Peritoneal mesothelioma and asbestos exposure: a population-based case–control study in Italy, 2000–2021
该研究基于意大利国家间皮瘤登记处数据，采用病例对照设计，分析了职业石棉暴露与腹膜间皮瘤风险的关系，发现两者存在显著关联，且不同暴露评估方法结果一致。
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.