{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,20]],"date-time":"2026-01-20T13:20:10Z","timestamp":1768915210798,"version":"3.49.0"},"reference-count":47,"publisher":"MDPI AG","issue":"6","license":[{"start":{"date-parts":[[2022,3,13]],"date-time":"2022-03-13T00:00:00Z","timestamp":1647129600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Fondazione Regionale per la Ricerca Biomedica","award":["ARL_2\/2018"],"award-info":[{"award-number":["ARL_2\/2018"]}]},{"DOI":"10.13039\/501100007707","name":"Istituto Nazionale per l'Assicurazione Contro gli Infortuni sul Lavoro","doi-asserted-by":"publisher","award":["BRIC55\/2019"],"award-info":[{"award-number":["BRIC55\/2019"]}],"id":[{"id":"10.13039\/501100007707","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["IJERPH"],"abstract":"<jats:p>The PRIMATE study is an Italian translational research project, which aims to identify personalized biomarkers associated with clinical characteristics of malignant pleural mesothelioma (MPM). For this purpose, characteristics of MPM patients with different degrees of asbestos exposure will be compared to identify somatic mutations, germline polymorphism, and blood inflammatory biomarkers. In this framework, we assessed exposure to asbestos for 562 cases of MPM extracted from the Lombardy region Mesothelioma Registry (RML), for which a complete interview based on a standardized national questionnaire and histopathological specimens were available. Exposure assessment was performed: (1) through experts' evaluation (considered as the gold standard for the purpose of this study), according to the guidelines of the Italian National Mesothelioma Registry (ReNaM) and (2) using a job-exposure matrix (SYN-JEM) to obtain qualitative (ever\/never) and quantitative estimates of occupational asbestos exposure (cumulative exposure expressed in fibers per mL (f\/mL)). The performance of SYN-JEM was evaluated against the experts' evaluation. According to experts' evaluation, occupational asbestos exposure was recognized in 73.6% of men and 23.6% of women; furthermore, 29 men (7.8%) and 70 women (36.9%) had non-occupational exposure to asbestos. When applying SYN-JEM, 225 men (60.5%) and 25 women (13.2%) were classified as occupationally exposed, with a median cumulative exposure higher for men (1.7 f\/mL-years) than for women (1.2 f\/mL-years). The concordance between the two methods (Cohen\u2019s kappa) for occupational exposure assessment was 0.46 overall (0.41 in men, and 0.07 in women). Sensitivity was higher in men (0.73) than in women (0.18), while specificity was higher in women (0.88) than in men (0.74). Overall, both methods can be used to reconstruct past occupational exposure to asbestos, each with its own advantages and limitations.<\/jats:p>","DOI":"10.3390\/ijerph19063390","type":"journal-article","created":{"date-parts":[[2022,3,13]],"date-time":"2022-03-13T22:29:43Z","timestamp":1647210583000},"page":"3390","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Asbestos Exposure in Patients with Malignant Pleural Mesothelioma included in the PRIMATE Study, Lombardy, Italy"],"prefix":"10.3390","volume":"19","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0371-3164","authenticated-orcid":false,"given":"Andrea","family":"Spinazz\u00e8","sequence":"first","affiliation":[{"name":"Department of Science and High Technology, University of Insubria, 22100 Como, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8935-3843","authenticated-orcid":false,"given":"Dario","family":"Consonni","sequence":"additional","affiliation":[{"name":"Occupational Health Unit, Fondazione IRCCS Ca\u2019 Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3452-2803","authenticated-orcid":false,"given":"Francesca","family":"Borghi","sequence":"additional","affiliation":[{"name":"Department of Science and High Technology, University of Insubria, 22100 Como, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6403-5101","authenticated-orcid":false,"given":"Sabrina","family":"Rovelli","sequence":"additional","affiliation":[{"name":"Department of Science and High Technology, University of Insubria, 22100 Como, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2962-7259","authenticated-orcid":false,"given":"Andrea","family":"Cattaneo","sequence":"additional","affiliation":[{"name":"Department of Science and High Technology, University of Insubria, 22100 Como, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Carolina","family":"Zellino","sequence":"additional","affiliation":[{"name":"Occupational Health Unit, Fondazione IRCCS Ca\u2019 Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Barbara","family":"Dallari","sequence":"additional","affiliation":[{"name":"Occupational Health Unit, Fondazione IRCCS Ca\u2019 Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0261-3252","authenticated-orcid":false,"given":"Angela Cecilia","family":"Pesatori","sequence":"additional","affiliation":[{"name":"Occupational Health Unit, Fondazione IRCCS Ca\u2019 Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy"},{"name":"Department of Clinical Sciences and Community Health, University of Milan, 20122 Milan, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4233-1890","authenticated-orcid":false,"given":"Hans","family":"Kromhout","sequence":"additional","affiliation":[{"name":"Institute for Risk Assessment Sciences, Utrecht University, 3584 CM Utrecht, The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Susan","family":"Peters","sequence":"additional","affiliation":[{"name":"Institute for Risk Assessment Sciences, Utrecht University, 3584 CM Utrecht, The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Luciano","family":"Riboldi","sequence":"additional","affiliation":[{"name":"Occupational Health Unit, Fondazione IRCCS Ca\u2019 Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Domenico Maria","family":"Cavallo","sequence":"additional","affiliation":[{"name":"Department of Science and High Technology, University of Insubria, 22100 Como, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9075-3684","authenticated-orcid":false,"given":"Carolina","family":"Mensi","sequence":"additional","affiliation":[{"name":"Occupational Health Unit, Fondazione IRCCS Ca\u2019 Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2022,3,13]]},"reference":[{"key":"ref_1","unstructured":"National Institute for Occupational Safety and Health (NIOSH) (2022, March 04). 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