Asbestos Exposure in Patients with Malignant Pleural Mesothelioma included in the PRIMATE Study, Lombardy, Italy

Andrea Spinazzè; Dario Consonni; Francesca Borghi; Sabrina Rovelli; Andrea Cattaneo; Carolina Zellino; Barbara Dallari; Angela Cecilia Pesatori; Hans Kromhout; Susan Peters; Luciano Riboldi; Domenico Maria Cavallo; Carolina Mensi

doi:10.3390/ijerph19063390

Asbestos Exposure in Patients with Malignant Pleural Mesothelioma included in the PRIMATE Study, Lombardy, Italy

Andrea Spinazzè^*
, Dario Consonni
, Francesca Borghi
, Sabrina Rovelli
, Andrea Cattaneo
, Carolina Zellino
, Barbara Dallari
, Angela Cecilia Pesatori
, Hans Kromhout
, Susan Peters
, Luciano Riboldi
, Domenico Maria Cavallo
, Carolina Mensi

^*Corresponding author for this work

IRAS OH Epidemiology Chemical Agents

Research output: Contribution to journal › Article › Academic › peer-review

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. 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.

Original language	English
Article number	3390
Pages (from-to)	1-11
Journal	International Journal of Environmental Research and Public Health
Volume	19
Issue number	6
DOIs	https://doi.org/10.3390/ijerph19063390
Publication status	Published - 1 Mar 2022

Bibliographical 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.

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. 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.

Keywords

Asbestos
Job-exposure matrix (JEM)
Mesothelioma
Occupational exposure
Retrospective exposure assessment
SYN-JEM

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

Access to Document

10.3390/ijerph19063390Licence: CC BY

ijerph-19-03390Final published version, 538 KBLicence: CC BY

Cite this

Spinazzè, A., Consonni, D., Borghi, F., Rovelli, S., Cattaneo, A., Zellino, C., Dallari, B., Pesatori, A. C., Kromhout, H., Peters, S., Riboldi, L., Cavallo, D. M., & Mensi, C. (2022). Asbestos Exposure in Patients with Malignant Pleural Mesothelioma included in the PRIMATE Study, Lombardy, Italy. International Journal of Environmental Research and Public Health, 19(6), 1-11. Article 3390. https://doi.org/10.3390/ijerph19063390

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title = "Asbestos Exposure in Patients with Malignant Pleural Mesothelioma included in the PRIMATE Study, Lombardy, Italy",

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. 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{\textquoteright}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.",

keywords = "Asbestos, Job-exposure matrix (JEM), Mesothelioma, Occupational exposure, Retrospective exposure assessment, SYN-JEM",

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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: {\textcopyright} 2022 by the authors. Licensee MDPI, Basel, Switzerland.",

year = "2022",

month = mar,

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doi = "10.3390/ijerph19063390",

language = "English",

volume = "19",

pages = "1--11",

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Spinazzè, A, Consonni, D, Borghi, F, Rovelli, S, Cattaneo, A, Zellino, C, Dallari, B, Pesatori, AC, Kromhout, H , Peters, S, Riboldi, L, Cavallo, DM & Mensi, C 2022, 'Asbestos Exposure in Patients with Malignant Pleural Mesothelioma included in the PRIMATE Study, Lombardy, Italy', International Journal of Environmental Research and Public Health, vol. 19, no. 6, 3390, pp. 1-11. https://doi.org/10.3390/ijerph19063390

Asbestos Exposure in Patients with Malignant Pleural Mesothelioma included in the PRIMATE Study, Lombardy, Italy. / Spinazzè, Andrea; Consonni, Dario; Borghi, Francesca et al.
In: International Journal of Environmental Research and Public Health, Vol. 19, No. 6, 3390, 01.03.2022, p. 1-11.

Research output: Contribution to journal › Article › Academic › peer-review

TY - JOUR

T1 - Asbestos Exposure in Patients with Malignant Pleural Mesothelioma included in the PRIMATE Study, Lombardy, Italy

AU - Spinazzè, Andrea

AU - Consonni, Dario

AU - Borghi, Francesca

AU - Rovelli, Sabrina

AU - Cattaneo, Andrea

AU - Zellino, Carolina

AU - Dallari, Barbara

AU - Pesatori, Angela Cecilia

AU - Kromhout, Hans

AU - Peters, Susan

AU - Riboldi, Luciano

AU - Cavallo, Domenico Maria

AU - Mensi, Carolina

N1 - 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.

PY - 2022/3/1

Y1 - 2022/3/1

N2 - 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. 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.

AB - 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. 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.

KW - Asbestos

KW - Job-exposure matrix (JEM)

KW - Mesothelioma

KW - Occupational exposure

KW - Retrospective exposure assessment

KW - SYN-JEM

UR - https://www.scopus.com/pages/publications/85126275582

U2 - 10.3390/ijerph19063390

DO - 10.3390/ijerph19063390

M3 - Article

AN - SCOPUS:85126275582

SN - 1661-7827

VL - 19

SP - 1

EP - 11

JO - International Journal of Environmental Research and Public Health

JF - International Journal of Environmental Research and Public Health

IS - 6

M1 - 3390

ER -

Asbestos Exposure in Patients with Malignant Pleural Mesothelioma included in the PRIMATE Study, Lombardy, Italy

Abstract

Bibliographical note

Funding

Keywords

UN SDGs

Access to Document

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