Visonà Silvia D, Villani Simona, Manzoni Federica, Chen Yao, Ardissino Giorgio, Russo Francesca, Moretti Matteo, Javan Gulnaz T, Osculati Antonio
Section of Legal Medicine and Forensic Science.
Section of Biostatistics and Clinical Epidemiology, Department of Public Health, Experimental and Forensic Medicine, University of Pavia.
J Public Health Res. 2018 Dec 20;7(3):1519. doi: 10.4081/jphr.2018.1519.
The goal of this study is to understand more about the role of asbestos in causing human diseases, first of all mesothelioma, by investigating a large series of deaths due to asbestos-related diseases (ARDs). The main aim is to clarify if even very low amounts of asbestos can cause mesothelioma and other ARDs, as well as to find out if a different individual vulnerability can be important. This retrospective study included 188 subjects who died from asbestos related diseases in 2000-2017 in the area around Broni, Italy, where an important asbestos cement factory had been active from 1932 until 1993. In each case, a forensic autopsy has been performed. In order to perform the present study, the records were retrieved, including the clinical files, the autopsy, and the histological report. The statistical analysis performed showed that there was a significant relation between the cause of death (mesothelioma, lung cancer or asbestosis) and the kind of exposure (occupational, neighborhood or household), showing that all the subjects not exposed occupationally (and, therefore, exposed to lower amounts of asbestos) died from mesothelioma, whereas the individuals who used to work at the plant died also from other caused (asbestosis, lung cancer). Significant differences were highlighted examining the distribution of the causes of death according to the smoking habits. Moreover, among the mesothelioma patients, the survival time was shorter in the subjects with a neighborhood or household exposure than in the occupationally exposed individuals. The study provided meaningful data about the role of asbestos in causing human pathologies. In particular, the present data appear to support the hypothesis that even an exposure to a very little amount of asbestos can cause mesothelioma in hypersusceptible subjects (probably, on a genetic basis).
本研究的目的是通过调查一系列与石棉相关疾病（ARDs）导致的死亡病例，更深入地了解石棉在引发人类疾病，尤其是间皮瘤方面的作用。主要目的是明确即使极少量的石棉是否会导致间皮瘤和其他ARDs，以及是否存在个体易感性差异。这项回顾性研究纳入了188名于2000年至2017年期间在意大利布罗尼周边地区死于石棉相关疾病的受试者，该地区有一家重要的石棉水泥厂从1932年至1993年一直运营。每例均进行了法医尸检。为开展本研究，检索了包括临床档案、尸检报告和组织学报告在内的记录。进行的统计分析表明，死亡原因（间皮瘤、肺癌或石棉肺）与接触类型（职业性、邻里或家庭接触）之间存在显著关联，表明所有非职业接触（因此接触石棉量较低）的受试者死于间皮瘤，而曾在该厂工作的个体也死于其他原因（石棉肺、肺癌）。根据吸烟习惯检查死亡原因分布时发现了显著差异。此外，在间皮瘤患者中，邻里或家庭接触组的存活时间短于职业接触组。该研究提供了关于石棉在引发人类病理方面作用的有意义数据。特别是，目前的数据似乎支持这样一种假设，即即使接触极少量的石棉也可能在超敏感个体（可能基于遗传）中引发间皮瘤。
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