Decade-long insights: tracking asbestos-related health impacts among formerly exposed workers in Palermo, Italy

Claudio Costantino¹, Caterina Ledda², Matteo Riccò³, Eduardo Costagliola⁴, Francesco Balsamo¹, Miriam Belluzzo¹, Nicole Bonaccorso¹, Alessandro Carubia¹, Luciano D’Azzo¹, Martina Sciortino¹, Tania Vitello¹, Luigi Zagra¹, Santo Fruscione¹, Sara Ilardo⁴, Elisa Trapani⁴, Giuseppe Calamusa¹, Venerando Rapisarda², Walter Mazzucco¹ Riccardo Vecchio1,2, Leandro Gentile^3,4, Silvio Tafuri⁵, Claudio Costantino⁶, Anna Odone^3,4

Affiliazioni

¹ Department of Health Promotion, Maternal and Infant Care, Internal Medicine and Excellence Specialties “G. D’Alessandro”, University of Palermo, Palermo, Italy
² Department of Clinical and Experimental Medicine, Occupational Medicine Unit, University of Catania, Catania, Italy
³ Department of Public Health, Occupational Health and Safety Services, AUSL-IRCCS di Reggio Emilia, Reggio Emilia, Italy
⁴ Prevention Department, Local Health Authority of Palermo, Palermo, Italy

Abstract

Background.
Asbestos is a foremost occupational carcinogen globally. Despite the prohibition under Law 257/1992, Italy persists as one of the European nations most burdened by asbestos-related diseases (ARDs). This research assessed ARD cases in asbestosexposed workers from the Province of Palermo, Italy, spanning 2010-2021.

Methods.
Data acquisition utilized the epidemiological dataset from the ‘Service of Prevention and Safety on Work Environment’ under the Prevention Department of Palermo’s Local Health Authority (LHA).

Results.
Between 2010 and 2021, we identified 245 ARD instances, comprising 163 Asbestosis/Pleural plaques, 41 Lung Cancers, 38 Mesotheliomas, and 3 unspecified cases. Multivariate analysis indicated a notable decline in temporal exposure for mesothelioma (HR=0.933; 95% CI=0.902-0.965) and lung cancer (HR=0.93; 95% CI=0.90-0.978) relative to pleural plaques/asbestosis. Tobacco use displayed a pronounced correlation with lung cancer (smoker HR=64.520 95% CI=13,075- 318.390; former smoker HR=20.917 95% CI=4,913-89.048). A significant link was observed between mesothelioma and pleural plaques/asbestosis in those employed in shipbuilding and repair (HR=0.371 95% CI=0.155-0.892).

Conclusions.
ARDs persist in clinical observations, even following the 1992 cessation of asbestos-related activities, emphasizing an enduring public health challenge. Enhancing prevention strategies is paramount, focusing on amplifying anamnestic and occupational data collection, thereby facilitating superior early diagnosis strategies for these maladies in the occupationally exposed cohort.

KEYWORDS: Asbestos-related diseases (ARDs); Mesothelioma; Occupational Health; lung cancer; smoking habits; asbestosis/pleural plaques

Marzo 8, 2024