手術室におけるアスベスト曝露による胸膜中皮腫

the malignant mesothelioma is a neoplasm caused by the exposure to asbestos in a wide majority of cases; however, in a significant number of these cases, it is not possible to highlight it and, as a consequence, a specific category named 'Asbestos Exposure Unknown' was adopted by the 2003 guidelines of the Italian National Mesothelioma Register (ReNaM).

to present a new occurrence of asbestos exposure in a case of mesothelioma diagnosed in a nurse who worked in the operating room, for which the exposure was initially classified as 'Unknown'.

case study.

in-depth studies were carried out on the tasks performed by the nurse. Samples of anti-heat protective gloves, used in the Eighties in operating rooms, were analysed using the Scanning Electron Microscopy (SEM).

pleural mesothelioma was diagnosed at age 56 and caused patient's death at 59 years. It was possible to confirm that the gloves used for the sterilization of surgical instruments during the years and up to 1990 were made of chrysotile asbestos and that they have been the sole sure cause of the nurse's professional exposure, which lasted 4 years. A possible family exposure has been hypothesized in the washing of parents work clothes. The case was re-classified as 'certain professional cause'; the occupational origin of the tumour has not been recognized from the Italian Workers' Compensation Authority (Inail).

this case-report suggests: a. the need to carry out any possible thorough analysis of the circumstances and of the sources of the exposure, every time this exposure is first classified as unknown, according to the ReNaM guidelines; b. to consider at least likely a professional asbestos exposure in case of frequent use of anti-heat protective gloves for surgical instrument sterilization.