[Compensated cases for asbestosis. A geographical analysis by Italian provinces]

During 1995-1999 among cases compensated by Italian National Institute for Insurance of Occupational Accidents (INAIL), asbestosis was classified as the second occupational disease after hypoacusia with the 7% of total cases. The present study describes the geographical distribution of 1.483 cases in men, notified to INAIL (and subsequently confirmed) during 1984-1992. Age-standardised incidence rates were calculated for the 93 Italian provinces. In addition, standardised incidence ratio (SIR) were computed, comparing the number of observed cases to the number of expected cases on the basis of age specific rates in the large geographical Italian areas (Northeast, Northwest, Centre and South and islands). Empirical Bayes estimates applying the Poisson-Gamma model were also estimated. The geographical distribution of standardised incidence ratios revealed a high excess risk for the province of Gorizia, Livorno, Massa Carrara, La Spezia, Trieste, Alessandria, Caltanissetta and a lower, but still significant, excess risk for the province of Siracusa, Ancona, Napoli, Genova, Reggio Emilia, Brindisi, Bergamo, Arezzo, Taranto, Pavia, Messina, Lecco and Varese. This study suggests the possibility to use the insurance files on asbestosis in order to estimate risks in Italy and to compare geographical clusters. Identification of provinces with significant excess number of compensated cases for asbestosis underscore the need for more detailed surveys aimed to detect conditions correlated with asbestos exposure and identifying persisting environmental pollution. Detailed enquiries are needed in particular in those provinces where excesses cannot be explained by current knowledge on circumstances of the presence of asbestos in the workplace.