Silvia D. Visonà
Section of Legal Medicine and Forensic Science, University of Pavia, Italy.
Simona Villani
Section of Biostatistics and Clinical Epidemiology, Department of Public Health, Experimental and Forensic Medicine, University of Pavia, Italy.
Federica Manzoni
Section of Biostatistics and Clinical Epidemiology, Department of Public Health, Experimental and Forensic Medicine, University of Pavia, Italy.
Yao Chen
Section of Legal Medicine and Forensic Science, University of Pavia, Italy.
Giorgio Ardissino
Section of Legal Medicine and Forensic Science, University of Pavia, Italy.
Francesca Russo
Section of Legal Medicine and Forensic Science, University of Pavia, Italy.
Matteo Moretti
Section of Legal Medicine and Forensic Science, University of Pavia, Italy.
Gulnaz T. Javan
Forensic Science Program, Department of Physical Sciences Alabama State University, Montgomery, AL, United States.
Antonio Osculati
Section of Legal Medicine and Forensic Science, University of Pavia, Italy.
ABSTRACT
The goal of this study is to understand more about the role of asbestos in causing human diseases, first of all mesothelioma, by investigating a large series of deaths due to asbestos-related diseases (ARDs). The main aim is to clarify if even very low amounts of asbestos can cause mesothelioma and other ARDs, as well as to find out if a different individual vulnerability can be important. This retrospective study included 188 subjects who died from asbestos related diseases in 2000-2017 in the area around Broni, Italy, where an important asbestos cement factory had been active from 1932 until 1993.
In each case, a forensic autopsy has been performed. In order to perform the present study, the records were retrieved, including the clinical files, the autopsy, and the histological report. The statistical analysis performed showed that there was a significant relation between the cause of death (mesothelioma, lung cancer or asbestosis) and the kind of exposure (occupational, neighborhood or household), showing that all the subjects not exposed occupationally (and, therefore, exposed to lower amounts of asbestos) died from mesothelioma, whereas the individuals who used to work at the plant died also from other caused (asbestosis, lung cancer).
Significant differences were highlighted examining the distribution of the causes of death according to the smoking habits. Moreover, among the mesothelioma patients, the survival time was shorter in the subjects with a neighborhood or household exposure than in the occupationally exposed individuals. The study provided meaningful data about the role of asbestos in causing human pathologies. In particular, the present data appear to support the hypothesis that even an exposure to a very little amount of asbestos can cause mesothelioma in hypersusceptible subjects (probably, on a genetic basis).