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. 2020 Feb 6;17(3):1020.
doi: 10.3390/ijerph17031020.

Estimation of Occupational Exposure to Asbestos in Italy by the Linkage of Mesothelioma Registry (ReNaM) and National Insurance Archives. Methodology and Results

Chiara Airoldi  1 , Daniela Ferrante  1 , Lucia Miligi  2 , Sara Piro  2 , Giorgia Stoppa  2 , Enrica Migliore  3 , Elisabetta Chellini  4 , Antonio Romanelli  5 , Carlo Sciacchitano  6 , Carolina Mensi  7 , Domenica Cavone  8 , Elisa Romeo  9 , Stefania Massari  10 , Alessandro Marinaccio  10 , Corrado Magnani  1   11
Affiliations

Estimation of Occupational Exposure to Asbestos in Italy by the Linkage of Mesothelioma Registry (ReNaM) and National Insurance Archives. Methodology and Results

Chiara Airoldi et al. Int J Environ Res Public Health. .

Abstract

The identification and monitoring of occupational cancer is an important aspect of occupational health protection. The Italian law on the protection of workers (D. Leg. 81/2008) includes different cancer monitoring systems for high and low etiologic fraction tumors. Record linkage between cancer registries and administrative data is a convenient procedure for occupational cancer monitoring. We aim to: (i) Create a list of industries with asbestos exposure and (ii) identify cancer cases who worked in these industries. The Italian National Mesothelioma Registry (ReNaM) includes information on occupational asbestos exposure of malignant mesothelioma (MM) cases. We developed using data from seven Italian regions a methodology for listing the industries with potential exposure to asbestos linking ReNaM to Italian National Social Security Institute (INPS) data. The methodology is iterative and adjusts for imprecision and inaccuracy in reporting firm names at interview. The list of asbestos exposing firms was applied to the list of cancer cases (all types associated or possibly associated with asbestos according to International Agency for Research on Cancer (IARC) monograph 100C) in two Italian regions for the indication of possible asbestos exposure. Eighteen percent of the cancer cases showed at least one work period in firms potentially exposing to asbestos, 48% of which in regions different from where the cases lived at diagnosis. The methodology offers support for the preliminary screening of asbestos exposing firms in the occupational history of cancer cases.

Keywords: asbestos; gastrointestinal cancer; larynx cancer; lung cancer; mesothelioma; occupational cancer; ovarian cancer; record linkage.

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Conflict of interest statement

The authors declare that they have no competing interests. The following authors reported that they served as an expert witness in court trials on asbestos-related diseases: C.M. (Corrado Magnani), C.M. (Carolina Mensi), L.M.

Figures

Figure 1
Figure 1
Graphical description of the different record linkage activities. ReNaM—The National Mesothelioma Registry; INPS—Italian National Social Security Institute; OCM—Occupational Cancer Monitoring.
Figure 2
Figure 2
Flowchart of the record linkage process.
Figure 3
Figure 3
Record linkage flowchart: ‘inexact matching’ steps.
Figure 4
Figure 4
(a) Italian map of regions involved in the study. (b) Italian map with the spatial distribution of exposed firms.
See this image and copyright information in PMC

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