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Between the end of the 19th century and the beginning of the 20th numerous asbestos industries began operations in various parts of the world. At the time of the First World War there is ample evidence of the use of this mineral in shipbuilding, the aircraft industry and in the construction industry. In the years 1912-17 the writer Franz Kafka was co-proprietor of a small asbestos factory in Prague. Some of the writer's novels and journal pages were inspired by this experience. In this way asbestos entered into the history of 20th century European literature. In 1917 asbestos extraction was started at the quarry in Balangero, near Turin, Italy. Risks related to the use of asbestos were known at the beginning of the 20th century and legislation aimed at preventing the harmful effects of the mineral were approved in Italy.

Asbestos was used in making pottery in Eastern Finland from around 4000 B.C. In the ancient era and in the Middle Ages, magic properties were frequently attributed to this mineral. In the first century A.D., the Latin encyclopaedist Pliny the Elder reported in his Historia Naturalis that asbestos protects against all poisonings, particularly that of magicians. Moreover, asbestos was often found in places of worship, in Rome as well as in Athens and in Jerusalem. In the Middle Ages asbestos was identified with some animals, such as the salamander and certain white rodents. With such appearance, the mineral  had a huge success in Western as well as in Eastern literature and the fine arts. Marco Polo (1254-1324) in the Milione tried to deny that asbestos was a salamander. Despite its noxious effects, asbestos continues to be used in much of the world. In the 21st century it seems to be maintaining its quality as a magic stone.

Background: The Province of Trieste, north-eastern Italy (population about 240,000), has been identified as an area with a high incidence of pleural mesothelioma., Objectives: (i) To obtain preliminary data on the trend of the mesothelioma epidemic in the Province of Trieste during the last six years; (ii) to define the cases in terms of asbestos exposure., Methods: Pleural mesotheliomas diagnosed at the Department of Surgery, Thoracic Surgery Unit, Trieste University, in the period January 2001-May 2006 were reviewed. The histological diagnosis was generally based on material obtained at thoracoscopy, pleurectomy, or pleuropneumonectomy. In three cases the pathological diagnosis was made by biopsy of the thoracic wall, and in a further three cases by cytological examination ofpleuralfluid. Detailed occupational histories were obtained from the patients themselves at the time of first admission., Results: The group included 99 people resident in the Province of Trieste (89 men and 10 women, aged between 43 and 89 years). On the basis of the occupational history, 95 cases were defined as asbestos-related. A majority ofpatients had been employed in marine work, including shipbuilding (46 cases), port activity (13 cases), and maritime trades (8 cases). Thirteen patients had worked in other industries (iron industry, petrochemical, etc.). Fourteen people had been employed in a variety of occupations (fire-fighter, lift mechanic, cinema projectionist, pastry worker, telephone technician, etc.). Five women had histories of exposure to asbestos at home. About 70% of the patients had their first exposure to asbestos before 1960. Two-thirds of the cases were exposed to asbestos for 20 years or more. Latency periods (time intervals elapsed between first exposure to asbestos and diagnosis of mesothelioma) rangedfrom 25 to 71 years (mean 49.3, median 49.0). One patient had a history ofprior thoracic irradiationfor Hodgkin's disease., Conclusions: In the Province of Trieste the mesothelioma epidemic does not show any signs of abatement. Besides marine work, a variety of other occupations appear to be associated with the tumour in this area.

Background: A large amount of data indicates that seafarers are at risk for asbestos disease., Objectives: To trace the outlines of pleural mesothelioma among seafarers., Methods: Pleural mesotheliomas diagnosed among seamen in the Trieste-Monfalcone area, Italy, in the period 1973-2003, were reviewed., Results: The series comprised 50 men aged between 53 and 91 years (mean age 75.7 years). The diagnosis of mesothelioma was confirmed by necropsy in 38 cases. The patients had served in the Italian Navy (24 persons), in the merchant navy (17 persons), or in both (9 persons). The trades were various including engine room as well as deck personnel. Asbestos bodies were detected on routine lung sections in 55% of the necropsy cases. Asbestos bodies isolated from the lungs in three cases ranged between 2100 and 7000 bodies per gram of dried tissue. Latency periods ranged between 33 and 72 years (mean 56.1 years)., Conclusions: When compared with shipyard workers, the seamen with mesothelioma show signs of less intense exposure to asbestos, and longer latency periods. Mesothelioma in seamen should be considered as an occupational disease.

Background: The epidemiological features of mesothelioma among women differ from those observed among men., Objectives: To trace the outline of pleural mesothelioma among women in the Monfalcone area, Italy., Methods: Thirty-three malignant mesotheliomas of the pleura observed in female patients at the Hospital of Monfalcone, Italy, in the period 1979-2002 were reviewed. The diagnosis was based on/or confirmed by necropsy findings in 30 cases. Occupational and social histories were obtained from the patients themselves or from their relatives by personal or telephone interviews. In 29 necropsy cases thoracic cavities were examined for the presence of pleural plaques. Routine lung section were examined for asbestos bodies in 30 cases. In 21 cases asbestos bodies were isolated and counted after chemical digestion of lung tissue., Results: The age of the patients ranged between 48 and 89 years (mean 72.85, median 73.00). All the patients had histories of exposure to asbestos, single in 25 cases and mixed in 8. Exposure at home due to cleaning of work clothes was the most frequent type of exposure. Various patients had been exposed in non-asbestos text industries (cotton mills). Unusual types of exposure occurred in some cases (distillery, small sodium carbonate factory, starch factory). The latency periods (time intervals elapsed between first exposure to asbestos and diagnosis of the tumour), calculated in 23 cases, ranged from 34 to 62 years. Pleural plaques were found in 21 cases. Twelve patients showed asbestos bodies on routine lung sections. The asbestos body burden ranged between only a few bodies and 92,000/g dried tissue., Conclusions: In contrast with other series of mesothelioma among women, all the present cases were attributable to asbestos. The detection of objective signs of exposure (pleural plaques, lung asbestos bodies) played a key role in attribution.