ITALY FIRST FOR ASBESTOS DEATHS. BUT, IN OUR COUNTRY, THE EUROSTAT DATA – 518 DEATHS – DO NOT COMPLY WITH THE REAL THOSE. FOR THENATIONAL ASBESTOS OBSERVATORY THERE ARE AT LEAST 2 THOUSAND. ACCORDING TO THE ATTORNEY. EZIO BONANNI, WE MUST TAKE ACCOUNT OF ALL ASBESTO-RELATED DISEASES AND NOT JUST MESOTHELIOMA
Asbestos and asbestos-related diseases. The European Union’s estimates are completely wrong, even if they give Italy the sad record of the number of mesothelioma. The lawyer Ezio Bonannipresident ofNational Asbestos Observatorycommented on the data and findings of the dataEurostat of 2021.
In fact, according to the European body, there were 518 deaths in Italy from mesothelioma. In reality, this is a serious mistake, says Bonanni, because there were at least 2,000 cases of mesothelioma in Italy, with 1,900 deaths in 2021.
The sad accounting of the cases of this pathology must unfortunately be integrated with the cases of lung cancer and all other asbestos-related cancers.
In fact, the lawyer, interviewed by the newspaper Futurereiterated that we must take into account all asbestos-related pathologies and not just mesothelioma. Therefore, what Bonanni declared is confirmed: “The figure is clearly underestimated and I also exclude that mesotheliomas are decreasing.”
The Dr. Pasquale Montillamember of the technical-scientific committee of the ONA, clarified that already in the first year from diagnosis, more than 70% of victims have an unfortunate outcome with an atrocious death.
Why is Italy the most affected country?
The explanation behind this sad record lies in the enormous quantity of asbestos used in our country until it was banned in 1992.
«Italy made excessive use of asbestos until 1992»says the lawyer Bonanni. It is estimated that in the country there are still 40 million tonnes of asbestos awaiting remediation, of which 34 million are in compact matrix and the rest is friable. An extremely dangerous condition for public health.
The biggest difficulty was the lack of a timely response: once the problem was identified, «the ability to clean up and neutralize the impact of active carcinogens has disappeared»continues the ONA president.
But it’s not just the cleanup that worries the experts. As Professor Montilla explains, mesothelioma can appear even forty years after exposure toasbestos. Which makes health surveillance complex.
The abnormal use of asbestos, until 20 April 1993, the date of entry into force of the ban on the use of this material pursuant to art. 1 of law no. 357 of 1992 and the delay in reclamation, is the explanation for the high incidence of victims in Italy.
An ineffective monitoring system
Another serious problem is the lack of clear and complete data, especially in some Italian regions. «There is something wrong, because the data we have is excessively fluctuating in reference to epidemiological trends», explains Bonanni, referring to the collection of data by the National Mesothelioma Registry (Renam)managed by Inail.
Regions such as Abruzzo, Campania and Calabria, for example, often do not send updated data from their Regional Operational Centers, thus compromising surveillance and prevention interventions.
This lack of data directly impacts the ability to plan effective prevention. Montilla therefore underlined the importance of improving data collection in order to effectively plan cancer prevention strategies. He also explained that the lack of information not only hinders progress in understanding the disease but also limits the possibility of implementing targeted and timely interventions.
Consequently, it is essential to integrate molecular epidemiology with classical one, i.e. «associate clinical information from sick patients with specific genetic tests”. This approach would allow people at risk to be identified in advance, allowing preventive measures to be taken before the disease manifests itself.
Instead of waiting for patients to develop cancer and only then starting treatments, such as the use of expensive therapies such as monoclonal antibodies, Montilla therefore proposes a paradigm shift towards primary prevention.
In this context, the future of oncology should focus on the implementation of targeted genetic tests to identify predisposing mutations. Once those at risk have been identified, it would be possible to intervene to neutralize exposure to carcinogenic factors, thus reducing the risk of developing the disease. In short, only through an integrated prevention strategy, which combines epidemiology and genetics, will it be possible to obtain significant results in the fight against cancer.
The illusion of a decline in asbestos deaths
Although Eurostat data seems to indicate a decrease in deaths from mesothelioma, both Bonanni and Montilla underline that this does not correspond to reality. «We often refer only to mesotheliomas from occupational exposure», says the oncologist. But there are many other asbestos-related cancers that are not adequately monitored, such as pancreatic cancer, lymphomas and reproductive system cancers.
If these are not included in official statistics, the death toll linked to the dangerous mineral is inevitably underestimated. «Mesothelioma is a rare neoplasm and its mortality rates are reduced by the use of immunotherapy and combined chemotherapy – explains the oncologist to Avvenire -. But we must be clear: we are still stuck. We try to guarantee the longest possible quality of life, but 3-year mortality remains around 70-80%, despite the advantages that monoclonal antibodies and radiotherapy also give us”.
Another factor that should not be underestimated is the remediation of sites contaminated by asbestos for the protection of right to health.
The case of the former Pertusola of Crotone: an unresolved emergency
An emblematic example of the inadequacy of reclamation in Italy is represented by the former Pertusola of Crotone, an industrial plant that operated for decades in the processing of metals and whose legacy is an environmental disaster that affects the health of citizens. In the area surrounding the factory, levels of contamination from asbestos and other toxic agents remain extremely high and put both the local population and theenvironment.
Montilla denounces this situation as «a very serious fact”. Despite the well-documented risks and the clear need for intervention, the authorities have not yet completed the complete remediation of the site.
This led to continuous exposure of the inhabitants of the area, with lethal consequences. The professor warns that «people continue to inhale the deadly fibers and die. The real issue is the delays in prevention” and in reclamation operations. The situation in Crotone is unfortunately only one of many in Italy, where bureaucratic slowness and lack of funds compromise public health.