Letter on: “Mortality of Talc Miners and Millers From Val Chisone, Northern Italy”

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To the Editor:
Pira et al1 recently updated a mortality study of Italian (Val Chisone or, more precisely, Val Germanasca) talc miners and millers, observing no pleural cancer deaths against two expected.
The Piedmont Registry of Malignant Mesotheliomas (RMM) is the regional operating center of the Italian National Mesothelioma Registry.2 Registration of mesothelioma cases is followed by personal interviews to obtain their occupational histories. As incidence and mortality data may differ, I checked the RMM files for cases employed in the Val Germanasca mine.
In 2007, a man aged 79 years was diagnosed with pleural mesothelioma, based on chest computed tomography and cytological examination of a pleural effusion. He died about 3 weeks after diagnosis, with the main cause of death recorded as “probable pleural mesothelioma.” An interview was obtained from a proxy who stated he had been a maintenance worker from 1947 to 1957 at the talc mill and from 1957 to 1981 in a ball bearings production plant.
Maintenance workers at the talc mill might have been exposed to asbestos for different reasons: from the use of asbestos-based insulation material to talc contamination. Rubino et al3 ruled out such a contamination but described low-level exposure to asbestos. Exposure to asbestos of maintenance crewmen may have occurred also at the ball bearings production plant.
I consider this case deserved to be reported. On the contrary, even if it had been included in the study by Pira et al,1 their finding of no excess risk of mortality from pleural cancer would not have changed.
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