Twenty-six years after Italy instituted a ban on cancer-causing asbestos, the number of people dying of malignant mesothelioma is still rising.
Researchers with the Istituto Superiore di Sanità in Rome computed the mortality rates from mesothelioma between 2003 and 2014 in each of the country’s 8,047 municipalities and found that more than 16,000 people had died from malignant mesothelioma.
Most of those deaths were from pleural mesothelioma and most occurred in areas near industrial asbestos sources.
Malignant Mesothelioma and Asbestos Bans
An estimated 80 percent of people diagnosed with mesothelioma have some type of known exposure to asbestos, a naturally-occurring fibrous mineral that embeds itself in body tissues.
Even though scientists were exploring the connection between asbestos exposure and diseases like pleural mesothelioma, lung cancer, pleural plaques and asbestosis as early as the 1930s, it took decades for country-wide bans of the toxin to be enacted.
Iceland was the first country to ban all type of asbestos in 1983. After having been one of the primary producers and consumers of asbestos in Europe, Italy did not ban the substance until 1992.
A total of 55 countries have now banned asbestos. The US is not among them.
Clusters of Mesothelioma Deaths
Before the 1992 ban, thousands of Italian workers were exposed to asbestos in mining, cement production, shipyards, and textile mills. The communities in which these businesses were located were also impacted, raising the environmental mesothelioma risk for residents.
“Significant clusters (p < 0.10) were found corresponding to areas that hosted major asbestos-cement plants, naval shipyards, petrochemical plants and refineries,” writes lead investigator Lucia Fazzo in Cancer Epidemiology. “Excesses were found also in areas near the chrysotile mine of Balangero, and in Biancavilla, a town with a stone quarry contaminated by fluoro-edenitic fibres.”
Fluoro-edenite is another fibrous mineral that has also been linked to pleural mesothelioma and lung cancer.
Understanding Mesothelioma Mortality Trends
Mesothelioma deaths are continuing to rise in Italy and many other countries with asbestos bans not because bans do not work but because mesothelioma has an unusually long latency period.
It can take decades for asbestos fibers to work their way deep into the tissues and trigger the cellular changes that result in malignant mesothelioma.
Eventually, mesothelioma deaths in Italy will likely level off and even drop as fewer and fewer asbestos workers are still living.
In the meantime, the research team says understanding the distribution of mesothelioma deaths in the country gives public health workers important information they can use to monitor and educate residents in high risk areas.
Fazzo, L, et al, “Epidemiological surveillance of mesothelioma mortality in Italy”, July 2018, Cancer Epidemiology, pp. 184-191, Epub ahead of print