Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2018 Apr;75(4):254-262.
doi: 10.1136/oemed-2016-104119. Epub 2017 Dec 21.

The epidemiology of malignant mesothelioma in women: gender differences and modalities of asbestos exposure

Alessandro Marinaccio  1 , Marisa Corfiati  1 , Alessandra Binazzi  1 , Davide Di Marzio  1 , Alberto Scarselli  1 , Pierpaolo Ferrante  1 , Michela Bonafede  1 , Marina Verardo  2 , Dario Mirabelli  3 , Valerio Gennaro  4 , Carolina Mensi  5 , Gert Schallemberg  6 , Guido Mazzoleni  7 , Enzo Merler  8 , Paolo Girardi  8 , Corrado Negro  9 , Flavia D'Agostin  9 , Antonio Romanelli  10 , Elisabetta Chellini  11 , Stefano Silvestri  12 , Cristiana Pascucci  13 , Roberto Calisti  13 , Fabrizio Stracci  14 , Elisa Romeo  15 , Valeria Ascoli  16 , Luana Trafficante  17 , Francesco Carrozza  18 , Italo Francesco Angelillo  19 , Domenica Cavone  20 , Gabriella Cauzillo  21 , Federico Tallarigo  22 , Rosario Tumino  23 , Massimo Melis  24 , Sergio Iavicoli  1 ; ReNaM Working Group
Collaborators, Affiliations

The epidemiology of malignant mesothelioma in women: gender differences and modalities of asbestos exposure

Alessandro Marinaccio et al. Occup Environ Med. 2018 Apr.

Abstract

Introduction: The epidemiology of gender differences for mesothelioma incidence has been rarely discussed in national case lists. In Italy an epidemiological surveillance system (ReNaM) is working by the means of a national register.

Methods: Incident malignant mesothelioma (MM) cases in the period 1993 to 2012 were retrieved from ReNaM. Gender ratio by age class, period of diagnosis, diagnostic certainty, morphology and modalities of asbestos exposure has been analysed using exact tests for proportion. Economic activity sectors, jobs and territorial distribution of mesothelioma cases in women have been described and discussed. To perform international comparative analyses, the gender ratio of mesothelioma deaths was calculated by country from the WHO database and the correlation with the mortality rates estimated.

Results: In the period of study a case list of 21 463 MMs has been registered and the modalities of asbestos exposure have been investigated for 16 458 (76.7%) of them. The gender ratio (F/M) was 0.38 and 0.70 (0.14 and 0.30 for occupationally exposed subjects only) for pleural and peritoneal cases respectively. Occupational exposures for female MM cases occurred in the chemical and plastic industry, and mainly in the non-asbestos textile sector. Gender ratio proved to be inversely correlated with mortality rate among countries.

Conclusions: The consistent proportion of mesothelioma cases in women in Italy is mainly due to the relevant role of non-occupational asbestos exposures and the historical presence of the female workforce in several industrial settings. Enhancing the awareness of mesothelioma aetiology in women could support the effectiveness of welfare system and prevention policies.

Keywords: asbestos; gender; mesothelioma.

PubMed Disclaimer

Conflict of interest statement

Competing interests: The following authors reported that they have served as expert witness for the public prosecutor in court trials on asbestos-related diseases: EM, DM, SS, VG, CM, RC.

Figures

Figure 1
Figure 1
Crude incidence rates (*100 000 inhabitants) for malignant mesothelioma in women by municipalities of residence at diagnosis. Municipalities with significant number of cases and modalities of asbestos exposure in women. Italian national mesothelioma register (ReNaM), Italy, period of incidence 1993–2012. Labels are reported for municipalities with crude incidence rates>4 and at least 8 MM female cases with occupational or non-occupational (environmental, familial, leisure activities-related) exposure. Labels show the municipalities and the modalities of asbestos exposure: O(Ta) prevalently occupational exposure in asbestos textile sector; O(Tna) non-asbestos textile; O(AC) asbestos-cement plant; O(S) shipbuilding and repair; E environmental exposure; F familial exposure, due to cohabitation with exposed workers.
Figure 2
Figure 2
Standardised mortality rates for malignant mesothelioma (both genders) and gender ratio (F/M). Based on ‘WHO mortality database’, year=2011; only countries with more than 20 cases.
See this image and copyright information in PMC

Comment in

References

    1. Straif K, Benbrahim-Tallaa L, Baan R, et al. . A review of human carcinogens-Part C: metals, arsenic, dusts, and fibres. Lancet Oncol 2009;10:453–4. 10.1016/S1470-2045(09)70134-2 - DOI - PubMed
    1. Park EK, Takahashi K, Hoshuyama T, et al. . Global magnitude of reported and unreported mesothelioma. Environ Health Perspect 2011;119:514–8. 10.1289/ehp.1002845 - DOI - PMC - PubMed
    1. WHO. Elimination of asbestos-related diseases. Geneva: World Health Organization, 2006. http://www.who.int/occupational_health/publications/asbestosrelateddisea...
    1. Marinaccio A, Binazzi A, Marzio DD, et al. . Pleural malignant mesothelioma epidemic: incidence, modalities of asbestos exposure and occupations involved from the Italian National Register. Int J Cancer 2012;130:2146–54. 10.1002/ijc.26229 - DOI - PubMed
    1. Lacourt A, Gramond C, Rolland P, et al. . Occupational and non-occupational attributable risk of asbestos exposure for malignant pleural mesothelioma. Thorax 2014;69:532–9. 10.1136/thoraxjnl-2013-203744 - DOI - PubMed

Publication types