L. Bordini

1769d Combination of mirnas, mesothelin and fibulin-3 as potential biomarkers in malignant pleural mesothelioma and asbestos-exposed subjects

Introduction Malignant Pleural Mesothelioma (MPM) is an aggressive cancer mainly caused by asbestos exposure. Due to its long latency and insidious onset, MPM is often diagnosed in advanced stages with poor prognosis. In addition, asbestos is still used in many non-European countries and the incidence of MPM is expected to increase. In this context, the need of reliable diagnostic markers for early MPM diagnosis is of paramount importance. Along with the more frequently studied biological markers (mesothelin, fibulin-3), new emerging biomarkers include miRNA expression in peripheral blood. Methods We previously investigated 23 MPM patients and 19 subjects with past asbestos exposure (PAE) to examine if a specific miRNA signature in plasmatic extracellular vesicles (EV) might help to discriminate between MPM and PAE (PLoS One, 2017). Criteria for enrollment, blood collection, miRNA extraction, screening and validation have been previously described. We found a two miRNA (miR-103a-3p and mir-30-3ep) diagnostic signature that discriminates the two groups with high accuracy (AUC 0.942), high sensitivity (95.5%) and good specificity (80.0%). We are currently expanding our study population to additionally include 25 MPM cases, 50 subjects with PAE, and 20 subjects with other respiratory diseases. Alongside miRNA expression, plasma mesothelin and fibulin-3 will be also measured. Results The diagnostic performance (AUC, Sensitivity and Specificity) of the best five miRNAs previously detected in our study will be examined in combination with plasma mesothelin and fibulin-3, taking into account major confounders (e.g. age, gender, BMI and smoking habit). Conclusions The combination of biological markers belonging to different molecular pathways might help in identifying a panel of biomarkers able to improve the overall diagnostic performance as suggested by Weber et al. (PLoS One, 2014), who recently showed an improved AUC of 0.93 when combining mesothelin and miR-103a-3p.

1233 Estimating the prevalence of occupational exposure in lung cancer. results from an hospital-based case-series in italy

Introduction Lung cancer (LC) is the leading oncologic cause of death among males. The role of occupational history with exposure to well-established carcinogens is very important, but usually deeply underestimated. To undervalue the occupational origin of cancer can affect the efficacy of preventive measures and preclude patients to receive insurance benefits. We performed a systematic occupational medicine evaluation of a cases-series of lung cancer cases to properly quantify the proportion of LC cases with previous occupational exposure to carcinogens. Methods We systematically evaluated all consecutive LC cases hospitalised in a large university hospital, in Milan. An active systematic search was carried out for 24 months, by trained occupational physicians, using a standardised questionnaire. Results We collected 123 consecutive LC cases (66% males). Former and current smoking habit was found in 61% and 22%, respectively. A clear exposure to occupational carcinogens (in details: asbestos, polycyclic aromatic hydrocarbons, paintings, diesel exhaust) was recognised in 10% of males cases. Discussion Previous occupational exposure to carcinogens was frequent among males cases in Northern Italy. The observed prevalence was even lower than the one reported in a previous systematic search in Lombardy (Porru S, et al. Int Arch Occ Env Health 89:981–9). If we applied our observed proportion of occupational cases to the entire incident LC cases in Lombardy population, we should observe about 460 male occupational LC cases per year (AIRTUM-AIOM report 2016), actually more than the entire number of cancer (all sites, both gender) annually notified to National Institute for Insurance (INAIL Rapporto regionale 2015).

1769 Occupational disease and morbidity modelling

Aim of special session To highlight examples and best practice in the area of occupational disease and modelling morbidity.

PM10 exposure is associated with increased hospitalizations for respiratory syncytial virus bronchiolitis among infants in Lombardy, Italy

ABSTRACT Respiratory syncytial virus (RSV) is the primary cause of acute lower respiratory infections in children, bronchiolitis in particular. Airborne particulate matter (PM) may influence the childrens immune system and foster the spread of RSV infection. We aimed to verify whether PM10 exposure is associated with hospitalization due to RSV bronchiolitis. We selected hospital discharge records (HRD) with ICD‐9‐CM code 466.11 of infants < 1 year of age, occurring in the epidemic seasons of two years (2012–2013) in Lombardy, Italy. Cases were assigned daily PM10 and apparent temperature levels of the capital city of their residential province. Different exposure windows were considered: single days preceding hospitalization (lag 0 to 30), their average estimates (lag 0–1 to 0–30), and the four weeks preceding hospitalization (week 1 to 4). Negative binomial regression models adjusted for apparent temperature and season were applied to the daily counts of hospitalizations in each province. Results were expressed as incidence rate ratios (IRR) and 95% confidence intervals (95%CI) per 10 &mgr;g/m3 increase in PM10 concentration. Random effects meta‐analyses of province‐specific IRR were performed to obtain regional estimates. 2814 HRD met our inclusion criteria; males represented about 55% of the cases. A 6% increased risk of hospitalization (95%CI: 1.03–1.10) was found at lag 0 and an almost overlapping 7% increase at lag 1. IRR ranged from 1.03 to 1.05 between lags 2 and 11. No increased risk was observed from lag 12. When considering averaged daily lags, risk estimates gradually increased in the two weeks preceding hospitalization from 1.08 (1.04–1.12) at lag 0–1 to 1.15 (1.08–1.23) between lags 0–11 and 0–13. Analyses on weekly lags showed a risk increase of 6% (1.01–1.12) during week 1 and of 7% (1.02–1.13) during week 2. Our study found a clear association between short‐ and medium‐term PM10 exposures and increased risk of hospitalization due to RSV bronchiolitis among infants. HighlightsRespiratory syncytial virus bronchiolitis (RSV‐B) might be influenced by air pollution.PM10 was associated with RSV‐B hospitalizations among infants in Lombardy, Italy.The most relevant exposure windows were the 2 weeks preceding hospitalization.