Occupational asbestos exposure after the ban: a job exposure matrix developed in Italy

Our plain-English summary of Occupational asbestos exposure after the ban: a job exposure matrix developed in Italy, by A. Scarselli, A. Marinaccio, M. Corfiati, et al (European Journal of Public Health, 2020).

The study

• Authors: A. Scarselli, A. Marinaccio, M. Corfiati, D. Di Marzio, S. Iavicoli
• Journal: European Journal of Public Health
• Published: 2020;30(5):936-941
• Cited by: 11 articles, as counted by NIH iCite
• Read it: PubMed · Publisher

Abstract

Background: Asbestos is a well-known carcinogen for humans. The aim of this study is to develop a tool to estimate occupational asbestos exposure in Italy after the ban using information collected in a national dataset.

Methods: Data were collected from firm registries of workers exposed to asbestos in the period 1996-2016. Descriptive statistics (arithmetic mean, standard deviation, geometric mean and geometric standard deviation) were calculated for the main exposure-related variables (activity sector, occupational group and exposure period). An estimate of workers potentially exposed to asbestos was also performed.

Results: A total of 19 704 airborne measurements of asbestos exposure was selected from the national database of occupational exposures in the sectors of asbestos abatement. Overall, a geometric mean of 7.93 f l-1 was found, and chrysotile was the asbestos type that had more exposures (41%). A total of 46 422 workers was estimated to be potentially at asbestos exposure risk. Exposure data were summarized by calendar period, activity sector and occupational group.

Conclusions: The construction of a job exposure matrix for different occupation/industry combinations may allow the assessment of occupational exposure to asbestos in several removal and disposal activities, and the estimate of the risks associated with asbestos-related diseases in epidemiological studies.

© The Author(s) 2020. Published by Oxford University Press on behalf of the European Public Health Association. All rights reserved.

In plain English

This study used SIREP, Italy's national register of workplace carcinogen exposures kept by the compensation authority INAIL, to build a job exposure matrix. A job exposure matrix is a table of typical asbestos exposure levels by industry, occupation and time period. This one covers the years after Italy's 1992 asbestos ban. The authors analysed 19 704 air measurements that firms reported for 1996 to 2016. These covered 2879 exposed workers (99% male) in 272 firms. The overall geometric mean was 7.93 fibres per litre. Chrysotile accounted for 41% of exposures, amosite 22% and crocidolite 12%. Garbage collectors had the highest occupational level (geometric mean 65.19 fibres per litre). Exposure was highest in 1999 to 2001. For most occupations or activities, the analysis found no decreasing trend over time. The authors estimated that 46 422 workers in selected industry sectors were potentially exposed. The authors concluded the matrix may allow assessment of exposure in removal and disposal work. They noted that reporting was mandatory only above 0.01 fibres per millilitre, making coverage uneven, and that the exposed-worker estimate may be an upper limit.

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: Descriptive analysis of a national registry of workplace exposure measurements, used to build a job exposure matrix (by economic sector, occupation and 3-year calendar period) and to estimate the number of potentially exposed workers
• Who was studied: Asbestos exposure data reported by firms to Italy's SIREP database, 1996–2016: 19 704 air measurements, corresponding to 8938 recorded exposures (work situations), 2879 exposed workers (99% male) and 272 firms (79% in construction)
• Exposure: Airborne asbestos fibres measured over full 8-hour shifts in post-ban work, mainly asbestos abatement, removal and disposal. Fiber types recorded were chrysotile, amosite, crocidolite, tremolite, anthophyllite and actinolite, plus a generic 'asbestos' group for unspecified or mixed fibres.
• Main results:
  • Across all 19 704 measurements, the geometric mean concentration was 7.93 fibres per litre (geometric standard deviation 9.6). The arithmetic mean was 45.97 fibres per litre (standard deviation 145).
  • By fiber type, chrysotile accounted for 41% of exposures, amosite 22% and crocidolite 12%. About 12% of measurements referred to a mixture of fibres.
  • The sector 'other construction work involving special trades' had the most measurements (8824) and a higher exposure level (geometric mean 20.84 fibres per litre).
  • Garbage collectors were the occupational group most at risk, with the highest exposure level (1993 measurements; geometric mean 65.19 fibres per litre).
  • The highest exposure level by period was in 1999–2001 (625 measurements; geometric mean 34.57 fibres per litre). The most measurements were collected in 2008–10 (7683; geometric mean 8.79 fibres per litre).
  • An estimated 46 422 workers (86% male) in the selected industrial sectors were potentially at risk of asbestos exposure. The largest group was in 'other construction installation' (15 541 potentially exposed workers).
  • For most occupations or activities, the analysis showed no decreasing trend in exposure over time.
• The authors' conclusion: The authors concluded that a job exposure matrix for different occupation and industry combinations may allow assessment of occupational asbestos exposure in removal and disposal activities. They also concluded it may allow estimation of asbestos-related disease risks in epidemiological studies.
• Limitations the authors state:
  • Most firms reported voluntarily, because reporting is mandatory only for exposures above 0.01 fibres per millilitre. This led to uneven data coverage.
  • Firms that did not report may have higher, or lower, exposure levels than those that did, which may have affected the estimates.
  • Differences in air sampling, analytical procedures and collection method (personal or stationary) may have biased the estimates. The sampling type was reported for fewer than 4% of measurements.
  • Incorrect classification of activity sector or job may have biased the results.
  • The exposed-worker estimate assumed the same ratio of exposed to non-exposed workers in reporting and non-reporting firms, which may have introduced bias.
  • The estimated numbers of exposed workers may represent upper limits of the true extent of exposure.

Topics

Medical terms in this study, explained in our Lexicon: Asbestos Exposure, Occupational Exposure, Abatement, Chrysotile.

Related studies

• Occupational exposure in the removal and disposal of asbestos-containing materials in Italy — A. Scarselli, M. Corfiati, et al. (2016)
• Occupational cancer in Italy: evaluating the extent of compensated cases in the period 1994-2006 — A. Scarselli, P. Scano, et al. (2009)
• Occupational cancer in Italy — E. Merler, P. Vineis, et al. (1999)
• Estimation of Occupational Exposure to Asbestos in Italy by the Linkage of Mesothelioma Registry (ReNaM) and National Insurance Archives. Methodology and Results — C. Airoldi, D. Ferrante, et al. (2020)
• Malignant mesothelioma due to non-occupational asbestos exposure from the Italian national surveillance system (ReNaM): epidemiology and public health issues — A. Marinaccio, A. Binazzi, et al. (2015)
• Italian National Register of Occupational Cancers: data system and findings — A. Scarselli, S. Massari, et al. (2010)

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