Peritoneal mesothelioma and asbestos exposure: a population-based case-control study in Italy, 2000-2021.
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Consonni Dario, Migliore Enrica, Gangemi Manuela, Cavone Domenica, Vimercati Luigi, Piro Sara, Giovannetti Lucia, Zabeo Valentina, Comiati Vera, Curti Stefania, Mattioli Stefano, Landi Maria Teresa, Gioscia Carmela, Eccher Silvia, Murano Stefano, D'Agostin Flavia, Genova Carlo, Perduri Riccardo, Grappasonni Iolanda, Stracci Fabrizio, Cozzi Ilaria, Staniscia Tommaso, Calista Franco, Angelillo Italo Francesco, Galasso Rocco, Tallarigo Federico, Cascone Giuseppe, Melis Massimo, Peters Susan, Kromhout Hans, Binazzi Alessandra, Marinaccio Alessandro, Mensi Carolina, ReNaM Working Group
Аннотация
METHODS: From the National Mesothelioma Registry, we selected cases (2000-2021) with life-time occupational history. Controls were 3045 from three case-control studies (region-sex-age-matched, performed in six regions), one in 2002-2004 (2116 population controls) and two in 2012-2016 (718 population and 211 hospital controls). For all subjects, exposure assignment was based on a quantitative job-exposure matrix (SYN-JEM). Qualitative expert-based evaluation was available for all cases, but only in 2012-2016 for 929 controls. We estimated ORs and 90% CIs using logistic regression models adjusted for residence, gender, period and age.
RESULTS: In complete analyses (1591 cases, all years/regions), the OR for ever exposure was 3.66 (CI 3.21 to 4.18, 45.4% cases and 27.8% controls exposed). Among the exposed, median cumulative exposure (fibres/mL-years) was 1.4 (max 20.0) in cases and 1.1 (max 10.9) in controls. The OR was 1.55 (1.48 to 1.62) per log10-transformed cumulative exposure. In analyses restricted to 290 cases (same years/regions of controls), ORs were 3.35 (2.57 to 4.37, 43.8% cases exposed) for ever exposure and 1.52 (1.39 to 1.65) for cumulative exposure. ORs for ever asbestos exposure using expert-based evaluation were particularly high, 4.32 (3.50 to 5.34, 53.9% cases and 26.4% controls exposed) in complete analyses (778 cases) and 6.35 (4.58 to 8.81, 57.1% cases exposed) in restricted analyses (245 cases), but are known to be more prone to bias.
CONCLUSIONS: Peritoneal mesothelioma showed clear associations with asbestos exposure using different exposure assessment methods.