Supplement For reprint orders, please contact: reprints@futuremedicine.com Occupational exposure to fuoro-edenite and prevalence of anti-nuclear autoantibodies Venerando Rapisarda ‡,1 , Carla Loreto ‡,2 , Sergio Castorina 2 , Gaetano Romano 1 , Sebastiano Fabio Garozzo 3 , Andrea Musumeci 4 , Marcello Migliore 5 , Roberto Avola 6 , Diana Cin ` a 3 , Cristoforo Pomara 7,8 & Caterina Ledda* ,1 1 Occupational Medicine, Department of Clinical & Experimental Medicine, University of Catania, Catania, Italy 2 Human Anatomy & Histology, Department of Biomedical & Biotechnology Sciences, University of Catania, Catania, Italy 3 Clinical Pathology Unit, ‘Garibaldi Centro’ Hospital of Catania, Italy 4 Radiology Unit, ‘Policlinico G. Rodolico’ Universitary Hospital of Catania, Catania, Italy 5 Academic Thoracic Surgery Unit, University Hospital ‘Policlinico-Vittorio Emanuele’, Department of Surgery, University of Catania, Catania, Italy 6 Biochemistry, Department of Biomedical Sciences & Biotechnology, University of Catania, Catania, Italy 7 Legal Medicine, Department of Clinical & Experimental Medicine, University of Foggia, Foggia, Italy 8 School of Medicine, Department of Anatomy, University of Malta, Msida, Malta * Author for correspondence: cledda@unict.it ‡ Authors contributed equally An environmental contamination due to an asbestiform mineral fber, fuoro-edenite (FE), caused a sig- nifcantly increased mortality rate for malignant mesothelioma in Biancavilla, Italy. Exposure to fuoro- edenite has been associated with infammatory processes as an early response to inhaled fbers. The aim was to explore prevalence of anti-nuclear autoantibodies (ANA) in a group of construction workers resid- ing and working in the contaminated area. Prevalences for samples positive to ANA were 60% (n = 9) and 13% (n = 2), for exposed and nonexposed, respectively (p-value <0.05), the odds ratio was 9.75 (95% CI: 1.59–59.69). The signifcance of elevated ANAs in subjects exposed to fbers is unknown; additional studies may provide a better opportunity to establish a correlation between autoimmunity and environmental exposure. First draft submitted: 4 August 2017; Accepted for publication: 31 October 2017; Published online: 17 March 2018 Keywords asbestos • autoimmunity • workers In the 1990s, a significantly increased mortality rate from malignant mesothelioma was reported in Biancavilla, a town on the southwest slope of Mt Etna in Italy [1]. Later studies spotted an asbestiform mineral fiber, named fluoro-edenite (FE), in the lava rocks excavated from a local stone quarry. The derived material had been employed for about 50 years for houses and roads construction nearby. The quarry was shut down in 1998 [2]. FE fibers share size and morphology similarities with certain amphibolic asbestos fibers, such as antophyllite, actinolite and tremolite [2]. After some in vitro, in vivo, and epidemiological studies [3–5], FE has been classified as carcinogenic to humans by the International Agency for Research on Cancer (Lyon, France) [6]. Exposure to FE has been associated with unbalanced inflammatory processes as an early response to inhaled fibers [7,8]. Immune system cells have been regarded as the main players in bringing about acute or chronic inflammation [7–10]. However, recent studies have shown that epithelial cells of the respiratory tract and mesothelial cells lining the body cavities are capable of starting inflammatory events after exposure to pathogenic fibers in the absence of immune system cells [8]. Autoimmune diseases such as rheumatoid arthritis, multiple sclerosis and systemic lupus erythematosus seem to be the product of a complex and poorly understood interaction between environmental exposure and genetic predisposition [11]. Autoantibodies may be markers of subclinical diseases [11]. Previous studies found evidence that Future Oncol. (2018) 14(6s), 59–62 ISSN 1479-6694 59 10.2217/fon-2017-0389 C  2018 Future Medicine Ltd