Table 3 Identified clusters of malignant mesothelioma cases by economic sector and modality of asbestos exposure (E = environmental; F = familial; O = occupational)

1

Casale Monferrato

Asbestos cement industry: N = 251 (E = 101, F = 59, O = 91); Construction: N = 43 (F = 12, O = 31); Metal engineering: N = 29 (O); Road transportation: N = 27 (F = 1, O = 26)

[19,28]

2

Cavagnolo

Asbestos cement industry: N = 8 (E = 1, F = 7); Construction: N = 3 (O); Electric power plant: N = 3 (O); Automotive industry: N = 2 (O)

3

Ciriè

Non-asbestos textile industry: N = 11 (F = 1, O = 10); Asbestos textile industry: N = 10 (E = 1, F = 2, O = 7); Mining: N = 6 (E = 3, O = 3); Construction: N = 5 (O); Metal engineering: N = 5 (O); Rubber industry: N = 5 (O)

[44,45]

4

Collegno

Asbestos textile industry: N = 40 (E = 8, F = 4, O = 28); Automotive industry: N = 16 (E = 6, F = 2, O = 8); Metal engineering: N = 14 (F = 1, O = 13); Construction: N = 11 (F = 1, O = 10); Plastics industry: N = 10 (F = 1, O = 9); Food industry: N = 9 (O); Non-asbestos textile industry: N = 8 (F = 1, O = 7); Rubber industry: N = 6 (O)

[24]

5

Dalmine

Metal product manufacturing: N = 41 (O); Non-asbestos textile industry: N = 33 (O); Construction: N = 27 (O); Metal engineering: N = 20 (O); Asbestos cement industry: N = 8 (F = 1, O = 7); Chemical industry: N = 8 (O)

6

Genoa

Shipyard: N = 269 (F = 17, O = 252); Port (handling and shipping): N = 183 (F = 14, O = 169); Construction: N = 102 (F = 4, O = 98); Steel industry: N = 90 (E = 1, F = 4, O = 85); Metal product manufacturing: N = 81 (F = 1, O = 80); Metal engineering: N = 51 (F = 5, O = 46)

[21]

7

Legnano

Non-asbestos textile industry: N = 88 (F = 1, O = 87); Metal engineering: N = 50 (O); Construction: N = 40 (F = 1, O = 39); Metal product manufacturing: N = 30 (O); Chemical industry: N = 10 (O)

8

Sarnico

Non-asbestos textile industry: N = 22 (F = 1, O = 21); Asbestos textile industry: N = 7 (O); Construction: N = 3 (O); Rubber industry: N = 2 (O)

[25]

9

Savona

Chemical industry: N = 24 (O); Construction: N = 20 (O); Port (shipping and handling): N = 11 (O); Shipyard: N = 9 (O); Glass industry: N = 7 (O); Metal product manufacturing: N = 7 (O); Manufacture of basic metals: N = 6 (O); Military defense: N = 6 (O); Railway carriage construction and maintenance: N = 5 (O)

[21]

10

Broni

Asbestos cement industry: N = 84 (E = 41, F = 15, O = 28); Construction: N = 31 (O)

[20]

11

La Spezia

Shipyard: N = 233 (E = 2, F = 14, O = 217); Construction: N = 50 (F = 2, O = 48); Port (handling and shipping): N = 41 (O); Military defense: N = 32 (O); Metal engineering: N = 32 (F = 1, O = 31); Oil refinery: N = 21 (O); Metal product manufacturing: N = 18 (O); Electric power plant: N = 14 (O); Manufacture of basic metals: N = 14 (E = 1; F = 2, O = 11)

[21,33]

12

Fiorenzuola d’Arda

Construction: N = 26 (F = 5, O = 21); Food industry: N = 18 (O); Glass industry: N = 11 (E = 4, F = 1, O = 6); Metal engineering: N = 10 (O); Metal product manufacturing: N = 8 (O)

13

Padua

Railway carriage construction and maintenance: N = 22 (E = 4, F = 1, O = 17); Construction: N = 19 (F = 4, O = 15); Metal engineering: N = 14 (F = 3, O = 11); Asbestos cement industry: N = 8 (E = 4, O = 4); Railway transport: N = 7 (E = 6, O = 1); Sugar industry: N = 6 (F = 2, O = 4); Non-asbestos textile industry: N = 6 (O)

[37]

14

Ravenna

Construction: N = 33 (F = 1, O = 32); Chemical industry: N = 26 (E = 1, F = 2, O = 23); Sugar industry: N = 22 (F = 1, O = 21); Metal engineering: N = 13 (O); Manufacture of synthetic fibers: N = 9 (F = 2, O = 7); Shipyard: N = 8 (E = 1, F = 1, O = 6)

[41]

15

Reggio nell’Emilia

Asbestos cement industry: N = 44 (E = 2, F = 2, O = 40); Railway carriage construction and maintenance: N = 31 (F = 7, O = 24); Construction: N = 18 (F = 1, O = 17); Non-asbestos textile industry: N = 6 (O)

[47,48]

16

Trieste

Shipyard: N = 241 (E = 1, F = 21, O = 219); Construction: N = 74 (F = 1, O = 73); Metal engineering: N = 54 (F = 1, O = 53); Port (handling and shipping): N = 48 (O); Metal product manufacturing: N = 45 (O)

[22,23]

17

Venice

Shipyard: N = 55 (E = 1, F = 9, O = 45); Construction: N = 54 (F = 5, O = 49); Port (handling and shipping): N = 41 (E = 1, F = 4, O = 36); Chemical Industry: N = 37 (E = 2, F = 1, O = 34); Metal engineering: N = 34 (F = 2, O = 32); Metal product manufacturing: N = 18 (O); Manufacture of basic metals: N = 17 (F = 3, O = 14); Glass industry: N = 12 (E = 1, O = 11)

[29]

18

Carrara

Shipyard: N = 25 (O); Construction: N = 25 (O); Metal engineering: N = 18 (O); Metal product manufacturing: N = 14 (F = 1, O = 13); Port (handling and shipping): N = 12 (O); Stone extraction and cutting: N = 10 (O); Motor vehicle repairing: N = 7 (O); Asbestos cement industry: N = 5 (F = 2, O = 3)

[49]

19

Ancona

Shipyard: N = 39 (F = 2, O = 37); Construction: N = 17 (F = 1, O = 16); Military defense: N = 9 (O); Asbestos cement industry: N = 8 (O)

[50]

20

Civitavecchia

Port (handling and shipping): N = 4 (O); Electric power plant: N = 4 (O); Construction: N = 4 (O); Metal engineering: N = 2 (O)

[51]

21

Leghorn

Construction: N = 56 (F = 1, O = 55); Shipyard: N = 48 (F = 2, O = 46); Metal product manufacturing: N = 45 (F = 1, O = 44); Military defense: N = 31 (O); Metal engineering: N = 31 (O); Port (handling and shipping): N = 25 (F = 1, O = 24); Chemical industry: N = 19 (O); Glass industry: N = 18 (O); Electric power plant: N = 16 (F = 3, O = 13); Food industry: N = 16 (O); Agriculture: N = 15 (F = 2, O = 13); Asbestos cement industry: N = 10 (E = 1, O = 9); Motor vehicle repairing: N = 9 (O)

[30,52]

22

Pesaro

Construction: N = 8 (O); Metal engineering: N = 5 (O); Military defense: N = 5 (O)

23

Piombino

Steel industry: N = 17 (F = 1, O = 16); Construction: N = 12 (O); Port (shipping and handling): N = 8 (O); Military defense: N = 5 (O); Metal product manufacturing: N = 4 (O); Agriculture: N = 4 (O); Food industry: N = 3 (O)

[30]

24

Prato

Non-asbestos textile industry: N = 39 (O); Wholesale of non-metal waste and scraps: N = 30 (O); Railway carriage construction and maintenance: N = 19 (E = 1, F = 1, O = 17); Construction: N = 14 (O); Agriculture: N = 13 (O); Manufacture of wood furniture: N = 10 (O); Metal engineering: N = 7 (O)

[35,38]

25

Bari

Asbestos cement industry: N = 59 (E = 42, F = 3; O = 14); Construction: N = 22 (O); Military defense: N = 21 (O); Railway transport: N = 19 (E = 4, O = 15); Port (handling and shipping): N = 17 (O); Metal product manufacturing: N = 8 (O)

[26]

26

Biancavilla

Mining: N = 7 (E); Construction: N = 3 (O)

[42,43]

27

Castellamare di Stabia

Shipyard: N = 20 (F = 4, O = 16); Asbestos cement industry: N = 6 (E = 1, O = 5); Port (shipping): N = 5 (E = 1, O = 4); Manufacture of basic metals: N = 5 (O); Metal product manufacturing: N = 4 (F = 2, O = 2); Manufacture of jewelry: N = 3 (O)

28

Gela

Construction: N = 5 (O); Oil refinery: N = 2 (O); Automotive industry: N = 2 (O)

[53]

29

Naples

Asbestos cement industry: N = 17 (F = 1, O = 16); Steel industry: N = 15 (F = 1, O = 14); Railway carriage construction and maintenance: N = 8 (O); Shipyard: N = 6 (O); Motor vehicle repairing: N = 6 (O); Port (handling and shipping): N = 4 (O)

[39,54]

30

Palermo

Shipyard: N = 31 (E = 1, F = 1, O = 29); Railway transport: N = 6 (F = 1, O = 5); Construction: N = 4 (O)

[55]

31

Syracuse

Construction: N = 16 (O); Asbestos cement industry: N = 6 (E = 2, O = 4); Port (shipping): N = 5 (E = 1, O = 4); Shipyard: N = 3 (E = 2, O = 1); Metal engineering: N = 3 (O)

32

Taranto

Shipyard: N = 54 (E = 4, F = 4, O = 45); Steel industry: N = 45 (E = 2, F = 2, O = 41); Military defense: N = 40 (F = 1, O = 39); Construction: N = 15 (O); Port (handling and shipping): N = 7 (E = 3, O = 4)

[32]