Occup Environ Med 65:815-819 doi:10.1136/oem.2007.037689
  • Original article

Excess of mesotheliomas after exposure to chrysotile in Balangero, Italy

  1. D Mirabelli1,4,
  2. R Calisti2,
  3. F Barone-Adesi1,4,
  4. E Fornero4,
  5. F Merletti1,4,
  6. C Magnani3,4
  1. 1
    Unit of Cancer Epidemiology, CeRMS and CPO-Piemonte, University of Turin, Turin, Italy
  2. 2
    Occupational Safety and Health Unit, Local Health Authority, Civitanova Marche, Italy
  3. 3
    Unit of Medical Statistics and Cancer Epidemiology, CPO-Piemonte, University of Eastern Piedmont, Novara, Italy
  4. 4
    Interdepartmental Centre G. Scansetti for Studies on Asbestos and Other Toxic Particulates, University of Turin, Turin, Italy
  1. Franco Merletti, Unit of Cancer Epidemiology, Via Santena 7, 10026 Turin (TO), Italy; franco.merletti{at}
  • Accepted 22 February 2008
  • Published Online First 4 June 2008


Background: Chrysotile from the mine in Balangero, Italy is considered to be free of tremolite. In a cohort study of miners and millers only two pleural cancers were reported, a finding considered to indicate that chrysotile has a low potency for inducing mesothelioma. However, follow-up ended in 1987 and white-collar workers and the employees of subcontractors were not studied.

Methods: To complete the case ascertainment, the study searched the Registry of Malignant Mesotheliomas of Piedmont for records of cases of pleural mesothelioma among the following: mine employees; employees of subcontractors or of other firms transporting or refining Balangero asbestos, asbestos ore or mine tailings; individuals exposed to air pollution from the mine or living with mine employees; and individuals exposed to mine tailings from Balangero.

Results: The study identified four new cases of pleural mesothelioma among blue-collar workers in the mine, in addition to the two reported in the cohort study. Thus, six mesotheliomas occurred, compared to the 1.5 expected (p<0.01). The study also identified three mesothelioma cases among white-collar employees at the mine, five in workers in the mine hired by subcontracting firms, and three among workers processing Balangero chrysotile outside the mine. Finally, 10 additional cases due to non-occupational exposure or exposure to re-used mine tailings were identified.

Conclusions: The cluster of 14 mesothelioma cases among workers who were active in the mine and 13 among other people exposed to Balangero chrysotile provides further evidence that tremolite-free chrysotile is carcinogenic.


  • Funding: This study was partially supported by AIRC, Compagnia di San Paolo and Regione Piemonte. Francesco Barone Adesi and Elisa Fornero were supported by a grant from Regione Piemonte, Assessorato all’Ambiente, project “Asbestos Hazard in the Western Alps”.

  • Competing interests: None.

Responses to this article