The Italian mesothelioma registry (ReNaM) estimates mesothelioma incidence and addresses its etiology by assessing cases’ exposures but cannot provide relative risk estimates. i) To estimate pleural mesothelioma relative risk by industry and occupation and by ReNaM categories of asbestos exposure; and ii) to provide quantitative estimates of the exposure–response relationship. A population-based mesothelioma case–control study was conducted in 2012–2014 in five Italian regions. Cases and age and gender frequency-matched controls were interviewed using a standard ReNaM questionnaire. Experts coded work histories according to international standard classifications of industries/occupations and assigned asbestos exposure according to ReNaM categories. Job codes were further linked to SYN-JEM, a quantitative job-exposure matrix. Cumulative exposure (CE, f/mL-years) was computed by summing individual exposures over lifetime work history. Unconditional logistic regression analyses adjusted by gender, centre and age were fitted to calculate odds ratios (OR) and 95% confidence intervals (CI). Among men we observed increased risks of mesothelioma in many industries and associated occupations, including: asbestos-cement (OR = 3.43), manufacture of railroad equipment (OR = 8.07), shipbuilding and repairing (OR = 2.34), iron and steel mills (OR = 2.15), and construction (OR = 1.94). ORs by ReNaM exposure categories were as follows: definite/probable occupational exposure (OR = 15.8, men; OR = 8.80, women), possible occupational (OR = 2.82, men; OR = 3.70, women), sharing home with an exposed worker (OR = 2.55, men; OR = 10.3, women), residential (OR = 2.14, men; OR = 3.24, women). Based on SYN-JEM, mesothelioma risk increased by almost 30% per f/mL-year (OR = 1.28, CI 1.16–1.42). Out study involved five regions with historically different types and levels of industrial development, encompassing one third of the Italian population and half of Italian mesothelioma cases. As expected, we found increased pleural mesothelioma risk in the asbestos industry and in trades with large consumption of asbestos materials. Clear associations were found using both qualitative (ReNaM classifications) and quantitative estimates (using SYN-JEM) of past asbestos exposure, with clear evidence of an exposure–response relationship.

中文翻译：

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按行业和职业划分的胸膜间皮瘤风险：意大利多中心间皮瘤病因研究 (MISEM) 的结果

意大利间皮瘤登记处 (ReNaM) 估计间皮瘤的发病率并通过评估病例的暴露来解决其病因，但不能提供相对风险估计。i) 按行业和职业以及石棉暴露的 ReNaM 类别估计胸膜间皮瘤的相对风险；ii) 提供暴露-反应关系的定量估计。2012-2014 年在意大利五个地区进行了一项基于人群的间皮瘤病例对照研究。使用标准的 ReNaM 问卷对病例和年龄和性别频率匹配的对照进行采访。专家根据行业/职业的国际标准分类对工作历史进行编码，并根据 ReNaM 类别分配石棉暴露。工作代码进一步与 SYN-JEM 相关联，这是一个量化的工作暴露矩阵。累积暴露量（CE，f/mL-年）是通过将个人暴露量在终生工作历史中相加来计算的。对按性别、中心和年龄进行调整的无条件逻辑回归分析进行拟合，以计算优势比 (OR) 和 95% 置信区间 (CI)。在男性中，我们观察到许多行业和相关职业的间皮瘤风险增加，包括：石棉水泥（OR = 3.43）、铁路设备制造（OR = 8.07）、造船和维修（OR = 2.34）、钢铁厂（ OR = 2.15）和构造（OR = 1.94）。按 ReNaM 暴露类别划分的 OR 如下：确定/可能的职业暴露（OR = 15.8，男性；OR = 8.80，女性）、可能的职业暴露（OR = 2.82，男性；OR = 3.70，女性）、与暴露的工人同住（OR = 2.55，男性；OR = 10.3，女性），住宅（OR = 2.14，男性；OR = 3.24，女性）。根据 SYN-JEM，间皮瘤风险每 f/mL 年增加近 30%（OR = 1.28，CI 1.16–1.42）。Out 研究涉及五个具有历史上不同类型和工业发展水平的地区，涵盖了意大利三分之一的人口和意大利一半的间皮瘤病例。正如预期的那样，我们发现石棉行业和大量消耗石棉材料的行业中胸膜间皮瘤的风险增加。使用过去石棉暴露的定性（ReNaM 分类）和定量估计（使用 SYN-JEM）发现了明确的关联，并有明确的证据表明暴露-反应关系。占意大利人口的三分之一和意大利间皮瘤病例的一半。正如预期的那样，我们发现石棉行业和大量消耗石棉材料的行业中胸膜间皮瘤的风险增加。使用过去石棉暴露的定性（ReNaM 分类）和定量估计（使用 SYN-JEM）发现了明确的关联，并有明确的证据表明暴露-反应关系。占意大利人口的三分之一和意大利间皮瘤病例的一半。正如预期的那样，我们发现石棉行业和大量消耗石棉材料的行业中胸膜间皮瘤的风险增加。使用过去石棉暴露的定性（ReNaM 分类）和定量估计（使用 SYN-JEM）发现了明确的关联，并有明确的证据表明暴露-反应关系。