Asbestos Exposure in Patients with Malignant Pleural Mesothelioma included in the PRIMATE Study, Lombardy, Italy
Spinazzè, Andrea; Consonni, Dario; Borghi, Francesca; Rovelli, Sabrina; Cattaneo, Andrea; Zellino, Carolina; Dallari, Barbara; Pesatori, Angela Cecilia; Kromhout, Hans; Peters, Susan; Riboldi, Luciano; Cavallo, Domenico Maria; Mensi, Carolina
(2022) International Journal of Environmental Research and Public Health, volume 19, issue 6, pp. 1 - 11
(Article)
Abstract
The PRIMATE study is an Italian translational research project, which aims to identify personalized biomarkers associated with clinical characteristics of malignant pleural mesothelioma (MPM). For this purpose, characteristics of MPM patients with different degrees of asbestos exposure will be compared to identify somatic mutations, germline polymorphism, and blood inflammatory biomarkers.
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In this framework, we assessed exposure to asbestos for 562 cases of MPM extracted from the Lombardy region Mesothelioma Registry (RML), for which a complete interview based on a standardized national questionnaire and histopathological specimens were available. Exposure assessment was performed: (1) through experts' evaluation (considered as the gold standard for the purpose of this study), according to the guidelines of the Italian National Mesothelioma Registry (ReNaM) and (2) using a job-exposure matrix (SYN-JEM) to obtain qualitative (ever/never) and quantitative estimates of occupational asbestos exposure (cumulative exposure expressed in fibers per mL (f/mL)). The performance of SYN-JEM was evaluated against the experts' evaluation. According to experts' evaluation, occupational asbestos exposure was recognized in 73.6% of men and 23.6% of women; furthermore, 29 men (7.8%) and 70 women (36.9%) had non-occupational exposure to asbestos. When applying SYN-JEM, 225 men (60.5%) and 25 women (13.2%) were classified as occupationally exposed, with a median cumulative exposure higher for men (1.7 f/mL-years) than for women (1.2 f/mL-years). The concordance between the two methods (Cohen’s kappa) for occupational exposure assessment was 0.46 overall (0.41 in men, and 0.07 in women). Sensitivity was higher in men (0.73) than in women (0.18), while specificity was higher in women (0.88) than in men (0.74). Overall, both methods can be used to reconstruct past occupational exposure to asbestos, each with its own advantages and limitations.
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Keywords: Asbestos, Job-exposure matrix (JEM), Mesothelioma, Occupational exposure, Retrospective exposure assessment, SYN-JEM, Pollution, Public Health, Environmental and Occupational Health, Health, Toxicology and Mutagenesis
ISSN: 1661-7827
Publisher: MDPI AG
Note: Funding Information: Funding: This research was funded by “Fondazione Regionale per la Ricerca Biomedica”-“Bando Progetto Speciale 2017 su Patologie Amianto-Correlate”, in the framework of the project “An integrated precision medicine approach to malignant mesothelioma: from mutation load to epidemiology and therapy” (acronym: PRIMATE-code ARL_2/2018; Principal Investigator: Tommaso Dragani), and partially funded by INAIL BRIC55/2019. Publisher Copyright: © 2022 by the authors. Licensee MDPI, Basel, Switzerland.
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