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A cluster of deaths from pleural mesothelioma was previously reported for Biancavilla, Italy, a city in eastern Sicily. An environmental survey suggested that the stone quarries located southeast of the city might be a source of asbestos exposure. The materials extracted from the quarries, used widely in the local building industry, contain large quantities of a fibrous amphibole that was initially referred to as an anomalous intermediate phase of sodium- and fluorine-rich tremolite-actinolite. A subsequent crystal chemistry investigation identified the mineral as fluoro-edenite, a new end-member of the edenite --> fluoro-edenite series. The material is very similar in morphology and composition to the minerals of the tremolite-actinolite series. To the authors' knowledge, fluoro-edenite becomes the 3rd mineral fiber (along with erionite and winchite), not yet classified as asbestos, with a demonstrable mesotheliomatogenous action in humans.

In a recent epidemiological study, researchers investigated mortality from malignant pleural neoplasms in Italy, and they detected some geographic clusters of cases of this disease. We found a town located in a volcanic area of eastern Sicily to be of special interest. The residents, some of whom were diagnosed with pleural mesothelioma, had never had any relevant exposure to asbestos during their professional lives. The results of an environmental survey suggested that a possible cause of asbestos exposure was the stone quarries near the town. The products of the quarries contain fibrous amphiboles, which are used widely in the local building industry. These fibrous amphiboles were identified as intermediate phases between tremolite and actinolite. Samples were collected from buildings in the town, and concentrations of amphibole fibers were evaluated. Fibrous phases were detected in 71% of the samples, and fiber concentrations ranged from a few thousand to more than 4 x 10(4) fibers/mg of material. In addition, we conducted a study on the mineral fiber lung burden in a pleural mesothelioma case. Many mineral fibers that were classified as the same tremolite-actinolite fibrous amphibole found in the quarries and in the building materials were detected in the lung tissue. The results suggest that the inhabitants of the town we studied had been exposed for several decades to asbestos fibers that were present in the material extracted from the local stone quarries. The material was subsequently used in the building industry, and this has caused an increased risk of pleural mesothelioma in the area.

Background: A smoking ban in all indoor public places was enforced in Italy on 10 January 2005. Methods: We compared indoor air quality before and after the smoking ban by monitoring the indoor concentrations of fine (,2.5 mm diameter, PM 2.5 ) and ultrafine particulate matter (,0.1 mm diameter, UFP). PM 2.5 and ultrafine particles were measured in 40 public places (14 bars, six fast food restaurants, eight restaurants, six game rooms, six pubs) in Rome, before and after the introduction of the law banning smoking (after 3 and 12 months). Measurements were taken using real time particle monitors (DustTRAK Mod. 8520 TSI; Ultra-fine Particles Counter-TRAK Model 8525 TSI). The PM 2.5 data were scaled using a correction equation derived from a comparison with the reference method (gravimetric measurement). The study was completed by measuring urinary cotinine, and pre-law and post-law enforcement among non-smoking employees at these establishments Results: In the post-law period, PM 2.5 decreased significantly from a mean concentration of 119.3 mg/m 3 to 38.2 mg/m 3 after 3 months (p,0.005), and then to 43.3 mg/m 3 a year later (p,0.01). The UFP concentrations also decreased significantly from 76 956 particles/cm 3 to 38 079 particles/cm 3 (p,0.0001) and then to 51 692 particles/cm 3 (p,0.01). Similarly, the concentration of urinary cotinine among nonsmoking workers decreased from 17.8 ng/ml to 5.5 ng/ml (p,0.0001) and then to 3.7 ng/ml (p,0.0001). Conclusion: The application of the smoking ban led to a considerable reduction in the exposure to indoor fine and ultrafine particles in hospitality venues, confirmed by a contemporaneous reduction of urinary cotinine.

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