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BACKGROUND The Tuscan Regional Operating Center (ROC) of Malignant Mesotheliomas has identified a cluster of 11 cases of malignant mesothelioma occurred in a textile plant manufacturing sewing thread. Using the common research method, the ROC had not previously been able to identify the specific sources of asbestos exposure causing such a large cluster. OBJECTIVES The ROC's objective was to review all cases of the cluster and to better identify their occupational asbestos exposures. METHODS The cases' occupational histories of asbestos