RT Journal Article SR Electronic T1 The epidemiology of malignant mesothelioma in women: gender differences and modalities of asbestos exposure JF Occupational and Environmental Medicine JO Occup Environ Med FD BMJ Publishing Group Ltd SP oemed-2016-104119 DO 10.1136/oemed-2016-104119 A1 Alessandro Marinaccio A1 Marisa Corfiati A1 Alessandra Binazzi A1 Davide Di Marzio A1 Alberto Scarselli A1 Pierpaolo Ferrante A1 Michela Bonafede A1 Marina Verardo A1 Dario Mirabelli A1 Valerio Gennaro A1 Carolina Mensi A1 Gert Schallemberg A1 Guido Mazzoleni A1 Enzo Merler A1 Paolo Girardi A1 Corrado Negro A1 Flavia D’Agostin A1 Antonio Romanelli A1 Elisabetta Chellini A1 Stefano Silvestri A1 Cristiana Pascucci A1 Roberto Calisti A1 Fabrizio Stracci A1 Elisa Romeo A1 Valeria Ascoli A1 Luana Trafficante A1 Francesco Carrozza A1 Italo Francesco Angelillo A1 Domenica Cavone A1 Gabriella Cauzillo A1 Federico Tallarigo A1 Rosario Tumino A1 Massimo Melis A1 Sergio Iavicoli A1 , YR 2017 UL http://oem.bmj.com/content/early/2017/12/21/oemed-2016-104119.abstract AB 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.