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Non-occupational exposure to asbestos and malignant mesothelioma in the Italian National Registry of Mesotheliomas
  1. Dario Mirabelli1,
  2. Domenica Cavone2,
  3. Enzo Merler3,
  4. Valerio Gennaro4,
  5. Antonio Romanelli5,
  6. Carolina Mensi6,
  7. Elisabetta Chellini7,
  8. Carmela Nicita8,
  9. Alessandro Marinaccio9,
  10. Corrado Magnani10,
  11. Marina Musti2
  1. 1Unit of Cancer Epidemiology, CeRMS and CPO-Piemonte, University of Turin, Turin, Italy
  2. 2Occupational Health Section “Ramazzini”, Department of Internal Medicine and Public Health, University of Bari, Bari, Italy
  3. 3Veneto Mesothelioma Registry, Occupational Health Unit, Department of Prevention, Padua Local Health Authority, Padua, Italy
  4. 4Liguria Mesothelioma Registry, Department of Epidemiology and Prevention, National Cancer Research Institute (IST), Genoa, Italy
  5. 5Emilia-Romagna Mesothelioma Registry, Department of Public Health, Reggio Emilia, Italy
  6. 6Lombardia Mesothelioma Registry, Department of Occupational and Environmental Health, Fondazione IRCCS Policlinico, Mangiagalli, Regina Elena and Center EBPI, University of Milan, Milan, Italy
  7. 7Unit of Environmental and Occupational Epidemiology, Cancer Prevention and Research Institute (ISPO), Florence, Italy
  8. 8Cancer Registry, Hospital “M.P. Arezzo”, Ragusa, Italy
  9. 9Unit of Epidemiology, Department of Occupational Medicine, Italian National Institute for Occupational Safety and Prevention (ISPESL), Rome, Italy
  10. 10Unit of Medical Statistics and Cancer Epidemiology, CPO-Piemonte, University of Eastern Piedmont, Novara, Italy
  1. Correspondence to Dr Dario Mirabelli, Unit of Cancer Epidemiology, Via Santena 7, 10126 Torino (TO), Italy; dario.mirabelli{at}


Background Malignant mesotheliomas are strictly related to asbestos, but in a proportion of cases no exposure can be recalled. Published estimates of this proportion have important variations. Historical and geographical differences in the fraction of cancer due to any given exposure are to be expected, but incomplete identification of non-occupational exposures may have played a role.

Methods To assess the role of non-occupational exposures in causing malignant mesotheliomas in Italy, the exposures of cases registered by the national mesothelioma registry (ReNaM) were examined. ReNaM started in 1993 in five regions and currently covers 98% of the Italian population. Information on occupational and non-occupational exposures of cases is collected whenever possible.

Results From 1993 to 2001 ReNaM registered 5173 malignant mesothelioma cases, and exposures were assessed in 3552 of them. 144 and 150 cases with exposures limited to environmental (living in the neighbourhood of an industrial or natural source of asbestos) or familial (living with a person occupationally exposed to asbestos) circumstances, respectively, were identified, accounting for 8.3% of all cases.

Conclusions Geographical variations in the proportion of cases due to non-occupational exposures may be explained by the past distribution of asbestos-using industries.

  • Asbestos
  • environmental exposure
  • household exposure
  • malignant mesothelioma
  • mesothelioma
  • environment

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  • Funding ReNaM is financed by ISPESL. The units of epidemiology or occupational health hosting the regional operating centres belong to the national health service and are financed by their health authorities.

  • Competing interests None.

  • Provenance and peer review Not commissioned; externally peer reviewed.