Peritoneal mesothelioma and asbestos exposure: a population-based case-control study in Italy, 2000-2021

ReNaM Working Group; Dario Consonni; Enrica Migliore; Manuela Gangemi; Domenica Cavone; Luigi Vimercati; Sara Piro; Lucia Giovannetti; Valentina Zabeo; Vera Comiati; Stefania Curti; Stefano Mattioli; Maria Teresa Landi; Carmela Gioscia; Silvia Eccher; Stefano Murano; Flavia D'Agostin; Carlo Genova; Riccardo Perduri; Iolanda Grappasonni; Fabrizio Stracci; Ilaria Cozzi; Tommaso Staniscia; Franco Calista; Italo Francesco Angelillo; Rocco Galasso; Federico Tallarigo; Giuseppe Cascone; Massimo Melis; Susan Peters; Hans Kromhout; Alessandra Binazzi; Alessandro Marinaccio; Carolina Mensi

doi:10.1136/oemed-2025-110414

Peritoneal mesothelioma and asbestos exposure: a population-based case-control study in Italy, 2000-2021

ReNaM Working Group
, Dario Consonni^*
, Enrica Migliore
, Manuela Gangemi
, Domenica Cavone
, Luigi Vimercati
, Sara Piro
, Lucia Giovannetti
, Valentina Zabeo
, Vera Comiati
, Stefania Curti
, Stefano Mattioli
, Maria Teresa Landi
, Carmela Gioscia
, Silvia Eccher
, Stefano Murano
, Flavia D'Agostin
, Carlo Genova
, Riccardo Perduri
, Iolanda Grappasonni

Fabrizio Stracci, Ilaria Cozzi, Tommaso Staniscia, Franco Calista, Italo Francesco Angelillo, Rocco Galasso, Federico Tallarigo, Giuseppe Cascone, Massimo Melis, Susan Peters, Hans Kromhout, Alessandra Binazzi, Alessandro Marinaccio, Carolina Mensi

^*Corresponding author for this work

Occupational Health Unit
University of Turin
University of Bari
Ontario Institute for Cancer Research
COR Veneto
University of Bologna
University of Ferrara
National Cancer Institute United States
COR Valle d'Aosta
COR Province of Trento
COR Province of Bolzano
University of Trieste - Trieste General Hospitals
Dipartimento di Medicina Interna e Specialità Mediche
COR Emilia-Romagna
University of Camerino
COR Umbria
COR Lazio
COR Abruzzo
COR Molise
University of Campania Luigi Vanvitelli
COR Basilicata
COR Calabria
COR Sicilia
Regional Epidemiological Center
Occupational and Environmental Medicine

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

Abstract

OBJECTIVES: Using a case-control design, we examined the association between occupational asbestos exposure and risk of peritoneal mesothelioma in the general population in Italy.

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 log 10-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.

Original language	English
Pages (from-to)	495-503
Number of pages	9
Journal	Occupational and Environmental Medicine
Volume	82
Issue number	10
Early online date	17 Nov 2025
DOIs	https://doi.org/10.1136/oemed-2025-110414
Publication status	Published - 3 Dec 2025

Bibliographical note

Publisher Copyright:
© Author(s) (or their employer(s)) 2025.

Funding

Studies providing controls had been supported in the past by: the Intramural Research Program of the National Institutes of Health, the National Cancer Institute, Division of Cancer Epidemiology and Genetics, Bethesda, Maryland, USA (EAGLE); Ministry of Health, CCM (Centro Nazionale per la Prevenzione e il Controllo delle Malattie), Rome, Italy (MISEM). The present work was supported by Istituto Nazionale per l’Assicurazione contro gli Infortuni sul Lavoro (INAIL), Rome, Italy: BRiC ID66/2022. The funder INAIL had involvement in the study design; in the collection and interpretation of the data; in the writing of the report; and in the decision to submit the paper for publication; it had no involvement in the analysis of data. The others funders had no involvement in any of these activities. The funder INAIL didn’t influence the results/outcomes of the study despite affiliations of three authors (AB, AM and Davide Di Marzio) with the funder.

Funders	Funder number
CCM
Centro Nazionale per la Prevenzione e il Controllo delle Malattie
National Institutes of Health
Ministero della Salute
National Cancer Institute
Division of Cancer Epidemiology and Genetics
Istituto Nazionale per l'Assicurazione Contro Gli Infortuni sul Lavoro	BRiC ID66/2022

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Peritoneal mesothelioma and asbestos exposure: a population-based case–control study in Italy, 2000–2021 Final published version, 594 KBLicence: CC BY-NC

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ReNaM Working Group, Consonni, D., Migliore, E., Gangemi, M., Cavone, D., Vimercati, L., Piro, S., Giovannetti, L., Zabeo, V., Comiati, V., Curti, S., Mattioli, S., Landi, M. T., Gioscia, C., Eccher, S., Murano, S., D'Agostin, F., Genova, C., Perduri, R., ... Mensi, C. (2025). Peritoneal mesothelioma and asbestos exposure: a population-based case-control study in Italy, 2000-2021. Occupational and Environmental Medicine, 82(10), 495-503. https://doi.org/10.1136/oemed-2025-110414

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title = "Peritoneal mesothelioma and asbestos exposure: a population-based case-control study in Italy, 2000-2021",

abstract = "OBJECTIVES: Using a case-control design, we examined the association between occupational asbestos exposure and risk of peritoneal mesothelioma in the general population in Italy.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 log 10-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.",

author = "\{ReNaM Working Group\} and Dario Consonni and Enrica Migliore and Manuela Gangemi and Domenica Cavone and Luigi Vimercati and Sara Piro and Lucia Giovannetti and Valentina Zabeo and Vera Comiati and Stefania Curti and Stefano Mattioli and Landi, \{Maria Teresa\} and Carmela Gioscia and Silvia Eccher and Stefano Murano and Flavia D'Agostin and Carlo Genova and Riccardo Perduri and Iolanda Grappasonni and Fabrizio Stracci and Ilaria Cozzi and Tommaso Staniscia and Franco Calista and Angelillo, \{Italo Francesco\} and Rocco Galasso and Federico Tallarigo and Giuseppe Cascone and Massimo Melis and Susan Peters and Hans Kromhout and Alessandra Binazzi and Alessandro Marinaccio and Carolina Mensi",

note = "Publisher Copyright: {\textcopyright} Author(s) (or their employer(s)) 2025.",

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month = dec,

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doi = "10.1136/oemed-2025-110414",

language = "English",

volume = "82",

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ReNaM Working Group, Consonni, D, Migliore, E, Gangemi, M, Cavone, D, Vimercati, L, Piro, S, Giovannetti, L, Zabeo, V, Comiati, V, Curti, S, Mattioli, S, Landi, MT, Gioscia, C, Eccher, S, Murano, S, D'Agostin, F, Genova, C, Perduri, R, Grappasonni, I, Stracci, F, Cozzi, I, Staniscia, T, Calista, F, Angelillo, IF, Galasso, R, Tallarigo, F, Cascone, G, Melis, M, Peters, S , Kromhout, H, Binazzi, A, Marinaccio, A & Mensi, C 2025, 'Peritoneal mesothelioma and asbestos exposure: a population-based case-control study in Italy, 2000-2021', Occupational and Environmental Medicine, vol. 82, no. 10, pp. 495-503. https://doi.org/10.1136/oemed-2025-110414

TY - JOUR

T1 - Peritoneal mesothelioma and asbestos exposure

T2 - a population-based case-control study in Italy, 2000-2021

AU - ReNaM Working Group

AU - Consonni, Dario

AU - Migliore, Enrica

AU - Gangemi, Manuela

AU - Cavone, Domenica

AU - Vimercati, Luigi

AU - Piro, Sara

AU - Giovannetti, Lucia

AU - Zabeo, Valentina

AU - Comiati, Vera

AU - Curti, Stefania

AU - Mattioli, Stefano

AU - Landi, Maria Teresa

AU - Gioscia, Carmela

AU - Eccher, Silvia

AU - Murano, Stefano

AU - D'Agostin, Flavia

AU - Genova, Carlo

AU - Perduri, Riccardo

AU - Grappasonni, Iolanda

AU - Stracci, Fabrizio

AU - Cozzi, Ilaria

AU - Staniscia, Tommaso

AU - Calista, Franco

AU - Angelillo, Italo Francesco

AU - Galasso, Rocco

AU - Tallarigo, Federico

AU - Cascone, Giuseppe

AU - Melis, Massimo

AU - Peters, Susan

AU - Kromhout, Hans

AU - Binazzi, Alessandra

AU - Marinaccio, Alessandro

AU - Mensi, Carolina

PY - 2025/12/3

Y1 - 2025/12/3

N2 - OBJECTIVES: Using a case-control design, we examined the association between occupational asbestos exposure and risk of peritoneal mesothelioma in the general population in Italy.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 log 10-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.

AB - OBJECTIVES: Using a case-control design, we examined the association between occupational asbestos exposure and risk of peritoneal mesothelioma in the general population in Italy.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 log 10-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.

UR - https://www.scopus.com/pages/publications/105022411258

U2 - 10.1136/oemed-2025-110414

DO - 10.1136/oemed-2025-110414

M3 - Article

C2 - 41249049

SN - 1351-0711

VL - 82

SP - 495

EP - 503

JO - Occupational and Environmental Medicine

JF - Occupational and Environmental Medicine

IS - 10

ER -

Peritoneal mesothelioma and asbestos exposure: a population-based case-control study in Italy, 2000-2021

Abstract

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