scarselli Alberto
Occupational and Environmental Medicine, Epidemiology and Hygiene Department, Occupational and Environmental Epidemiology Unit, Italian Workers' Compensation Authority (INAIL), Rome, Italy.
J Thorac Dis. 2018 Jan;10(Suppl 2):S221-S227. doi: 10.21037/jtd.2017.12.146.
As a legacy of the large asbestos consumption until the definitive ban in 1992, Italy is currently suffering a severe epidemic of asbestos related diseases. The aim of this paper is to describe the surveillance system for mesothelioma incidence and to provide evidences regarding the occurrence of the disease in Italy and the circumstances of asbestos exposure.
Italian National Register of Malignant Mesotheliomas (ReNaM) is a permanent surveillance system of mesothelioma incidence, with Regional Operating Centres (CORs) active in each Italian region, identifying incident malignant mesothelioma (MM) cases from health care structures. Occupational history, lifestyle habits and residential history are obtained using a standardised questionnaire, administered by a trained interviewer, to the subject or to the next of kin. Descriptive epidemiological figures, occupations involved in exposures and territorial maps of MM cases have been produced.
At December 2016, ReNaM has collected 27,356 MM cases for the incidence period between 1993 and 2015. The modalities of exposure to asbestos have been investigated for 21,387 (78%) and an occupational exposure has been defined for around 70% of interviewed cases (14,818). Non-occupational exposure is still relevant with 4.9% and 4.4% of cases for which respectively a familial exposure (due to the cohabitation with an occupational exposed subject) and an environmental exposure (due to the residence near a contaminated site) has been detected.
The epidemiological surveillance of MM incident cases, by the means of a national register for estimating the occurrence of the disease and identifying the circumstances of asbestos exposure, is a relevant tool for preventing asbestos exposure, for supporting the effectiveness of insurance system and for estimating reliable epidemiological figures.
作为1992年彻底禁止大规模石棉消费之前的遗留问题，意大利目前正遭受与石棉相关疾病的严重流行。本文旨在描述间皮瘤发病率监测系统，并提供有关该疾病在意大利的发病率以及石棉接触情况的证据。
意大利恶性间皮瘤国家登记处（ReNaM）是间皮瘤发病率的永久性监测系统，在意大利每个地区都设有区域运营中心（COR），从医疗机构中识别出间皮瘤确诊病例。职业史、生活习惯和居住史通过由经过培训的访谈员向受试者或其近亲发放的标准化问卷获取。已得出描述性流行病学数据、涉及接触石棉的职业以及间皮瘤病例的地域分布图。
截至2016年12月，ReNaM已收集了1993年至2015年发病期的27356例间皮瘤病例。对21387例（78%）病例的石棉接触方式进行了调查，约70%的受访病例（14818例）被确定为职业接触。非职业接触仍然很重要，分别有4.9%和4.4%的病例被检测出存在家庭接触（由于与职业接触者共同居住）和环境接触（由于居住在受污染场地附近）。
通过国家登记处对间皮瘤确诊病例进行流行病学监测，以估计疾病的发病率并确定石棉接触情况，这是预防石棉接触、支持保险系统有效性以及估计可靠流行病学数据的重要工具。
