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

Int Arch Occup Environ Health. 2009 Mar;82(4):489-97. doi: 10.1007/s00420-008-0358-5. Epub 2008 Sep 23.


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.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Air Pollutants / adverse effects*
  • Asbestos / adverse effects*
  • Case-Control Studies
  • Environmental Exposure / adverse effects*
  • Environmental Exposure / analysis
  • Female
  • Geography
  • Humans
  • Italy / epidemiology
  • Logistic Models
  • Lung Neoplasms / chemically induced
  • Lung Neoplasms / epidemiology*
  • Male
  • Mesothelioma / chemically induced
  • Mesothelioma / epidemiology*
  • Middle Aged
  • Registries
  • Residence Characteristics
  • Urban Population


  • Air Pollutants
  • Asbestos