BACKGROUND:Cases of malignant mesothelioma (MM) in the non-asbestos textile industry have recently been described, but asbestos exposure in spinning and looming has seldom been reported. Nevertheless, on a national level the Italian Mesothelioma Registry (Re.Na.M) contains numerous cases of MM with past non-asbestos textile work but classified as "unknown" exposure due to poor information. OBJECTIVES:The aim of this research was to investigate possible past occupational exposure to asbestos in this specific industrial sector. METHODS:The MM cases were collected from the Mesothelioma Registry of Brescia. Work histories were obtained via a standardized questionnaire. Investigations were conducted in textile machinery manufacturing plants in order to collect information regarding the possible use of asbestos parts; at the same time, the use of asbestos friction materials and the use of sprayed asbestos for noise abatement purposes or thermal insulation was checked in the cotton industry by interviewing the management of two companies where a cluster of MM was observed. RESULTS:The Mesothelioma Registry of Brescia retrieved and collected 15 MM cases with past work in the cotton spinning industry, 4 of them employed in the same company. Further search of asbestos use gave positive results as the use of friction materials has been widespread since the fifties, while sprayed asbestos was not found anywhere in the cotton industry. On the other hand, half of the cases were employed during the thirties and forties, when friction materials appear to have been asbestos-free. Therefore the other hypothesis of exposure could be direct manufacture of asbestos yarn. CONCLUSION:The results of this investigation indicate the attribution, at least, of possible asbestos exposure"for those cases employed in textile industries since the fifties, according to the Re.Na.M guidelines; for those cases employed before that period the same classification can be attributed on an epidemiological basis. Previous work periods need further investigation in order to demonstrate the circumstances of the occupational asbestos exposure, given the heterogeneity of work processes and machinery characteristic of this industrial sector.