Abstract
The chapter presents a summary of evidence regarding the aetiology of malignant mesothelioma (MM), a malignant neoplasm associated to asbestos exposure in the large majority of cases. MM is nowadays the most important cause of death associated to asbestos exposure in the world, and its frequency has been increasing steadily, with over 38,000 deaths estimated each year. Forecasts of future epidemic indicate a reduction expected in the next years in the countries that reduced or banned asbestos use. However, epidemic is expected to continue in the large part of the world where asbestos is still in use. MM registration systems are active only in few countries (Italy, Australia, France and South Korea), while most countries rely on mortality data. Scientific data indicate the association of MM with asbestos exposure, with risk increasing with dose and time since first exposure, both from occupational and nonoccupational origins. Environmental exposure to asbestos-like mineral fibres is the explanation for important MM outbreaks observed in different countries. Other aetiological factors for MM are limited to ionizing radiations that explain only a minimal proportion of cases. The summary of evidence indicates the need for the worldwide extension of the asbestos ban.
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Notes
- 1.
Definite occupational exposure is assigned to the subjects whose work has involved the use of asbestos or materials containing asbestos. Probable occupational exposure is attributed to the subjects who have worked in a firm where asbestos was certainly used, but whose exposure cannot be documented, and possible occupational exposure to the subjects who have worked in a firm referring to an economic sector where asbestos has been used.
- 2.
The indirect estimator of pleural mesothelioma mortality that was used prior the adoption of the tenth Revision of the International Classification of Disease.
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Conflict of Interest
DM and CM acted as expert witnesses for the public prosecutor in court trials on asbestos-related diseases.
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Mirabelli, D., Marinaccio, A., Comba, P., Magnani, C. (2019). Epidemiology of Mesothelioma. In: Ceresoli, G., Bombardieri, E., D'Incalci, M. (eds) Mesothelioma. Springer, Cham. https://doi.org/10.1007/978-3-030-16884-1_1
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