Veneto Mesothelioma Registry

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Veneto Mesothelioma Registry

INTRO

The aim of the Mesothelioma Registry is to identify all the cases of mesothelioma occurring in the Veneto Region, and to investigate the patients’ professional, domestic and environmental history.

METHODS

The procedures for identifying, collecting, defining, classifying, and coding cases, and patients’ stories of exposure to asbestos - the main risk factor for mesothelioma - are defined by national guidelines.

The diagnosis of mesothelioma is particularly difficult due to the complex features of this disease (low incidence, histological picture, etc.), and that is why a reference protocol was developed to classify cases by the level of diagnostic certainty.

The occupational history of each patient with mesothelioma is assessed by means of a standard questionnaire administered directly to the individuals affected (if still alive), or to their relatives. To gather data relating to any history of exposure to asbestos, the Registry collaborates with the Local Health Units’ Services for Prevention, Hygiene and Safety in the Workplace (SPISAL).

NATIONAL LEGISLATION

The Legislative Decree of the President of the Council of Ministers n. 308/2002 assigned the epidemiological surveillance of mesothelioma cases to the National Registry of Mesotheliomas (ReNaM), established at the Department of Medicine, Epidemiology, and  Occupational and Environmental Hygiene of the INAIL (National Institute for Insurance against Accidents at Work), which is organized as a regional network, each region having its own Regional Operating Center (COR). The identification of any new mesothelioma cases and the reconstruction of any history of exposure to asbestos is mandatory by law in Italy.

In the Veneto Region, the COR was instituted in 2001 by Regional Council Decree (Decreto della Giunta Regionale - DGR) 538/01, which defines the  center’s objectives and working methods. The COR for the Veneto Region, called the "Veneto Mesothelioma Registry", is located at the SPISAL of the ex-AULSS 16. As a consequence of DGR 14/11 and the Regional Health Plan, the Veneto Mesothelioma Registry is part of the Regional Epidemiological Service, together with other disease registries.

ACTIVITIES

The activities conducted in the Veneto Region have enabled the incidence of mesothelioma to be calculated, and the circumstances of any asbestos exposure to be reconstructed for cases mesothelioma involving residents in the Veneto since 1987. Information on new incident cases identified from 1993 to 2015 has been transmitted to the National Mesothelioma Registry by several Italian Regions, including the Veneto. The data collected have led to five publications (and a sixth is underway).  These publications  are reports that provide details of the circumstances of asbestos exposure and the burden of mesothelioma cases for different types of exposure observed in Italy. These concern people involved in:

  • the production of asbestos-cement;
  • the building industry;
  • the construction, repair and maintenance of railway carriages;
  • shipyards;
  • port handling activities;
  • agricultural sectors (i.e. the recycling of bags containing asbestos);
  • non-asbestos textile industries (asbestos in the brakes or linings of looms);
  • steel mills;
  • oil refineries and chemical industries;
  • certain environmental and domestic activities.

The Mesothelioma Registry has edited two volumes describing its regional data (2001, 2006). The trend of mesothelioma relates to the past consumption of asbestos and the circumstances of asbestos exposure occurring decades ago. As the risk, for a given individual, is proportional to the cumulative exposure (its intensity and duration), most cases of mesothelioma occur in individuals whose exposure levels were higher.

The most up-to-date figures on the frequency of mesothelioma in the Veneto, and on the circumstances of exposure that gave rise to these cases of mesothelioma are presented in the Social-Health Report from the Veneto Regional Authority, published in 2016. The Regional Registry participates in detailed projects and is responsible for the publication of scientific articles.