The relationship between malignant mesothelioma and an asbestos cement plant environmental risk: a spatial case-control study in the city of Bari (Italy).

ABSTRACT

OBJECTIVES: To estimate the mesothelioma risk and environmental asbestos exposure (EAE) due to an asbestos-cement plant. METHODS: A spatial case-control study including 48 malignant mesothelioma (MM) cases occurred in the period 1993-2003 selected from the regional mesothelioma register (RMR) and 273 controls. The disease risk was estimated by means of a logistic-regression model, in which the probability of disease-occurrence is expressed as a function of the classes of distances. A non-parametric method was applied to estimate the full relative risk surface. RESULTS: Significant MM odds ratio of 5.29 (95 CI 1.18-23.74) was found for people living within a range up to 500 m centered on the plant. The non-parametric estimation of relative risk surface unveiled a marked peak near the plant not paralleled by the spatial distribution of controls. CONCLUSION: Evidence of an association between mesothelioma risk and EAE is highlighted. The role played by the RMR in increasing the public health local authorities awareness is stressed.