Browsing by Autor "Pietro Comba"

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A Suspected Mesothelioma Cluster in Colombia: What We Know
(National Institute of Environmental Health Sciences, 2018) Juan Pablo Ramos-Bonilla; María Fernanda Cely‐García; Benedetto Terracini; Pietro Comba; Roberto Pasetto; Daniela Marsili; Valeria Ascoli; María Camila Rueda; Benjamin Lysaniuk; Agata Mazzeo
Introduction: Asbestos are mineral fibers that have been used in a wide range of products. All forms of asbestos cause mesothelioma and cancers of the lung, larynx, and ovaries. The asbestos industry began operations in Colombia in 1942, with an asbestos cement facility located in the municipality of Sibate (current population 38,000). Historically the plant produced asbestos-cement roof tiles and water pipes. The latest figure available indicates that in 2012 the facility used 5,955 tons of asbestos. Inhabitants of Sibate have been complaining that a large number of people are being diagnosed and are dying from asbestos related diseases. Aim: The aim of this study is to investigate the potential existence of a mesothelioma cluster in Sibate. Methods: In 2015/16, 354 door-to-door health and socioeconomic surveys were applied in three large neighborhoods, to identify potential asbestos related cases. Asbestos exposure sources have also been studied, including soil-sampling campaigns conducted at locations that were determined using Geographic Information Systems. Results: Thirty-one (31) self-reported mesothelioma cases were identified with the surveys. For 21 of these cases, a copy of the medical diagnosis has been obtained (14 with immunohistochemistry report), as an initial step to confirm the original diagnosis. Core biopsy paraffins for each case are currently being collected for validation purposes. During the soil survey campaign, an underground layer of friable asbestos (chrysotile content 5-10%) was identified at different depths. This asbestos layer was created during the construction of landfills intended to desiccate areas of a water reservoir located next to the town. Conclusion: With the information collected so far, 3 of the 5 criteria established by the US CDC cluster investigation guidelines have been met. At this stage, the case in Sibate can be labeled as a suspected mesothelioma cluster, pending further confirmation of the mesothelioma diagnosis.
An Approach to Overcome the Limitations of Surveillance of Asbestos Related Diseases in Low- and Middle-Income Countries: What We Learned from the Sibaté Study in Colombia
(Elsevier BV, 2023) Juan Pablo Ramos-Bonilla; Margarita Giraldo; Daniela Marsili; Roberto Pasetto; Benedetto Terracini; Agata Mazzeo; Corrado Magnani; Pietro Comba; Benjamin Lysaniuk; María Fernanda Cely‐García
The findings of this study emphasize the urgent need for Colombia to establish a reliable epidemiological surveillance system for asbestos-related diseases (ARDs). Active surveillance strategies can play a crucial role in identifying mesothelioma clusters and enhancing our understanding of the health effects of asbestos exposure in low- and middle-income countries.
Prevention of Asbestos Exposure in Latin America within a Global Public Health Perspective
(Elsevier BV, 2019) Eduardo Algranti; Juan Pablo Ramos-Bonilla; Benedetto Terracini; Vilma Sousa Santana; Pietro Comba; Roberto Pasetto; Agata Mazzeo; Fulvio Cavariani; Andrés Trotta; Daniela Marsili
Recent data on chrysotile strengthened the evidence of its carcinogenicity and showed an excessive risk of lung cancer at cumulative exposure levels as low as 1.5 fibre-years/ml. Technology for substitution is available for all asbestos-containing products and ceasing asbestos production and manufacturing will not result in unemployment and loss of income, except for the mining industry. The flawed arguments used by the industry to maintain its market, both to the public and in courtrooms, strongly relies on the lack of local evidence of the ill effects and on the invisibility of asbestos-related diseases in LA, due to the limited number of studies and the exposed workers' difficulty accessing health services. The few epidemiological studies available show clear evidence of clusters of mesothelioma in municipalities with a history of asbestos consumption and a forecasted rise in its incidence in Argentina and Brazil for the next decade. In Brazil, non-governmental organizations of asbestos workers were pivotal to counterbalance misinformation and inequities, ending recently in a Supreme Court decision backing an asbestos ban. In parallel, continuous efforts should be made to stimulate the growth of competent and ethical researchers to convey adequate information to the scientific community and to the general public.