Malignant mesothelioma in Italy, 1997

BACKGROUND: The Italian National Mesothelioma Register (ReNaM) was set up at the Istituto Superiore Prevenzione e Sicurezza Lavoro (ISPESL), in Rome, in accordance with Art. 36 of Italian Legislative Decree No. 277 [1991]. METHODS: Five Italian regions, Piedmont, Liguria, Emilia-Romagna, Tuscany, and Apulia, agreed to record mesothelioma cases according to guidelines established by ISPESL, to define exposure to asbestos and transmit the data systematically to ISPESL. RESULTS: Four hundred and twenty-nine mesothelioma cases, diagnosed in 1997, are recorded. The standardized annual incidence rate for definite pleural mesothelioma is 1.51 per 100,000 inhabitants (2.26 for males and 0.79 for females). Exposure was defined for 198 mesotheliomas with a histological diagnosis: 125 (63%) refer to occupational exposure, 10 (5%) to environmental exposure, and 5 (2.5%) to household exposure. CONCLUSIONS: Despite the ReNaM's work, many limitations still have to be overcome. Clear-cut information on asbestos exposure is available for a limited number of cases; and differing regional procedures in collecting and evaluating mesotheloma cases exist. At this stage the identification and evaluation of a large number of cases of mesothelioma is a worthwhile result. This epidemiological surveillance, currently being extended to other regions, will enable us to better assess the impact and diffusion of this disease in future, and to monitor more closely the effects of ceasing asbestos use in 1992, and the efficacy of preventive measures since mid '70s. Am. J. Ind. Med. 45:55-62, 2004.