TY - JOUR T1 - The epidemiology of malignant mesothelioma in women: gender differences and modalities of asbestos exposure JF - Occupational and Environmental Medicine JO - Occup Environ Med DO - 10.1136/oemed-2016-104119 SP - oemed-2016-104119 AU - Alessandro Marinaccio AU - Marisa Corfiati AU - Alessandra Binazzi AU - Davide Di Marzio AU - Alberto Scarselli AU - Pierpaolo Ferrante AU - Michela Bonafede AU - Marina Verardo AU - Dario Mirabelli AU - Valerio Gennaro AU - Carolina Mensi AU - Gert Schallemberg AU - Guido Mazzoleni AU - Enzo Merler AU - Paolo Girardi AU - Corrado Negro AU - Flavia D’Agostin AU - Antonio Romanelli AU - Elisabetta Chellini AU - Stefano Silvestri AU - Cristiana Pascucci AU - Roberto Calisti AU - Fabrizio Stracci AU - Elisa Romeo AU - Valeria Ascoli AU - Luana Trafficante AU - Francesco Carrozza AU - Italo Francesco Angelillo AU - Domenica Cavone AU - Gabriella Cauzillo AU - Federico Tallarigo AU - Rosario Tumino AU - Massimo Melis AU - Sergio Iavicoli A2 - , Y1 - 2017/12/21 UR - http://oem.bmj.com/content/early/2017/12/21/oemed-2016-104119.abstract N2 - Introduction The epidemiology of gender differences for mesothelioma incidence has been rarely discussed in national case lists. In Italy an epidemiological surveillance system (ReNaM) is working by the means of a national register.Methods Incident malignant mesothelioma (MM) cases in the period 1993 to 2012 were retrieved from ReNaM. Gender ratio by age class, period of diagnosis, diagnostic certainty, morphology and modalities of asbestos exposure has been analysed using exact tests for proportion. Economic activity sectors, jobs and territorial distribution of mesothelioma cases in women have been described and discussed. To perform international comparative analyses, the gender ratio of mesothelioma deaths was calculated by country from the WHO database and the correlation with the mortality rates estimated.Results In the period of study a case list of 21 463 MMs has been registered and the modalities of asbestos exposure have been investigated for 16 458 (76.7%) of them. The gender ratio (F/M) was 0.38 and 0.70 (0.14 and 0.30 for occupationally exposed subjects only) for pleural and peritoneal cases respectively. Occupational exposures for female MM cases occurred in the chemical and plastic industry, and mainly in the non-asbestos textile sector. Gender ratio proved to be inversely correlated with mortality rate among countries.Conclusions The consistent proportion of mesothelioma cases in women in Italy is mainly due to the relevant role of non-occupational asbestos exposures and the historical presence of the female workforce in several industrial settings. Enhancing the awareness of mesothelioma aetiology in women could support the effectiveness of welfare system and prevention policies. ER -