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Zunarelli C, Godono A, Visci G, Violante FS, Boffetta P. Occupational exposure to asbestos and risk of kidney cancer: an updated meta-analysis. Eur J Epidemiol 2021; 36:927-936. [PMID: 34195879 PMCID: PMC8502743 DOI: 10.1007/s10654-021-00769-x] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2021] [Accepted: 05/28/2021] [Indexed: 12/24/2022]
Abstract
Limited information is available on carcinogenicity of asbestos on non-respiratory organs. We aimed at conducted an updated systematic review and meta-analysis of cohort studies on occupational exposure to asbestos and risk of kidney cancer. We searched through three databases, PubMed, Embase and Scopus for article published after 2000, and after eliminating duplicates and non-relevant studies, we identified 13 studies. We combined their results with those of 31 non-overlapping studies included in a previous review up to 2000. We conducted a meta-analysis based on random-effects models. The pooled relative risk of kidney cancer for asbestos exposure was 0.94 (95% confidence interval, 0.84–1.04), with no differences according to type of asbestos fiber, geographic region, period of exposure, or estimated quality of the study. Our results showed a lack of association between occupational asbestos exposure and risk of kidney cancer.
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Affiliation(s)
- Carlotta Zunarelli
- Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy
| | - Alessandro Godono
- Department of Public Health and Pediatric Sciences, University of Turin, Turin, Italy
| | - Giovanni Visci
- Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy
| | - Francesco S Violante
- Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy
| | - Paolo Boffetta
- Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy.
- Stony Brook Cancer Center, Stony Brook University, Lauterbur Dr, Stony Brook, NY, 11794, USA.
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Ferrante D, Chellini E, Merler E, Pavone V, Silvestri S, Miligi L, Gorini G, Bressan V, Girardi P, Ancona L, Romeo E, Luberto F, Sala O, Scarnato C, Menegozzo S, Oddone E, Tunesi S, Perticaroli P, Pettinari A, Cuccaro F, Mattioli S, Baldassarre A, Barone-Adesi F, Cena T, Legittimo P, Marinaccio A, Mirabelli D, Musti M, Pirastu R, Ranucci A, Magnani C. Italian pool of asbestos workers cohorts: mortality trends of asbestos-related neoplasms after long time since first exposure. Occup Environ Med 2017; 74:887-898. [PMID: 28775133 DOI: 10.1136/oemed-2016-104100] [Citation(s) in RCA: 41] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2016] [Revised: 04/05/2017] [Accepted: 05/17/2017] [Indexed: 11/04/2022]
Abstract
OBJECTIVE Asbestos is a known human carcinogen, with evidence for malignant mesothelioma (MM), cancers of lung, ovary, larynx and possibly other organs. MM rates are predicted to increase with a power of time since first exposure (TSFE), but the possible long-term attenuation of the trend is debated. The asbestos ban enforced in Italy in 1992 gives an opportunity to measure long-term cancer risk in formerly exposed workers. METHODS Pool of 43 previously studied Italian asbestos cohorts (asbestos cement, rolling stock, shipbuilding), with mortality follow-up updated to 2010. SMRs were computed for the 1970â€"2010 period, for the major causes, with consideration of duration and TSFE, using reference rates by age, sex, region and calendar period. RESULTS The study included 51 801 subjects (5741 women): 55.9% alive, 42.6% died (cause known for 95%) and 1.5% lost to follow-up. Mortality was significantly increased for all deaths (SMR: men: 1.05, 95% CI 1.03 to 1.06; women: 1.17, 95% CI to 1.12 to 1.22), all malignancies combined (SMR: men: 1.17, 95% CI to 1.14 to 1.20; women: 1.33, 95% CI 1.24 to 1.43), pleural and peritoneal malignancies (SMR: men: 13.28 and 4.77, 95% CI 12.24 to 14.37 and 4.00 to 5.64; women: 28.44 and 6.75, 95% CI 23.83 to 33.69 and 4.70 to 9.39), lung (SMR: men: 1.26, 95% CI 1.21 to 1.31; women: 1.43, 95% CI 1.13 to 1.78) and ovarian cancer (SMR=1.38, 95% CI 1.00 to 1.87) and asbestosis (SMR: men: 300.7, 95% CI 270.7 to 333.2; women: 389.6, 95% CI 290.1 to 512.3). Pleural cancer rate increased during the first 40 years of TSFE and reached a plateau after. DISCUSSION The study confirmed the increased risk for cancer of the lung, ovary, pleura and peritoneum but not of the larynx and the digestive tract. Pleural cancer mortality reached a plateau at long TSFE, coherently with recent reports.
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Affiliation(s)
- Daniela Ferrante
- Department of Translational Medicine, Unit of Medical Statistics and Epidemiology, University of Eastern Piedmont, and CPO-Piemonte, Novara, Italy
| | - Elisabetta Chellini
- Occupational & Environmental Epidemiology Unit, Cancer Prevention and Research Institute (ISPO), Florence, Italy
| | - Enzo Merler
- Local Health Unit, Mesothelioma Register of the Veneto Region, Padua, Italy
| | - Venere Pavone
- Department of Public Health, Prevention and Security Area Work Environments, Local Health Authority, Bologna, Italy
| | | | - Lucia Miligi
- Occupational & Environmental Epidemiology Unit, Cancer Prevention and Research Institute (ISPO), Florence, Italy
| | - Giuseppe Gorini
- Occupational & Environmental Epidemiology Unit, Cancer Prevention and Research Institute (ISPO), Florence, Italy
| | - Vittoria Bressan
- Local Health Unit, Mesothelioma Register of the Veneto Region, Padua, Italy
| | - Paolo Girardi
- Local Health Unit, Mesothelioma Register of the Veneto Region, Padua, Italy
| | - Laura Ancona
- Department of Epidemiology, Lazio Regional Health Service, Rome, Italy
| | - Elisa Romeo
- Department of Epidemiology, Lazio Regional Health Service, Rome, Italy
| | - Ferdinando Luberto
- Inter-institutional Epidemiology Unit, AUSL Reggio Emilia and Arcispedale Santa Maria Nuova, IRCCS, Reggio Emilia, Italy
| | - Orietta Sala
- ARPAE Emilia Romagna, Sezione Provinciale di Reggio Emilia, Reggio Emilia, Italy
| | - Corrado Scarnato
- Department of Public Health, Prevention and Security Area Work Environments, Local Health Authority, Bologna, Italy
| | - Simona Menegozzo
- National Cancer Institute IRCCS Fondazione Pascale, Napoli, Italy
| | - Enrico Oddone
- Department of Public Health, Experimental and Forensic Medicine, University of Pavia, Pavia, Italy
| | - Sara Tunesi
- Department of Translational Medicine, Unit of Medical Statistics and Epidemiology, University of Eastern Piedmont, and CPO-Piemonte, Novara, Italy.,Unit of Cancer Epidemiology, CPO Piemonte and University of Turin, Turin, Italy
| | | | | | - Francesco Cuccaro
- Unit of Epidemiology and Statistics -Local Health Unit of Barletta-Andria-Trani, Barletta, Italy
| | - Stefano Mattioli
- Department Medical and Surgical Sciences, University of Bologna, Bologna, Italy.,Unit of Occupational Medicine, S.Orsola-Malpighi University Hospital, Bari, Italy
| | - Antonio Baldassarre
- Interdisciplinary Department of Medicine, Occupational Medicine 'B. Ramazzini, University of Bari, Bari, Italy
| | | | - Tiziana Cena
- Department of Translational Medicine, Unit of Medical Statistics and Epidemiology, University of Eastern Piedmont, and CPO-Piemonte, Novara, Italy
| | - Patrizia Legittimo
- Department Medical and Surgical Sciences, University of Bologna, Bologna, Italy.,Unit of Occupational Medicine, S.Orsola-Malpighi University Hospital, Bari, Italy
| | - Alessandro Marinaccio
- Italian Workers' Compensation Authority (INAIL), Department of Occupational and Environmental Medicine, Epidemiology and Hygiene, Unit of Occupational and Environmental Epidemiology, Italian Mesothelioma Register, Rome, Italy
| | - Dario Mirabelli
- Unit of Cancer Epidemiology, CPO Piemonte and University of Turin, Turin, Italy
| | - Marina Musti
- Interdisciplinary Department of Medicine, Occupational Medicine 'B. Ramazzini, University of Bari, Bari, Italy
| | - Roberta Pirastu
- Department of Biology and Biotechnologies'Charles Darwin', Sapienza Rome University, Rome, Italy
| | - Alessandra Ranucci
- Department of Translational Medicine, Unit of Medical Statistics and Epidemiology, University of Eastern Piedmont, and CPO-Piemonte, Novara, Italy
| | - Corrado Magnani
- Department of Translational Medicine, Unit of Medical Statistics and Epidemiology, University of Eastern Piedmont, and CPO-Piemonte, Novara, Italy
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