[Pleural malignant mesotheliomas from environmental exposures to asbestos In Italy]. / Mesoteliomi maligni della pleura da esposizione ambientale ad amianto in Italia.

Pleural mesothelioma clusters from outdoor environmental exposure have been highlighted also in Italy and, on the basis of epidemiological surveillance coordinated by the Italian National Mesothelioma Register, their frequency has been estimated at about 4.5%. Epidemiological studies and evaluations of some regional mesothelioma registers have made it possible to highlight that the dispersion of asbestos fibers in the outdoor environment was the only ascertained cause of mesothelioma in subjects from asbestos-cement factories, from the Balangero mine (Piedmont Region), from some serpentine rock quarries with tremolite outcrops in the Southern Apennines and in Alta Val di Susa (Piedmont Region); from chrysotile and serpentine caves in Valmalenco (Lombardy Region). Furthermore, cases of pleural mesothelioma were clearly caused by environmental pollution from fluoroedenite fibers in Biancavilla (Sicily Region). On the other hand, regional mesothelioma registers have also reported other circumstances of environmental asbestos exposure, like in the case of steel industry, shipbuilding, chemical plants, railway lines, and repair/demolition of railway carriages. However, these reports have not found confirmation on the basis of ad-hoc studies and it is likely that there is a lack of homogeneity in the assessment of individual cases. Apart from the scenarios which have been the subject of ad-hoc studies, the assessment of the causal role of environmental exposure to "in place" asbestos in the onset of pleural mesothelioma is problematic without an effort to more carefully examine the circumstances of possible exposure, harmonization of the attribution criteria used in the individual regional registers, analytical assessment of the impact of such exposure on the risk of onset of mesothelioma.

[About the asbestos and the Position Paper on asbestos of the Italian Society of Occupational Medicine]. / A proposito dell'amianto e del Position Paper della Società italiana di medicina del lavoro sull'amianto.

The SIML Position Paper dedicated to asbestos (PPA) is addressed (mainly) to competent practitioners (CP) for the purposes to provide a guidance about a set of items classified as markedly interesting: the actuality of asbestos exposure and the evaluation of the related risk; the diagnosis of the asbestos related diseases; the shape of the risk functions (namely about mesotheliomas); the causal relationship between exposure and disease; the medical surveillance of the workers currently and previously exposed. The scientific literature doesn't acknowledge the idea that nowadays in Italy the frequency of pleural mesotheliomas deriving from environmental asbestos from outdoor sources exposures is really a relevant item. Inside the SIML PPA the chapter concerning industrial hygiene and environmental monitoring themes shows inaccuracies and deficiencies, so resulting of scarce utility for the CPs that should be called for a more cooperative role in front of the employers. The arguments of the diagnosis of the asbestos related diseases is developed with an undue emphasis upon the differential histological diagnosis of asbestosis and, especially, of pleural mesothelioma: nosographic aspects that hardly are posed to the attention of the CP. A similar emphasis is posed towards the shape of the risk function for pleural mesothelioma, a theme absent from the current practice of the CP such as of other occupational practitioners. In conclusion, next to themes of undoubted interest for the PC, the SIML PPA dwells on the scrutiny of some topics representing critical elements of the current contrast between consultants and valuers in the context of criminal prosecutions: subjects having forensic relevance but far from the "application actuality" for the CP invoked in the PPA. A greater transparency, last but not least, was to have been posed, inside the SIML PPA, in the disclosure of the conflict of interests (COIs) of some Authors, declaring their consultancy in favour of companies.

[Occupational accidents among immigrant women in the Italian North-Eastern regions (Veneto and Friuli Venezia Giulia)]. / Gli infortuni sul lavoro tra le donne immigrate nelle regioni del Nord-Est (Veneto e Friuli Venezia Giulia).

OBJECTIVES: to describe occupational accidents among foreign women working in two regions of North-Eastern Italy, in the perspective of a desirable prevention policy. SETTING AND DESIGN: frequency distribution of occupational accidents among foreign women covered by the National Institute for Insurance against Work Accidents (INAIL) in 2000. PARTICIPANTS: foreign female workers employed in two regions of North-Eastern Italy. MAIN OUTCOME MEASURES: frequency distribution of work accidents. RESULTS: 1003 occupational accidents to foreign female workers occurred in Veneto and 383 in Friuli Venezia Giulia. The most frequent places of origin of injured workers in Friuli Venezia Giulia (borderline region with Slovenia) were former Yugoslavia (113) and Albania (28). In Veneto, corresponding countries of origin were Africa (156), Romania (84) and Albania (80).