1
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Azzolina D, Consonni D, Ferrante D, Mirabelli D, Silvestri S, Luberto F, Angelini A, Cuccaro F, Nannavecchia AM, Oddone E, Vicentini M, Barone-Adesi F, Cena T, Mangone L, Roncaglia F, Sala O, Menegozzo S, Pirastu R, Tunesi S, Chellini E, Miligi L, Perticaroli P, Pettinari A, Bressan V, Merler E, Girardi P, Bisceglia L, Marinaccio A, Massari S, Magnani C. Rate advancement measurement for lung cancer and pleural mesothelioma in asbestos-exposed workers. Thorax 2023; 78:808-815. [PMID: 36357176 DOI: 10.1136/thorax-2021-217862] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2021] [Accepted: 10/13/2022] [Indexed: 11/12/2022]
Abstract
INTRODUCTION Exposure to asbestos increases the risk of lung cancer and mesothelioma. Few studies quantified the premature occurrence of these diseases in asbestos-exposed workers. Focus on premature disease onset (rate advancement or acceleration) can be useful in risk communication and for the evaluation of exposure impact. We estimated rate advancement for total mortality, lung cancer and pleural mesothelioma deaths, by classes of cumulative asbestos exposure in a pooled cohort of asbestos cement (AC) workers in Italy. METHOD The cohort study included 12 578 workers from 21 cohorts, with 6626 deaths in total, 858 deaths from lung cancer and 394 from pleural malignant neoplasm (MN). Rate advancement was estimated by fitting a competitive mortality Weibull model to the hazard of death over time since first exposure (TSFE). RESULT Acceleration time (AT) was estimated at different TSFE values. The highest level of cumulative exposure compared with the lowest, for pleural MN AT was 16.9 (95% CI 14.9 to 19.2) and 33.8 (95% CI 29.8 to 38.4) years at TSFE of 20 and 40 years, respectively. For lung cancer, it was 13.3 (95% CI 12.0 to 14.7) and 26.6 (95% CI 23.9 to 29.4) years, respectively. As for total mortality, AT was 3.35 (95% CI 2.98 to 3.71) years at 20 years TSFE, and 6.70 (95% CI 5.95 to 7.41) at 40 years TSFE. CONCLUSION The current study observed marked rate advancement after asbestos exposure for lung cancer and pleural mesothelioma, as well as for total mortality.
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Affiliation(s)
| | - Dario Consonni
- Unit of Epidemiology, Fondazione IRCCS Ca' Granda-Ospedale Maggiore Policlinico, Milan, Italy
| | - Daniela Ferrante
- Department of Translational Medicine, Unit of Medical Statistics and Cancer Epidemiology, Università degli Studi del Piemonte Orientale Amedeo Avogadro, Novara, Italy
| | - Dario Mirabelli
- Unit of Cancer Epidemiology, CPO Piedmont and University of Turin, Turin, Italy
| | - Stefano Silvestri
- Department of Translational Medicine, Unit of Medical Statistics and Cancer Epidemiology, Università degli Studi del Piemonte Orientale Amedeo Avogadro, Novara, Italy
| | - Ferdinando Luberto
- Epidemiology Unit, Azienda Unità Sanitaria Locale-IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | - Alessia Angelini
- Department of Translational Medicine, Unit of Medical Statistics and Cancer Epidemiology, Università degli Studi del Piemonte Orientale Amedeo Avogadro, Novara, Italy
| | - Francesco Cuccaro
- Unit of Epidemiology and Statistics, Local Health Unit of Barletta-Andria-Trani, Barletta, Italy
| | - Anna Maria Nannavecchia
- Unit of Epidemiology and Statistics, Local Health Unit of Barletta-Andria-Trani, Barletta, Italy
| | - Enrico Oddone
- Department of Public Health, Experimental and Forensic Medicine, University of Pavia, and ICS Maugeri IRCCS, Pavia, Italy
| | - Massimo Vicentini
- Epidemiology Unit, Azienda Unità Sanitaria Locale-IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | - Francesco Barone-Adesi
- Unit of Public Health, Department of Translational Medicine, University of Eastern Piedmont, Novara, Italy
| | - Tiziana Cena
- Department of Translational Medicine, Unit of Medical Statistics and Cancer Epidemiology, Università degli Studi del Piemonte Orientale Amedeo Avogadro, Novara, Italy
| | - Lucia Mangone
- Epidemiology Unit, Azienda Unità Sanitaria Locale-IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | - Francesca Roncaglia
- Epidemiology Unit, Azienda Unità Sanitaria Locale-IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | - Orietta Sala
- Regional Agency for Protection, Environment and Energy Emilia-Romagna, Reggio Emilia, Italy
| | - Simona Menegozzo
- National Cancer Institute IRCCS Fondazione Pascale, Napoli, Italy
| | - Roberta Pirastu
- Department of Biology and Biotechnologies 'Charles Darwin', Sapienza University, Rome, Italy
| | - Sara Tunesi
- Department of Translational Medicine, Unit of Medical Statistics and Cancer Epidemiology, Università degli Studi del Piemonte Orientale Amedeo Avogadro, Novara, Italy
| | - Elisabetta Chellini
- Occupational & Environmental Epidemiology Unit-Institute for Cancer Research, Prevention and Clinical Network (ISPRO), Firenze, Italy
| | - Lucia Miligi
- Occupational & Environmental Epidemiology Unit-Institute for Cancer Research, Prevention and Clinical Network (ISPRO), Firenze, Italy
| | | | | | | | - Enzo Merler
- Mesothelioma Register of the Veneto Region, Regional Epidemiologic System, Local Health Unit 6, Padua, Italy
| | - Paolo Girardi
- Mesothelioma Register of the Veneto Region, Regional Epidemiologic System, Local Health Unit 6, Padua, Italy
- Department of Developmental and Social Psychology Department of Statistical Sciences University of Padova, Padua, Italy
| | - Lucia Bisceglia
- Apulia Regional Agency for Health and Social Policies-ARESS Puglia, 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, Roma, Italy
| | - Stefania Massari
- Italian Workers' Compensation Authority (INAIL), Department of Occupational and Environmental Medicine, Epidemiology and Hygiene, Unit of Occupational and Environmental Epidemiology, Italian Mesothelioma Register, Roma, Italy
| | - Corrado Magnani
- Department of Translational Medicine, Unit of Medical Statistics and Cancer Epidemiology, Università degli Studi del Piemonte Orientale Amedeo Avogadro, Novara, Italy
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Magnani C, Silvestri S, Angelini A, Ranucci A, Azzolina D, Cena T, Chellini E, Merler E, Pavone V, Miligi L, Gorini G, Bressan V, Girardi P, Bauleo 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, Musti M, Mirabelli D, Pirastu R, Marinaccio A, Massari S, Ferrante D. Italian pool of asbestos workers cohorts: asbestos related mortality by industrial sector and cumulative exposure. Ann Ist Super Sanita 2021; 56:292-302. [PMID: 32959795 DOI: 10.4415/ann_20_03_07] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
OBJECTIVE Italy has been a large user of asbestos and asbestos containing materials until the 1992 ban. We present a pooled cohort study on long-term mortality in exposed workers. METHODS Pool of 43 Italian asbestos cohorts (asbestos cement, rolling stock, shipbuilding, glasswork, harbors, insulation and other industries). SMRs were computed by industrial sector for the 1970-2010 period, for the major causes, 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. Asbestos exposure was estimated at the plant and period levels. Asbestos related mortality was significantly increased. All industrial sectors showed increased mortality from pleural malignancies, and most also from peritoneal and lung cancer and asbestosis, with exposure related trend. Increased mortality was also observed for ovarian cancer and for bladder cancer. 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. A large increase in mortality from asbestosis was observed.
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Affiliation(s)
- Corrado Magnani
- Dipartimento di Medicina Traslazionale, Università degli Studi del Piemonte Orientale, Novara, Italy - Centro Interdipartimentale per lo Studio degli Amianti e di altri Particolati Nocivi "Giovanni Scansetti", Università degli Studi di Torino, Turin, Italy
| | - Stefano Silvestri
- Dipartimento di Medicina Traslazionale, Università degli Studi del Piemonte Orientale, Novara, Italy
| | - Alessia Angelini
- Dipartimento di Medicina Traslazionale, Università degli Studi del Piemonte Orientale, Novara, Italy
| | - Alessandra Ranucci
- Dipartimento di Medicina Traslazionale, Università degli Studi del Piemonte Orientale, Novara, Italy
| | - Danila Azzolina
- Dipartimento di Medicina Traslazionale, Università degli Studi del Piemonte Orientale, Novara, Italy
| | - Tiziana Cena
- Dipartimento di Medicina Traslazionale, Università degli Studi del Piemonte Orientale, Novara, Italy
| | - Elisabetta Chellini
- Istituto per lo Studio, la Prevenzione e la Rete Oncologica (ISPRO), Florence, Italy
| | - Enzo Merler
- Registro Mesoteliomi del Veneto, Sistema Epidemiologico Regionale, ASL 6, Padua, Italy
| | - Venere Pavone
- Dipartimento di Sanità Pubblica, Azienda Sanitaria Locale, Bologna, Italy
| | - Lucia Miligi
- Istituto per lo Studio, la Prevenzione e la Rete Oncologica (ISPRO), Florence, Italy
| | - Giuseppe Gorini
- Istituto per lo Studio, la Prevenzione e la Rete Oncologica (ISPRO), Florence, Italy
| | - Vittoria Bressan
- Registro Mesoteliomi del Veneto, Sistema Epidemiologico Regionale, ASL 6, Padua, Italy
| | - Paolo Girardi
- Registro Mesoteliomi del Veneto, Sistema Epidemiologico Regionale, ASL 6, Padua, Italy
| | - Lisa Bauleo
- Dipartimento di Epidemiologia del Servizio Sanitario Regionale, ASL RM 1, Rome, Italy
| | - Elisa Romeo
- Dipartimento di Epidemiologia del Servizio Sanitario Regionale, ASL RM 1, Rome, Italy
| | - Ferdinando Luberto
- Servizio di Epidemiologia, Azienda Unità Sanitaria Locale, IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | - Orietta Sala
- formerly ARPAE Emilia-Romagna, Ufficio Provinciale di Reggio Emilia, Reggio Emilia, Italy
| | - Corrado Scarnato
- Dipartimento di Sanità Pubblica, Azienda Sanitaria Locale, Bologna, Italy
| | - Simona Menegozzo
- Istituto Nazionale Tumori IRCCS Fondazione G.Pascale, Naples, Italy
| | - Enrico Oddone
- Dipartimento di Sanità Pubblica, Medicina Sperimentale e Forense, Università degli Studi di Pavia, Pavia, Italy
| | - Sara Tunesi
- Dipartimento di Medicina Traslazionale, Università degli Studi del Piemonte Orientale, Novara, Italy
| | | | - Aldo Pettinari
- Dipartimento Prevenzione, ASUR Marche, Senigallia, Italy
| | - Francesco Cuccaro
- Unità di Epidemiologia e Statistica, Unità Sanitaria Locale di Barletta-Andria-Trani, Barletta, Italy
| | - Stefano Mattioli
- Dipartimento di Scienze Mediche e Chirurgiche, Università degli Studi di Bologna, Bologna, Italy
| | - Antonio Baldassarre
- Unità di Medicina del Lavoro, Azienda Ospedaliero-Universitaria Careggi, Florence, Italy
| | - Francesco Barone-Adesi
- Dipartimento di Medicina Traslazionale, Università degli Studi del Piemonte Orientale, Novara, Italy
| | - Marina Musti
- Dipartimento Interdisciplinare di Medicine, Università degli Studi di Bari, Bari, Italy
| | - Dario Mirabelli
- Unità di Epidemiologia dei Tumori, Università degli Studi di Torino, Turin, Italy - Centro Interdipartimentale per lo Studio degli Amianti e di altri Particolati Nocivi "Giovanni Scansetti", Università degli Studi di Torino, Turin, Italy
| | - Roberta Pirastu
- Dipartimento di Biologia e Biotecnologie "Charles Darwin", La Sapienza Università di Roma, Rome, Italy
| | - Alessandro Marinaccio
- Dipartimento di Medicina, Epidemiologia, Igiene del Lavoro e Ambientale, Istituto Nazionale per l'Assicurazione contro gli Infortuni sul Lavoro (INAIL), Rome, Italy
| | - Stefania Massari
- Dipartimento di Medicina, Epidemiologia, Igiene del Lavoro e Ambientale, Istituto Nazionale per l'Assicurazione contro gli Infortuni sul Lavoro (INAIL), Rome, Italy
| | - Daniela Ferrante
- Dipartimento di Medicina Traslazionale, Università degli Studi del Piemonte Orientale, Novara, Italy
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Girardi P, Merler E, Ferrante D, Silvestri S, Chellini E, Angelini A, Luberto F, Fedeli U, Oddone E, Vicentini M, Barone-Adesi F, Cena T, Mirabelli D, Mangone L, Roncaglia F, Sala O, Menegozzo S, Pirastu R, Azzolina D, Tunesi S, Miligi L, Perticaroli P, Pettinari A, Cuccaro F, Nannavecchia AM, Bisceglia L, Marinaccio A, Pavone VLM, Magnani C. Factors Affecting Asbestosis Mortality Among Asbestos-Cement Workers in Italy. Ann Work Expo Health 2020; 64:622-635. [PMID: 32328661 DOI: 10.1093/annweh/wxaa037] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2019] [Revised: 03/10/2020] [Accepted: 03/19/2020] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVES This study was performed with the aim of investigating the temporal patterns and determinants associated with mortality from asbestosis among 21 cohorts of Asbestos-Cement (AC) workers who were heavily exposed to asbestos fibres. METHODS Mortality for asbestosis was analysed for a cohort of 13 076 Italian AC workers (18.1% women). Individual cumulative asbestos exposure index was calculated by factory and period of work weighting by the different composition of asbestos used (crocidolite, amosite, and chrysotile). Two different approaches to analysis, based on Standardized Mortality Ratios (SMRs) and Age-Period-Cohort (APC) models were applied. RESULTS Among the considered AC facilities, asbestos exposure was extremely high until the end of the 1970s and, due to the long latency, a peak of asbestosis mortality was observed after the 1990s. Mortality for asbestosis reached extremely high SMR values [SMR: males 508, 95% confidence interval (CI): 446-563; females 1027, 95% CI: 771-1336]. SMR increased steeply with the increasing values of cumulative asbestos exposure and with Time Since the First Exposure. APC analysis reported a clear age effect with a mortality peak at 75-80 years; the mortality for asbestosis increased in the last three quintiles of the cumulative exposure; calendar period did not have a significant temporal component while the cohort effect disappeared if we included in the model the cumulative exposure to asbestos. CONCLUSIONS Among heaviest exposed workers, mortality risk for asbestosis began to increase before 50 years of age. Mortality for asbestosis was mainly determined by cumulative exposure to asbestos.
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Affiliation(s)
- Paolo Girardi
- Mesothelioma Register of the Veneto Region, Regional Epidemiological System, Azienda Zero, Padua, Italy
| | - Enzo Merler
- Mesothelioma Register of the Veneto Region, Regional Epidemiological System, Azienda Zero, Padua, Italy
| | - Daniela Ferrante
- Unit of Medical Statistics and Cancer Epidemiology, Department of Translational Medicine, University of Eastern Piedmont, Novara, Italy.,CPO-Piedmont, Novara, Italy
| | - Stefano Silvestri
- CPO-Piedmont, Novara, Italy.,Occupational Hygienists, Unit of Medical Statistics and Epidemiology, Department of Translational Medicine, University of Eastern Piedmont, Novara, Italy
| | - Elisabetta Chellini
- Occupational & Environmental Epidemiology Unit-Institute for Cancer Research, Prevention and Clinical Network (ISPRO), Florence, Italy
| | - Alessia Angelini
- Occupational & Environmental Epidemiology Unit-Institute for Cancer Research, Prevention and Clinical Network (ISPRO), Florence, Italy
| | - Ferdinando Luberto
- Epidemiology Service, Azienda Unità Sanitaria Locale-IRCCS, Montecchio Emilia, Reggio Emilia, Italy
| | - Ugo Fedeli
- Mesothelioma Register of the Veneto Region, Regional Epidemiological System, Azienda Zero, Padua, Italy
| | - Enrico Oddone
- Department of Public Health, Experimental and Forensic Medicine, University of Pavia, Pavia, Italy
| | - Massimo Vicentini
- Epidemiology Service, Azienda Unità Sanitaria Locale-IRCCS, Montecchio Emilia, Reggio Emilia, Italy
| | - Francesco Barone-Adesi
- CPO-Piedmont, Novara, Italy.,Department of 'Scienze del Farmaco', University of Eastern Piedmont, Novara, Italy
| | - Tiziana Cena
- Unit of Medical Statistics and Cancer Epidemiology, Department of Translational Medicine, University of Eastern Piedmont, Novara, Italy.,CPO-Piedmont, Novara, Italy
| | - Dario Mirabelli
- Unit of Cancer Epidemiology, CPO Piedmont and University of Turin, Turin, Italy
| | - Lucia Mangone
- Epidemiology Service, Azienda Unità Sanitaria Locale-IRCCS, Montecchio Emilia, Reggio Emilia, Italy
| | - Francesca Roncaglia
- Epidemiology Service, Azienda Unità Sanitaria Locale-IRCCS, Montecchio Emilia, Reggio Emilia, Italy
| | - Orietta Sala
- Occupational Hygienist, Formerly: Regional Agency for Prevention, Environment and Energy Emilia-Romagna, Provincial Office of Reggio Emilia, Reggio Emilia, Italy
| | - Simona Menegozzo
- National Cancer Institute IRCCS Fondazione Pascale, Naples, Italy
| | - Roberta Pirastu
- Department of Biology and Biotechnologies 'Charles Darwin', Sapienza University, Rome, Italy
| | - Danila Azzolina
- Unit of Medical Statistics and Cancer Epidemiology, Department of Translational Medicine, University of Eastern Piedmont, Novara, Italy.,CPO-Piedmont, Novara, Italy
| | - Sara Tunesi
- Unit of Medical Statistics and Cancer Epidemiology, Department of Translational Medicine, University of Eastern Piedmont, Novara, Italy.,CPO-Piedmont, Novara, Italy.,Unit of Cancer Epidemiology, CPO Piedmont and University of Turin, Turin, Italy
| | - Lucia Miligi
- Occupational & Environmental Epidemiology Unit-Institute for Cancer Research, Prevention and Clinical Network (ISPRO), Florence, Italy
| | | | - Aldo Pettinari
- Prevention Department, ASUR Marche, Senigallia, Ancona, Italy
| | - Francesco Cuccaro
- Unit of Epidemiology and Statistics-Local Health Unit of Barletta-Andria-Trani, Barletta, Italy
| | - Anna Maria Nannavecchia
- Unit of Epidemiology and Statistics-Local Health Unit of Barletta-Andria-Trani, Barletta, 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
| | - Venere Leda Mara Pavone
- Department of Public Health, Prevention and Security Area Work Environments, Local Health Authority, San Lazzaro di Savena, Italy
| | - Corrado Magnani
- Unit of Medical Statistics and Cancer Epidemiology, Department of Translational Medicine, University of Eastern Piedmont, Novara, Italy.,CPO-Piedmont, Novara, Italy
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Barone-Adesi F, 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, Curti S, Baldassarre A, Cena T, Angelini A, Marinaccio A, Mirabelli D, Musti M, Pirastu R, Ranucci A, Magnani C. Role of asbestos clearance in explaining long-term risk of pleural and peritoneal cancer: a pooled analysis of cohort studies. Occup Environ Med 2020; 76:611-616. [PMID: 31413184 DOI: 10.1136/oemed-2019-105779] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2019] [Revised: 06/06/2019] [Accepted: 07/10/2019] [Indexed: 11/04/2022]
Abstract
OBJECTIVES Models based on the multistage theory of cancer predict that rates of malignant mesothelioma continuously increase with time since first exposure (TSFE) to asbestos, even after the end of external exposure. However, recent epidemiological studies suggest that mesothelioma rates level off many years after first exposure to asbestos. A gradual clearance of asbestos from the lungs has been suggested as a possible explanation for this phenomenon. We analysed long-term trends of pleural and peritoneal cancer mortality in subjects exposed to asbestos to evaluate whether such trends were consistent with the clearance hypothesis. METHODS We used data from a pool of 43 Italian asbestos cohorts (51 801 subjects). The role of asbestos clearance was explored using the traditional mesothelioma multistage model, generalised to include a term representing elimination of fibres over time. RESULTS Rates of pleural cancer increased until 40 years of TSFE, but remained stable thereafter. On the other hand, we observed a monotonic increase of peritoneal cancer with TSFE. The model taking into account asbestos clearance fitted the data better than the traditional one for pleural (p=0.004) but not for peritoneal (p=0.09) cancer. CONCLUSIONS Rates of pleural cancer do not increase indefinitely after the exposure to asbestos, but eventually reach a plateau. This trend is well described by a model accounting for a gradual elimination of the asbestos fibres. These results are relevant for the prediction of future rates of mesothelioma and in asbestos litigations.
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Affiliation(s)
| | - Daniela Ferrante
- Unit of Medical Statistics and Cancer Epidemiology, University of Eastern Piedmont and CPO-Piemonte, Novara, Italy
| | - Elisabetta Chellini
- Environmental and Occupational Epidemiology, Cancer Prevention and Research Institute (ISPO), Firenze, Italy
| | - Enzo Merler
- Mesothelioma Register of the Veneto Region, Local Health Unit, Padua, Italy
| | - Venere Pavone
- Department of Public Health, Prevention and Security Area Work Environments, Local Health Authority, Bologna, Italy
| | | | - Lucia Miligi
- Environmental and Occupational Epidemiology Unit, ISPO Cancer Prevention and Research Institute, Florence, Italy
| | - Giuseppe Gorini
- Environmental and Occupational Epidemiology, Cancer Prevention and Research Institute (ISPO), Firenze, Italy
| | - Vittoria Bressan
- Mesothelioma Register of the Veneto Region, Local Health Unit, Padua, Italy
| | - Paolo Girardi
- Local Health Authority of Padua, Venetian Mesothelioma Registry, 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
- Occupational Epidemiology, 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
- Unit of Medical Statistics and Cancer Epidemiology, University of Eastern Piedmont and CPO-Piemonte, Novara, Italy
| | | | | | - Francesco Cuccaro
- Statistics and Epidemiology, Local Health Unit of Barletta-Andria-Trani, Barletta, Italy
| | - Stefania Curti
- Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy
| | - Antonio Baldassarre
- Interdisciplinary Department of Medicine - Occupational Medicine 'B. Ramazzini', Università degli Studi di Bari 'Aldo Moro', Bari, Italy
| | - Tiziana Cena
- Department of Translational Medicine, University of Eastern Piedmont, Novara, Italy
| | | | - Alessandro Marinaccio
- Occupational Medicine Department, Italian Workers' Compensation Authority (INAIL), Rome, Italy
| | - Dario Mirabelli
- Epidemiologia dei Tumori 1, Ospedale San Giovanni Battista di Torino, Torino, 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
- Epidemiology Unit - Department of Translational Medicine, CPO Piemonte and University of Eastern Piedmont, Turin, Italy
| | - Corrado Magnani
- Dipartimento di Medicina Traslazionale, SCDU Epidemiologia del Tumori, Universita del Piemonte Orientale, Novara, Italy
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5
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Luberto F, Ferrante D, Silvestri S, Angelini A, Cuccaro F, Nannavecchia AM, Oddone E, Vicentini M, Barone-Adesi F, Cena T, Mirabelli D, Mangone L, Roncaglia F, Sala O, Menegozzo S, Pirastu R, Azzolina D, Tunesi S, Chellini E, Miligi L, Perticaroli P, Pettinari A, Bressan V, Merler E, Girardi P, Bisceglia L, Marinaccio A, Massari S, Magnani C. Cumulative asbestos exposure and mortality from asbestos related diseases in a pooled analysis of 21 asbestos cement cohorts in Italy. Environ Health 2019; 18:71. [PMID: 31391078 PMCID: PMC6686495 DOI: 10.1186/s12940-019-0510-6] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2019] [Accepted: 07/30/2019] [Indexed: 05/09/2023]
Abstract
BACKGROUND Despite the available information on cancer risk, asbestos is used in large areas in the world, mostly in the production of asbestos cement. Moreover, questions are raised regarding the shape of the dose response relation, the relation with time since exposure and the association with neoplasms in various organs. We conducted a study on the relationship between cumulative asbestos exposure and mortality from asbestos related diseases in a large Italian pool of 21 cohorts of asbestos-cement workers with protracted exposure to both chrysotile and amphibole asbestos. METHODS The cohort included 13,076 workers, 81.9% men and 18.1% women, working in 21 Italian asbestos-cement factories, with over 40 years of observation. Exposure was estimated by plant and period, and weighted for the type of asbestos used. Data were analysed with consideration of cause of death, cumulative exposure and time since first exposure (TSFE), and by gender. SMRs were computed using reference rates by region, gender and calendar time. Poisson regression models including cubic splines were used to analyse the effect of cumulative exposure to asbestos and TSFE on mortality for asbestos-related diseases. 95% Confidence Intervals (CI) were computed according to the Poisson distribution. RESULTS Mortality was significantly increased for 'All Causes' and 'All Malignant Neoplasm (MN)', in both genders. Considering asbestos related diseases (ARDs), statistically significant excesses were observed for MN of peritoneum (SMR: men 14.19; women 15.14), pleura (SMR: 22.35 and 48.10), lung (SMR: 1.67 and 1.67), ovary (in the highest exposure class SMR 2.45), and asbestosis (SMR: 507 and 1023). Mortality for ARDs, in particular pleural and peritoneal malignancies, lung cancer, ovarian cancer and asbestosis increased monotonically with cumulative exposure. Pleural MN mortality increased progressively in the first 40 years of TSFE, then reached a plateau, while peritoneal MN showed a continuous increase. The trend of lung cancer SMRs also showed a flattening after 40 years of TSFE. Attributable proportions for pleural, peritoneal, and lung MN were respectively 96, 93 and 40%. CONCLUSIONS Mortality for ARDs was associated with cumulative exposure to asbestos. Risk of death from pleural MN did not increase indefinitely with TSFE but eventually reached a plateau, consistently with reports from other recent studies.
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Affiliation(s)
- Ferdinando Luberto
- Epidemiology Unit, Azienda Unità Sanitaria Locale - IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | - Daniela Ferrante
- Unit of Medical Statistics and Cancer Epidemiology, Department of Translational Medicine, University of Eastern Piedmont, via Solaroli 17, 28100, Novara, Italy.
- CPO-Piedmont, Novara, Italy.
| | - Stefano Silvestri
- Unit of Medical Statistics and Cancer Epidemiology, Department of Translational Medicine, University of Eastern Piedmont, via Solaroli 17, 28100, Novara, Italy
- CPO-Piedmont, Novara, Italy
| | - Alessia Angelini
- Unit of Medical Statistics and Cancer Epidemiology, Department of Translational Medicine, University of Eastern Piedmont, via Solaroli 17, 28100, Novara, Italy
- CPO-Piedmont, Novara, Italy
| | - Francesco Cuccaro
- Unit of Epidemiology and Statistics, Local Health Unit of Barletta-Andria-Trani, Barletta, Italy
| | - Anna Maria Nannavecchia
- Unit of Epidemiology and Statistics, Local Health Unit of Barletta-Andria-Trani, Barletta, Italy
| | - Enrico Oddone
- Department of Public Health, Experimental and Forensic Medicine, University of Pavia, and ICS Maugeri IRCCS, Pavia, Italy
| | - Massimo Vicentini
- Epidemiology Unit, Azienda Unità Sanitaria Locale - IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | - Francesco Barone-Adesi
- Department of Pharmaceutical Sciences, University of Eastern Piedmont, and CPO Piedmont, Novara, Italy
| | - Tiziana Cena
- Unit of Medical Statistics and Cancer Epidemiology, Department of Translational Medicine, University of Eastern Piedmont, via Solaroli 17, 28100, Novara, Italy
- CPO-Piedmont, Novara, Italy
| | - Dario Mirabelli
- Unit of Cancer Epidemiology, CPO Piedmont and University of Turin, Turin, Italy
- Interdepartmental Centre G. Scansetti for Studies on Asbestos and other Toxic Particulates, University of Turin, Turin, Italy
| | - Lucia Mangone
- Epidemiology Unit, Azienda Unità Sanitaria Locale - IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | - Francesca Roncaglia
- Epidemiology Unit, Azienda Unità Sanitaria Locale - IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | - Orietta Sala
- Regional Agency for Prevention, Environment and Energy Emilia-Romagna, Provincial Office of Reggio Emilia, Reggio Emilia, Italy
| | - Simona Menegozzo
- National Cancer Institute IRCCS Fondazione Pascale, Naples, Italy
| | - Roberta Pirastu
- Department of Biology and Biotechnologies "Charles Darwin", Sapienza University, Rome, Italy
| | - Danila Azzolina
- Unit of Medical Statistics and Cancer Epidemiology, Department of Translational Medicine, University of Eastern Piedmont, via Solaroli 17, 28100, Novara, Italy
- CPO-Piedmont, Novara, Italy
| | - Sara Tunesi
- Unit of Medical Statistics and Cancer Epidemiology, Department of Translational Medicine, University of Eastern Piedmont, via Solaroli 17, 28100, Novara, Italy
- CPO-Piedmont, Novara, Italy
| | - Elisabetta Chellini
- Occupational & Environmental Epidemiology Unit - Institute for Cancer Research, Prevention and Clinical Network (ISPRO), Florence, Italy
| | - Lucia Miligi
- Occupational & Environmental Epidemiology Unit - Institute for Cancer Research, Prevention and Clinical Network (ISPRO), Florence, Italy
| | | | | | | | - Enzo Merler
- Mesothelioma Register of the Veneto Region, Regional Epidemiologic System, Local Health Unit 6, Padua, Italy
| | - Paolo Girardi
- UOSD Servizio di Epidemiologia AULSS6 EUGANEA, Padua, Italy
| | - Lucia Bisceglia
- Apulia Regional Agency for Health and Social Policies - ARESS Puglia, 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
| | - Stefania Massari
- 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
| | - Corrado Magnani
- Unit of Medical Statistics and Cancer Epidemiology, Department of Translational Medicine, University of Eastern Piedmont, via Solaroli 17, 28100, Novara, Italy
- CPO-Piedmont, Novara, Italy
- Interdepartmental Centre G. Scansetti for Studies on Asbestos and other Toxic Particulates, University of Turin, Turin, Italy
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6
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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] [What about the content of this article? (0)] [Affiliation(s)] [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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7
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Magnani C, Ancona L, Baldassarre A, Bressan V, Cena T, Chellini E, Cuccaro F, Ferrante D, Legittimo P, Luberto F, Marinaccio A, Mattioli S, Menegozzo S, Merler E, Miligi L, Mirabelli D, Musti M, Oddone E, Pavone V, Perticaroli P, Pettinari A, Pirastu R, Ranucci A, Romeo E, Sala O, Scarnato C, Silvestri S. [Time trend in mesothelioma and lung cancer risk in asbestos workers in Italy]. Epidemiol Prev 2016; 40:64-67. [PMID: 26951735 DOI: 10.19191/ep16.1s1.p064.032] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
This study aims at investigating, in asbestos exposed workers, the time trend of their risk of mesothelioma and of other neoplasm after very long latency and after the cessation of asbestos exposure. We pooled a large number of Italian cohorts of asbestos workers and updated mortality follow-up. The pool of data for statistical analyses includes 51,988 workers, of which 6,058 women: 54.2% was alive at follow-up, 42.6% was dead, and 2.8%was lost. Cause of death is known for 94.3%: 2,548 deaths from lung cancer, 748 frompleural cancer, 173 fromperitoneal cancer, and 434 from asbestosis. An exposure index is being developed to compare the different cohorts. Data analysis is in progress. This study will have the size for analysing not only time trends in mesothelioma, but also the occurrence of rarer diseases and cancer specific mortality in women.
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Affiliation(s)
- Corrado Magnani
- Dipartimento di medicina traslazionale, Università del Piemonte Orientale e CPO Piemonte, Novara.
| | - Laura Ancona
- Dipartimento di epidemiologia, Regione Lazio, Roma
| | | | - Vittoria Bressan
- Registro regionale veneto dei casi di mesotelioma, SPISAL AULSS 16, Padova
| | - Tiziana Cena
- Dipartimento di medicina traslazionale, Università del Piemonte Orientale e CPO Piemonte, Novara
| | - Elisabetta Chellini
- SS epidemiologia ambientale occupazionale, Istituto per lo studio e la prevenzione oncologica (ISPO), Firenze
| | | | - Daniela Ferrante
- Dipartimento di medicina traslazionale, Università del Piemonte Orientale e CPO Piemonte, Novara
| | - Patrizia Legittimo
- Dipartimento di scienze mediche e chirurgiche, Settore di medicina del lavoro, "Alma Mater Studiorum" Università di Bologna
| | - Ferdinando Luberto
- Servizio interaziendale di epidemiologia, AUSL Reggio Emilia e Arcispedale Santa Maria Nuova - IRCCS Reggio Emilia
| | - Alessandro Marinaccio
- Laboratorio di epidemiologia occupazionale e ambientale, Dipartimento di medicina, epidemiologia, igiene del lavoro e ambientale, INAIL, Roma
| | - Stefano Mattioli
- Dipartimento di scienze mediche e chirurgiche, Settore di medicina del lavoro, "Alma Mater Studiorum" Università di Bologna
| | | | - Enzo Merler
- Registro regionale veneto dei casi di mesotelioma, SPISAL AULSS 16, Padova
| | - Lucia Miligi
- SS epidemiologia ambientale occupazionale, Istituto per lo studio e la prevenzione oncologica (ISPO), Firenze
| | | | - Marina Musti
- Sezione di medicina del lavoro, Università degli Studi di Bari
| | - Enrico Oddone
- Dipartimento di sanità pubblica, medicina sperimentale e forense, Università degli Studi di Pavia
| | - Venere Pavone
- Dipartimento di sanità pubblica, Area PSAL, Azienda USL Bologna
| | | | - Aldo Pettinari
- Dipartimento di prevenzione, SPSAL, Area Vasta 2, ASL Marche, Senigallia (AN)
| | - Roberta Pirastu
- Dipartimento di biologia e biotecnologie "Charles Darwin", Università Sapienza, Roma
| | - Alessandra Ranucci
- Dipartimento di medicina traslazionale, Università del Piemonte Orientale e CPO Piemonte, Novara
| | - Elisa Romeo
- Dipartimento di epidemiologia, Regione Lazio, Roma
| | - Orietta Sala
- ARPA Emilia-Romagna, Sezione provinciale di Reggio Emilia
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8
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Perticaroli P, Mengucci R, Carletti M, Magnini P, Marcellini M, Pettinari A, Durastanti M. [Asbestos-related diseases in former asbestos-cement workers in Senigallia]. Med Lav 2013; 104:277-288. [PMID: 24228306] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
BACKGROUND A factory that produced asbestos-cement products, using chrysotile, amosite and crocidolite in very low percentages, cement and water, operated in Senigallia from 1948 to 1984. Workers and residents still living in Senigallia are 238. OBJECTIVES The need for an organic response to requests by former workers for protection of health and recognition of occupational diseases induced the Prevention and Safety at the Workplace Service in Senigallia/Area Vasta 2 to implement a programme of health surveillance. METHODS In 2010 a health surveillance programme was initiated that involved 158 subjects, 58 women and 100 men. The average age of men was 75 years and 70 for women. The time elapsed between first exposure and participation in the programme was on average 50 years (SD 7.49). The average number of years of exposure to asbestos fibres was 17 (SD 10.36). The programme included counselling activities, especially as regards cessation of smoking, and first and second level health checks. RESULTS The health surveillance programme enabled us to diagnose pleural plaques and pleural thickening in 81% of the subjects and various degrees of interstitial abnormalities in 49.4%. The high percentage of asbestos-related diseases was connected mainly with the long latency of the population under study and the higher diagnostic sensitivity of low dose chest CT scan applied to these diseases. CONCLUSIONS In our experience, in order to optimize the benefits of a health surveillance programme of former workers exposed to asbestos, it will be advisable to define parameters of access to the programme for individual subjects in relation to life expectancy, clinical conditions, time elapsed since first exposure, time of cessation of exposure. Such parameters, together with any risk factors, will influence the diagnostic process.
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Affiliation(s)
- Patrizia Perticaroli
- Servizio Prevenzione e Sicurezza Ambienti di Lavoro, Dipartimento di Prevenzione, ASUR Marche Area Vasta 2 Senigallia.
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9
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Alessandroni M, Balzani B, Cancellieri F, Colao A, Comai M, Elezi L, Mengucci R, Montesi S, Olivi C, Perticaroli P, Pettinari A, Ruschioni A. [Protection of working mothers: operational guide document. The Marche Regional Section of the Italian Society of Occupational Health and Industrial Hygiene (SIMLII) ]. Med Lav 2013; 104:319-328. [PMID: 24228309] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
Protection of working mothers: operational guide document. The aim of this operational guide document is to protect the health of working mothers and their babies during pregnancy, puerperium and breastfeeding. The project was developed by a technical working group which included professionals in the pertinent fields from the Workplace Prevention and Safety Services of the local Vasta-2 Area of the Marche Regional Health Service:physicians, health assistants, and nurses. It is considered to be a useful tool for risk assessment at the workplace aimed at professionals who are involved, with various duties and responsibilities, in the health care of the working mother. This paper consists of two functionally related sections, "Table of risks" and "Technical specifications". In the "Table of Risks" section, the occupational hazards for women during pregnancy or postpartum were analyzed with the highest possible degree of care. To this end the technical group provided, for each occupational hazard, its own operational suggestions, in relation to legislation, current scientific knowledge and Guidelines of other Italian Regions. The Marche Regional Section of the Italian Society of Occupational Health and Industrial Hygiene (SIMLII) participated in the final draft of the entire document. The second section, "Technical Specifications", illustrates the main tasks and any risks involved in the 34 manufacturing sectors most prevalent in this area. This operational guide document is intended to be the beginning of a common strategy in public health to achieve a wider field of action in promotion and information aimed at protecting the reproductive health of working mothers.
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10
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Pettinari A, Mengucci R, Belli S, Comba P. [Mortality of workers employed at an asbestos cement manufacturing plant in Senigallia]. Med Lav 1994; 85:223-30. [PMID: 7935144] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
The mortality (1948-1990) was investigated in 561 workers employed in an asbestos cement plant in Senigallia (Central Italy). A significant increase in lung cancer was observed in male subjects (SMR: 276; 95% C.I.: 175.2-414.8, 23 observed). The excess mortality was a function of the induction-latency time. Five deaths were observed among women, one of which due to malignant pleural neoplasm.
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Affiliation(s)
- A Pettinari
- Servizio di Igiene e Sanità Pubblica, Settore di Igiene e Sicurezza nei Luoghi di Lavoro, Regione Marche, U.S.L. 7, Senigallia, AN
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11
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Migliori MV, Cherubini V, Bartolotta E, Pettinari A, Pecora R. Ring chromosome 5 associated with severe growth retardation as the sole major physical abnormality. Am J Med Genet 1994; 49:108-10. [PMID: 8172236 DOI: 10.1002/ajmg.1320490121] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
We report on a case of ring chromosome 5 in a 36-month-old girl with severe growth retardation, clinodactyly, mild psychological abnormalities, and normal facial appearance. Endocrine tests showed partial growth hormone deficiency. Cytogenetic investigation failed to demonstrate any apparent microscopic deletion of either short or long arm of chromosome 5 as consequence of ring formation. In 12% of cells examined, the ring was either absent or present in multiple copies. Only 3 previous cases of ring chromosome 5 have been reported in association with short stature of prenatal onset and minor anomalies, without mental retardation.
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Affiliation(s)
- M V Migliori
- Laboratorio di Citogenetica, Ospedale Salesi, Ancona, Italy
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12
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Caramia G, Compagnoni L, Pettinari A, Gregorini S. [Efficiency and possibility of the use of aztreonam in bacterial infections caused by gram-negative organisms]. Minerva Pediatr 1986; 38:773-7. [PMID: 3796535] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
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