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Asbestos-related disease

A note from our CEO
Section I: Taking action to eliminate asbestos-related diseases
Actions leading to national bans on asbestos
Towards a global ban on asbestos
International bilateral & multilateral mechanisms
History of Mining, consumption production and use of asbestos
Transitioning to alternative non-asbestos materials
Proactive removal of ageing legacy asbestos materials
Section II: Country summaries, case studies and resources
Country summaries
Case studies
Research on ARDs
Section III: What asbestos is and the risks it poses
What asbestos is and how to identify it
Exposure pathways
Asbestos removal, management and disposal
Asbestos in fibres in drinking water
Public health risks from asbestos cement products
Section IV: Health impacts of exposure to asbestos
What are asbestos-related diseases
How are asbestos-related diseases diagnosed?
Can ARDs be treated?
Patient support, care and information
Reporting, coding and registration of ARDs

Italy: Contribution to the planning of public health actions of mortality analyses for asbestos-related diseases

Contributo alla pianificazione di azioni di sanità pubblica delle analisi di mortalità per malattie correlate ad amianto

Italy was one of the largest producers and users of asbestos in Europe before the 1992 ban (Law 257/1992),1 with over three and a half million tons of raw asbestos produced between the end of the Second World War and the ban. Although the ban dates back more than thirty years, the health legacy of asbestos remains current, both because of the long latency of asbestos-related diseases and because of exposure to residual asbestos-containing materials.
Globally, occupational exposure to asbestos caused more than 200,000 deaths per year in the period 2000-2016.  Asbestos causes neoplasms (mesothelioma, lung, laryngeal and ovarian cancers) and non-cancerous diseases, such as asbestosis and pleural plaques. Mesothelioma, with a high etiological fraction due to asbestos (more than 80%), is used as a sentinel tumor. 3
The World Health Organization recommends the development of national asbestos profiles (NAPs) as a tool for the elimination of asbestos-related diseases. NAPs should include up-to-date information on several aspects in a single document, including the burden of asbestos-related diseases, risk assessments and legislation.
3 The aim of this paper is to summarize in a single document the results of the studies on mesothelioma mortality and on the burden of disease due to asbestos in Italy, carried out as part of the Asbestos Epidemiological Surveillance, Prevention and Research Project (SEPRA), funded by INAIL, in order to provide a picture of the burden of asbestos-related diseases, in line with what is suggested by the WHO, to identify concrete implications of research results for prevention, surveillance and health care.
In Italy, the National Mesothelioma Registry (ReNaM) has been collecting information on incident cases and sources of exposure since 2002.  Since the end of the eighties, the Istituto Superiore di Sanità has periodically updated the data on mortality from mesothelioma at municipal level.  In the SEPRA Project, databases were integrated and the burden of disease was estimated, in terms of Disability Adjusted Life Years (DALYs), mesothelioma and asbestosis. DALYs represent an important tool for quantifying the impact of risk factors and disease burden for health planning purposes.  The integration with the information available in the ReNaM has provided important interpretative elements of the results of the spatio-temporal analyses of mesothelioma mortality, valuable tools for estimating the trend and distribution of the health impact of asbestos, to identify priorities in public health.

Reference

Contribution to the planning of public health actions of mortality analyses for asbestos-related diseases

Arianna Guaita, Giorgia Stoppa, Allegra Sartore, Giada Minelli, Lucia Fazzo

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