Epidemiologist Dr Dario Mirabelli, former head of Piedmont’s Mesothelioma Register is no more

Statement from Silvana Mossano

Dr Dario Mirabelli, epidemiologist and former coordinator (head) of Piedmont’s Mesothelioma Register (Renan), died in Turin, Italy on February 9, 2025. He was 71 years old.

He was an expert witness in many trials and his testimony focused on asbestos and the onset of mesothelioma. In particular, the Turin Prosecution relied on his expertise both in the Eternit Uno maxi-trial and in the Eternit Bis trial, the appeal of the Court of Assizes being currently underway.

A serious illness led to his death extremely quickly, in a matter of just a few weeks. In mid-January he suffered the first symptoms, was diagnosed, and his condition quickly got worse.

The news of his death, which circulated on Sunday afternoon, was made public on February 10, 2025 in Turin’s courtroom 6 where one of the hearings of the Eternit Bis trial was taking place, now in its final stages before the Court of Assizes of Appeal.

The Court decided to interrupt the hearings because, it felt it necessary to further investigate medical-scientific aspects before reaching a verdict. Professor Corrado Magnani was summoned for this purpose, and Dr Dario Mirabelli had not died, he too would have returned to the trial on Monday 17 February, 2025 alongside his colleague. Together they had worked and presented the results of their studies in the first trial and before the Court of Assizes of Novara, in November 2021.

Dr Mirabelli and Prof Magnani were born in the same year –1953- had studied together at university and had become epidemiologists carrying out studies under the guidance of their ’ teacher and master’, Prof Benedetto Terracini, at the time director of what was then called the Servizio di Epidemiologia dei Tumori Convenzionato (Service of Cancer Epidemiology for the Health service) of the University of Turin and San Giovanni Battista Hospital, now CPO (Centre for Epidemiology and Oncological Prevention in Piedmont), which Prof. Terracini directed until his retirement in 1999.

Dr Mirabelli arrived at the CPO at the beginning of the 2000s, after a long period of experience at Spresal in Settimo Torinese.

He participated and carried out many scientific studies: the list of his papers is very long, many together with Professors Terracini, Magnani and other internationally recognised scientists in the field.

During his professional experience at the CPO, he was in charge of the Regional Operations Centre (COR) for Piedmont of the National Register of Mesotheliomas, which he followed meticulously, aware of how much the carefully gathered data, can contribute to scientific research aimed at finding a cure for malignant cancer caused by asbestos.

What can we say about Dr Dario Mirabelli the scientist? A well-prepared, curious, scrupulous researcher with the sort of self-effacement that makes the most authentic men of science aware of how small they are faced with the major issues. It was this intelligent and rigorous modesty that guided him in his constant activity of analysing in depth and comparing, with serious intellectual honesty and authoritative objectivity.

What can we say about Dr Dario Mirabelli as a person? The scientist, the countless studies, the valued consultations, the several scientific reports at conferences or in courtrooms give the measure of his professional skills, but as a man all we can say is that it has been a privilege to have known him.

He made himself understood with simple words, even when he had to explain difficult concepts. When challenged by his opponents, he reacted with the calm strength, courtesy and respect, with which he ended up determining the tone of the dialogue to his interlocutor.

Respectful of the thoughts and lives of others, deeply generous, a tireless worker who never jostled for limelight, Dario Mirabelli guarded his own feelings with modesty,  expressed with a kind smile, without complaining about a fate that had been cruel to him and his wife Claudia when, just over ten years ago, they lost their only son, Luca, to a very rare disease when he was very young.

Having retired a few years ago, Dr Mirabelli had never stopped studying and researching. This absence will be felt.

He loved the people of Casale Monferrato and shared their human suffering. For the people of Casale, it is a sad moment: they knew how much they had received from him and had great affection for him.

The funeral will take place on Wednesday 12th February at 10.30am at the city cemetery in Turin, at 135 Corso Novara.

Prof. Benedetto Terracini remembers Dr. Dario Mirabelli (Source:CPO website)

Dario Mirabelli passed away on Sunday 9th February, at the age of 71. He had retired a few years ago, but was very much present in the daily life of the CPO - Reference Centre for Epidemiology and Oncological Prevention in Piedmont.

Dario had approached cancer epidemiology as a student in the 1970s. From the Ipca tragedy in Ciriè he had perceived the role of the working environment on health. After graduating, he worked for over a decade as manager of SPreSAL (the Workplace Prevention and Safety Service) of the Local Health Authority of Settimo Torinese, maintaining excellent relations with the Department of Cancer Epidemiology and participating in several research projects, one of which measured the risk of work-related lung cancer in the Turin outskirts.

In 2000, he moved to the Piedmont CPO (Cancer Prevention Organisation), where he was in charge of the mesothelioma register. For the twenty years that followed, Dario and Corrado Magnani the responsibility of studying the effects of asbestos in Piedmont, both as scientific contributions and as expert witnesses in court, right up to the trial at the Court of Novara in 2021-2023 for the 392 deaths from mesothelioma in Casale Monferrato (the appeal trial is underway in Turin).

Under the headings ‘Mirabelli’ and ‘Asbestos’, Medline has 109 citations of publications with Dario as author. First and foremost, his work confirmed the notion that carcinogenesis - including that caused by asbestos – as a multistage process. A fair number of citations are letters to magazines, commenting on and criticising other people's publications, sponsored by industry, intended to pass off questionable scientific concepts, which could be used in court to exonerate those responsible for the exposures.

In Casale Monferrato, Dario played a key role in four different population case-control studies on mesotheliomas, which contributed to fine tuning the definition of the dose-response relationship between asbestos exposure and mesothelioma risk. For these studies, his ability to create a relationship of mutual sympathy and trust with the population of Casale was important, also in obtaining the cases and (above all) controls to be interviewed.

Furthermore, in the Balangero studies, Dario confirmed that chrysotile (white asbestos) can cause mesothelioma, disproving a concept favoured by producers (and often reported in magazines financed by them).

Some of Dario's literature reviews are a ‘must’ to understand the tortuous mechanisms of production of ‘fake scientific news’ which - unfortunately - can no longer be ignored by those who do research in epidemiology and public health.

Dario was also an important international researcher with numerous connections to the International Agency for Research on Cancer in Lyon, where he contributed to important projects and consortia. On a national level, he made a significant contribution to the development of the Mesothelioma Registry and the Nasosinusal Tumour Registry.

I had the privilege of working with Dario for over 40 years. We shared a model of scientific rigour and moral standards. Over time, our original teacher (me)/student (him) relationship was reversed: he taught me many things in recent years.

Dario (together with his wife Claudia) has faced painful experiences with courage and generosity. An example for all of us.

Statement from AFEVA (Association of Asbestos Victims and their Families) (Casale Monferrato)

‘To the family of our dear Dario, our deepest condolences and sympathy, from all the asbestos victims, the unions and all the active citizens of communities of Casale Monferrato and surroundings. Dr Dario Mirabelli has left us far too soon. We would like to express our heartfelt gratitude for his great and very valuable work in carrying out the most important epidemiological investigations into deaths caused by asbestos and other causes, including those in Casale, with the first ones in 1985-87 led by Prof. B. Terracini.

Great gratitude also certainly for the work he carried out together with a group of equally talented colleagues, for the Prosecutors in the Trials for the enormous massacres, such as for Eternit and others. A wonderful example of the choice of rigorous consistency in the work aimed at researching the causes and dimensions of workplace and environmental disasters, with the consequent scientific results. All this, always with a sensitive and friendly approach to human relationships and feelings. The way he was, as a scientist and as a man, gives us relief and hope in the face of the suffering and injustices that we often encounter in life.

Goodbye Dario, and thank you. 

Dr. Barry Castleman's Statement

Dario Mirabelli, one of the leading scientists documenting and analyzing mesothelioma deaths in Italy, has died. Dr. Mirabelli contributed a great deal to the criminal prosecutions of asbestos billionaire Stephan Schmidheiny, as an expert witness.  His studies of deaths at the mine in Balangero documented the potential of chrysotile asbestos to cause mesothelioma. I always enjoyed seeing Dario, he was so knowledgeable, kind, and modest.  He will be missed greatly, by many of us.

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India continues to import more of toxic white chrysotile mineral, despite banning its mining, lessons from excesses and malpractices of National Emergency forgotten

Nikkei Asia has published an investigative report entitled "India's appetite for asbestos undaunted by global bans:Expert says 'commercial interests' drive the trade of deadly fibers in South Asian nation". India's insatiable appetite for asbestos has been undaunted by a global push to ban the deadly fiber and warnings from experts over the health risks to millions in the world's top consumer. It states: "Though India banned asbestos mining in 1993 by ceasing to issue new licenses, it continues to import more of the toxic mineral than any other country. In 2023, the country accounted for 56.7% of the world's asbestos imports, with Brazil and Russia as its primary suppliers, according to World Bank trade data." 

Nikkei Asia story is linked to what Navin Chawla, said as the Secretary, Union Ministry of Consumer Affairs in 2004, when he was asked about his failure to ban asbestos laden consumer products. He said,"if his ministry had the power to ban asbestos ridden products, he would have banned it. Ministries of commerce, chemicals and health can ban it." Chawla passed away on February 1, 2025. 

Notably, the Superintendent of Tihar Jail had deposed before the Justice J. C. Shah Judicial Inquiry Commission stating that Chawla had asked him to throw political prisoners in asbestos cells and “bake” them. He wanted him to construct asbestos roof tops in some cells, so that hardcore political leaders could be kept there during the hot summer. 

The Shah Commission of Inquiry, led by retired chief justice of the Supreme Court of India, Justice Shah, was convened by the union government on May 28, 1977, under Section 3 of the Commissions of Inquiry Act, 1952, to inquire into the transgressions, violations, and violence committed during the national emergency. The commission submitted its evaluative findings on the grave conditions during the emergency in three parts in August 1978. The Commission held 100 sittings in open session. It submitted two interim reports.

Photo:Shah Commission of Inquiry, Interim Report I, March 11, 1978, Chapter 1, "Ministry of Home Affairs Notification” (1978, Page 1) 

At page no. 246 of the Commission's report, it is recorded:"Though Shri Navin Chawla had no position in the jail. hierarchy, he was exercising extra statutory control in jail matters and sending instructions on all matters including the treatment of particular detenus. Shri Chawla had suggested the construction of some Cells with asbestos roofs to 'bake' certain persons. (Para 11.47).

In the third part of its report, it observed: "The Commission has viewed with concern the evidence relating to the enormous power that was wielded by the lower functionaries like Shri R. K. Dhawan, Shri R. C. Mehtani, Shri Navin Chawla and some others; It is necessary for the Government to appreciate the need for defining the various functions and powers of the several lower functionaries who are in close proximity to the seats of power. The Commission views the developments in this regard with great concern, for power came to be exercised by some of these lower functionaries without the requisite authority and the accountability that goes with it. Power and responsibility must generally go together. During the emergency, the political component of Government in quite a few important cases came to be divorced from the channel of communication. The result was that powers came to be wielded by the Special Assistants or the Private Secretaries in the name of and on behalf of the Ministers, and the people at the receiving end of, the orders were left with no option but to carry out their orders without even having any facility or the desire to verify the authenticity and the authority of the orders emanating from the lower functionaries attached to the Ministers. This. style of functioning at higher level of the Administration has indeed taken a toll of the liberty and careers of countless people. The Government should define as precisely as it is possible, the circumstances under which the personal staff including Special Assistants and the Private Secretaries attached to the Ministers could convey orders. The Government should also provide checks and safeguards to ensure that in the event of doubt or difference of Opinion the levels receiving the orders from the Ministers are in a position to check back and satisfy themselves that the orders in, fact had emanated from the source in whose name the orders were issued. Unless every level of the Government starting with the political component and going down the line is animated by one and the only desire to function within a democratic set up with the ultimate aim and object being only to be able to look after the interest of the common man, there is no hope that we in this country will be able to graduate ourselves from mere words, to the real core of democracy". (p.230-231)  

The Shah Commission Report was presented to Parliament on August 3, 1978. It suggested a periodic review of all laws by the legislatures to ensure that the powers conferred on public servants are not abused or misused as had happened during the dark days of the emergency. In its final report presented to Parliament it has observed that unless public servants work for and establish a reputation of "political neutrality", the citizens will have no confidence in the impartiality and fairness of the services. 

 

 

 

Complaint filed in National Human Rights Commission for complete stoppage of ongoing exposure of Indians to carcinogenic asbestos fibers

A complaint was filed on January 27, 2025 in the National Human Rights Commission (NHRC) for prevention of continuous exposure to carcinogenic asbestos fibers from abandoned asbestos mines. The complaint is addressed to Justice V. Ramasubramanian, the new chairperson, NHRC drawing on Commission’s order dated May 6, 2024, and its mandate to save environment and health. 

The complainant drew the attention of the NHRC towards a paper entitled "Understanding exposure risk using soil testing and GIS around an abandoned asbestos mine" published in Annals of Global Health, a journal by Ubiquity Press Ltd, London on January 22, 2025. The paper has been authored by Abhijeet V. Jadhav, Nilesh Gawde, Ramesh Veerapan, Yeyong Choi and Arthur L. Frank. The paper has found that out of 16 soil samples from residential areas, 12 residential areas around the abandoned asbestos mines are a potential source of environmental contamination and exposure for nearby residents at Birsingh Hatu, Roro, Singijari and Tilaisud villages of West Singhbhum district, Roro Hills, Jharkhand. The asbestos exposure risk persists even after the cessation of mining activity. The paper is available at https://annalsofglobalhealth.org/articles/4624/files/67909e12a0727.pdf 

The study showed the presence of white chrysotile asbestos. The asbestos-containing areas had enlarged by around 20% over the years. It has concluded that "The evidence indicated the presence of asbestos in the soil of nearby residential areas around the mine, and this contamination has spread over the years. Similar studies at other mine locations are needed, and timely interventions are warranted to protect nearby residents." There was an asbestos mine that was operational from 1963 to 1983. The total population of these four villages was 2454 according to the 2011 census. The paper implies that the entire population of these four villages are exposed to asbestos in the soil. It has been established that contaminated soil is exposing people while doing routine activities.  

In the light of the findings of the paper, the National Mineral Policy, 2019 and the ‘Final Mine Closure Plan’ manual, 2022, there is an urgent need to ensure scientific and environmentally sound closure of the asbestos mine and disposal of hazardous asbestos waste (dust and fibres) to safeguard the life and health of villagers living in the vicinity of an old abandoned asbestos mine from exposure to carcinogenic fibres of asbestos.

It has been estimated that one person dies from mesothelioma for every 170 tons of asbestos consumed. WHO estimates we have 107,000 deaths worldwide per year from occupational exposure to asbestos. If non occupational exposure is added it reaches a figure of about 120,000deaths. Average world consumption/year 30-60 years ago was -- looks like 3/2 of what it is now (2 million metric tons/year). Give India its share of that based on its share of global consumption. At 300,000 tons in 2013, that's about 18,000 deaths (15% of 120,000). Asbestos diseases have a very long incubation period. So if you are exposed today to asbestos fibre, you are likely to get the disease in the next 10-35 years. Asbestos is like a time bomb to the lungs and Indians will suffer the most. If it is banned today that does not mean people will not suffer. Because of past usage people will continue to suffer from these diseases.

In this backdrop, the following documents are quite relevant:

1. Calcutta High Court’s verdict dated July 21, 2017 in Writ Petition (Civil). No. 14729 (W) of 2016, by the Division Bench of Acting Chief Justice Nishita Mhatre and Justice Tapabrata Chakraborty in Ashis Mitra vs. The State of West Bengal and Others drawing on Supreme Court's verdict of January 27, 1995 in Consumer Education and Research Center and Others Vs. Union of India & Others by the Bench of Justice K. Ramaswamy, Chief Justice A. M. Ahmadi and Justice M.M. Punchhi; 

2.  World Health Organisation (WHO)'s publication dated September 27, 2024 refers to the World Health Assembly Resolution 58.22 on cancer prevention urges Member States to pay special attention to cancers for which avoidable exposure is a factor, including exposure to chemicals at the workplace and in the environment. Eliminating asbestos-related diseases is particularly targeted at countries still using chrysotile asbestos, in addition to assistance in relation to exposures arising from historical use of all forms of asbestos. WHO, in collaboration with the International Labour Organization and other intergovernmental organizations and civil society, works with countries towards elimination of asbestos-related diseases by: recognizing that the most efficient way to eliminate asbestos-related diseases is to stop the use of all types of asbestos; providing information about solutions for replacing asbestos with safer substitutes and developing economic and technological mechanisms to stimulate its replacement;taking measures to prevent exposure to asbestos in place and during asbestos removal (abatement);improving early diagnosis, treatment, and rehabilitation services for asbestos-related diseases; establishing registries of people with past and/or current exposures to asbestos and organizing medical surveillance of exposed workers; and providing information on the hazards associated with asbestos-containing materials and products, and by raising awareness that waste containing asbestos should be treated as hazardous waste;

3. World Bank's Asbestos Good Practice Guidelines-These Guidelines, as well as its earlier Environmental, Health & Safety General Guidelines, require that the use of asbestos must be avoided in new construction in projects funded by the World Bank around the world. The Guidelines also provide information on available safer alternatives to asbestos;

4. Asian Development Bank (ADB)'s Good Practice Guidance for the Management and Control of Asbestos: Protecting Workplaces and Communities from Asbestos Exposure Risks, March 2022

5. Asbestos: Medical and Legal Aspects (2005), Barry I. Castleman, Stephen L. Berger,  Alphen aan den Rijn, Netherlands

The complaint pointed out that human biology is the same everywhere if asbestos is deemed hazardous in the developed countries; it must be deemed so in India as well.  There is an abundance of incontrovertible adverse health effects asbestos based plants and products which create a compelling logic for the phase out of all kinds of asbestos including white chrysotile to protect the lives of present and future generations.

Given the fact that there were 30 functional asbestos mines in India till 2001 and several asbestos mines were operational till 2014 in Rajasthan, Andhra Pradesh, and Jharkhand, the complainant has asked the Commission to recommend study of the presence of asbestos, its spread, and exposure in nearby communities around such abandoned mines by the authors of the paper and Asbestos: Medical and Legal Aspects, and to recommend measures to protect citizens who are exposed to carcinogenic fibres.

It has sought Commission's urgent intervention to recommend complete stoppage of ongoing exposure of Indians to carcinogenic asbestos fibers.