Pleural Mesothelioma: forecasts of the death toll in the area of Casale Monferrato, Italy

In the city of Casale Monferrato, the largest Italian factory that produced asbestos cement goods was active from 1907 to 1985. As a consequence, asbestos fibers scattered in the surrounding area and caused an enormous number of pleural mesotheliomas. Due to the very long latency of this disease, many subjects have not exhibited its symptoms yet. The aim of this paper is to model and predict the future evolution of the number of deaths due to this disease among residents in the area around that city. The model used here is based on a Cellular Automata that is assumed to pass through three steps: exposure, contamination, diagnosis. In that way, forecasts of the future evolution take into account the environmental conditions that changed in time during the last century because of different levels in plant activity. The model is fitted to annual diagnosis data starting from 1954 to 2009. Results show that deaths will not end until 2033, and that in the next two decades, at least 479 more subjects will be diagnosed with this disease.