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Chrysotile asbestos causes an increased risk of mesothelioma (MM), but the extent of this risk and the carcinogenic potency of chrysotile fibers is in discussion. We studied mortality and MM incidence among workers employed at the Balangero mine (Italy), the largest chrysotile mine in Western Europe, active from 1917 to 1985. The cohort included 974 male workers employed for at least 6 months and active on January 1st, 1946 or subsequently hired. Vital status and causes of death were ascertained. Past exposure to asbestos by working area and calendar period was estimated, based on historical measurements of fibre concentrations, and individual cumulative exposure was assessed by applying these estimates to the job history of cohort members.Local reference rates were used to compute expected deaths from selected diseases and expected incident MM cases. Observed to expected ratios were calculated along with 95% confidence intervals.Mortality was increased for all causes (SMR=1.28; CI95% 1.17–1.40), pleural cancer (SMR=4.30; CI95% 1.58–9.37) and asbestosis (SMR=375.06; CI95% 262.68–519.23). SMRs for lung cancer (SMR=1.14; CI95% 0.81–1.55) and peritoneal cancer (SMR=3.25; CI95% 0.39–11.75) showed a nonstatistically significant increase. Six cases of pleural MM were observed and the SIR was 6.3 (CI95% 2.3–13.7). The analysis by duration and latency for pleural cancer showed an increased risk with increasing duration of exposure and the risk flattened out for latency greater than 40 years. Further analyses based on quantitative exposure indices are being conducted to contribute to the debate on chrysotile potency.