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Para-occupational exposures to asbestos: lessons learned from Casale Monferrato, Italy
  1. Leslie Thomas Stayner
  1. Correspondence to Professor Leslie Thomas Stayner, Division of Epidemiology and Biostatistics, University of Illinois at Chicago, School of Public Health (M/C 923), 1603 West Taylor Street, Room 978a, Chicago, IL 60612, USA; lstayner{at}

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The paper by Ferrante et al1 presents the latest findings from a series of studies2–4 revealing the tragic story of the impact of an Eternit asbestos cement facility on the health of the workers and the community in Casale Monferrato, Italy.

This study provides strong evidence of an association between pleural mesothelioma and non-occupational exposures to asbestos. An approximately twofold increase in risk was observed for having lived with a family member who worked in the Eternit asbestos cement plant (OR=2.4, 95% CI 1.3 to 4.4), or having been exposed from domestic or environmental sources (OR=2.0, 95% CI 1.2 to 3.2).

This is unfortunately not a new story. In the seminal report by Wagner in 19605 of a series of mesothelioma cases with exposure to crocidolite asbestos exposure in South Africa, 18 of the 32 cases were born in the vicinity of the mines and had no known occupational exposures. Since then numerous cases of mesothelioma have been reported among family member of asbestos workers,6 7 …

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  • Competing interests Dr Stayner has in the past served as an expert witness in litigation cases on asbestos for the victims of exposure in the United States. He has never been involved in legal cases or research pertaining to workers or the community in Casal Monferrato, and does not have any competing interests in this case.

  • Provenance and peer review Commissioned; internally peer reviewed.

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