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Our plain-English summary of [Not Available], by A. Angelini, E. Chellini, D. Parducci, et al (La Medicina del Lavoro, 2020).

The study

• Authors: A. Angelini, E. Chellini, D. Parducci, M. Puccetti, L. Mauro
• Journal: La Medicina del Lavoro
• Published: 2020;111(2):126-132
• Language: Italian
• Cited by: 4 articles, as counted by NIH iCite
• Read it: PubMed · Publisher · Free full text

Abstract

Unlabelled: «Reconstruction of the asbestos exposure in a textile company producing sewing threads through the use of an unusual information source».

Background:: The Tuscan Regional Operating Center (ROC) of Malignant Mesotheliomas has identified a cluster of 11 cases of malignant mesothelioma occurred in a textile plant manufacturing sewing thread. Using the common research method, the ROC had not previously been able to identify the specific sources of asbestos exposure causing such a large cluster.

Objectives:: The ROC’s objective was to review all cases of the cluster and to better identify their occupational asbestos exposures.

Methods:: The cases’ occupational histories of asbestos exposure have been reviewed, using information deriving from the annual reports sent to the Tuscany Region since 1988 by all the asbestos removal companies according to the Law no. 257/1992, article 9, and from interviews to former employees of the plant.

Results:: The work cycle has been reconstructed and enriched with the new information about the asbestos presence and its uses in the plant. The eleven cases were all reclassified as “certainly occupational exposed” given that the new collected information depicted a widespread asbestos pollution of the workplace during the period of employment of all cases.

Conclusions:: Using different sources of information, in addition to those traditionally collected through questionnaires, to reconstruct past asbestos exposuresallowed us to clarify the existence of the cluster of mesothelioma cases and the highest level of occupational asbestos exposure was attributed to all cases with consequent activation of the medico-legal procedure.

In plain English

This article, written in Italian, described how the Tuscan Regional Operating Center of Malignant Mesotheliomas re-examined a cluster of 11 malignant mesothelioma cases (4 men and 7 women; ten pleural, one peritoneal) among workers of a sewing-thread textile plant that operated from 1890 to 2006. Before this review, only two cases, both maintenance workers, had been classed as certainly exposed to asbestos. The authors reviewed the cases' work histories alongside annual reports that asbestos removal companies must send to the Tuscany Region under Law 257/1992, article 9, and interviews with removal workers. These sources described sprayed asbestos in the steam generator room and friable pipe insulation, mainly amosite, on steam pipes running through basements where raw material was stored. Recorded removals included 1130 kg of sprayed asbestos, 64 kg of asbestos textiles and 1760 kg of pipe insulation. The authors judged that insulation dust likely settled on the raw material and spread to other departments, causing indirect exposure. All 11 cases were reclassified at the highest level of certainty of occupational exposure. The authors considered the removal quantities underestimated.

We wrote this plain-English summary from the full article with the help of AI, and a second AI model checked each sentence against the article. It is not the authors' wording; the abstract and the article are their own account.

What the study did and found

• Design: Investigation of a workplace cluster of mesothelioma cases: re-assessment of each case's occupational asbestos exposure using removal-company records, health-service archives and interviews
• Who was studied: 11 malignant mesothelioma cases (4 men, 7 women) recorded between 1997 and 2016 by the Tuscan regional mesothelioma center among workers of one sewing-thread textile plant in Tuscany, Italy, active 1890 to 2006. Ten cases were pleural and one was peritoneal. The cases' periods of work ran from 1943 to 1993.
• Exposure: Asbestos at the plant. Pipe insulation samples contained chrysotile and amosite. The friable pipe lagging was mainly amosite. Asbestos was also sprayed on the walls of the steam generator room and used in gaskets and insulation. The authors describe the exposure of production workers (spinning, twisting, winding, packaging) as indirect.
• Main results:
  • Before the review, of the 11 cases, only the two maintenance workers who also worked in the boiler and steam generator rooms had been assigned certain asbestos exposure.
  • Apart from the 2 maintenance workers, the cases had varied production jobs: spinning, twisting, winding and packaging of the threads.
  • Pipe-lining samples taken by the local health unit in 2001 and 2009 were friable, and some contained more than 90% asbestos.
  • Removal-company workers reported sprayed asbestos on the walls of the steam generator room, as well as gaskets and insulation there.
  • Asbestos-insulated pipes ran through the basements, with an estimated length of about 4 km per shed.
  • Recorded removals included 1130 kg of friable sprayed asbestos on ceilings and walls, 64 kg of asbestos textiles, and 1760 kg of friable asbestos pipe insulation.
  • The authors judged that dust from the insulation was likely the vehicle that contaminated the raw material and, through it, the other departments. They described the exposure of all production workers as indirect, and with certainty to amphiboles, in particular amosite.
  • All 11 mesothelioma cases were reclassified with the highest level of certainty of occupational asbestos exposure.
• The authors' conclusion: The authors concluded that using information sources collected for other purposes explained the reason for the cluster. As a result, all cases were assigned the highest level of certainty of asbestos exposure, and the medico-legal procedure was started.
• Limitations the authors state:
  • The authors considered the asbestos quantities found to be underestimated, because they cover only part of the removals of friable material carried out since the regional records were computerized.
  • For the older removals, the computerized system did not hold the work plans. Only the quantity of asbestos removed was available, not details of where it was located or how it was used.

Topics

The National Library of Medicine indexes this study under subjects our site covers: Lung cancer, Mesothelioma.

Medical terms in this study, explained in our Lexicon: Asbestos Exposure, Mesothelioma.

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