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Ferrante D, Angelini A, Barbiero F, Barbone F, Bauleo L, Binazzi A, Bovenzi M, Bruno C, Casotto V, Cernigliaro A, Ceppi M, Cervino D, Chellini E, Curti S, De Santis M, Fazzo L, Fedeli U, Fiorillo G, Franchi A, Gangemi M, Giangreco M, Rossi PG, Girardi P, Luberto F, Massari S, Mattioli S, Menegozzo S, Merlo DF, Michelozzi P, Migliore E, Miligi L, Oddone E, Pernetti R, Perticaroli P, Piro S, Addario SP, Romeo E, Roncaglia F, Silvestri S, Storchi C, Zona A, Magnani C, Marinaccio A. Cause specific mortality in an Italian pool of asbestos workers cohorts. Am J Ind Med 2024; 67:31-43. [PMID: 37855384 DOI: 10.1002/ajim.23546] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2023] [Revised: 10/03/2023] [Accepted: 10/06/2023] [Indexed: 10/20/2023]
Abstract
BACKGROUND Asbestos is a known human carcinogen and is causally associated with malignant mesothelioma, lung, larynx and ovarian cancers. METHODS Cancer risk was studied among a pool of formerly asbestos-exposed workers in Italy. Fifty-two Italian asbestos cohorts (asbestos-cement, rolling-stock, shipbuilding, and other) were pooled and their mortality follow-up was updated to 2018. Standardized mortality ratios (SMRs) were computed for major causes of death considering duration of exposure and time since first exposure (TSFE), using reference rates by region, age and calendar period. RESULTS The study included 63,502 subjects (57,156 men and 6346 women): 40% who were alive, 58% who died (cause known for 92%), and 2% lost to follow-up. Mortality was increased for all causes (SMR: men = 1.04, 95% confidence interval [CI] 1.03-1.05; women = 1.15, 95% CI 1.11-1.18), all malignancies (SMR: men = 1.21, 95% CI 1.18-1.23; women = 1.29, 95% CI 1.22-1.37), pleural and peritoneal malignancies (men: SMR = 10.46, 95% CI 9.86-11.09 and 4.29, 95% CI 3.66-5.00; women: SMR = 27.13, 95% CI 23.29-31.42 and 7.51, 95% CI 5.52-9.98), lung (SMR: men = 1.28, 95% CI 1.24-1.32; women = 1.26, 95% CI 1.02-1.53), and ovarian cancer (SMR = 1.42, 95% CI 1.08-1.84). Pleural cancer mortality increased during the first 40 years of TSFE (latency), reaching a plateau thereafter. CONCLUSIONS Analyses by time-dependent variables showed that the risk for pleural neoplasms increased with latency and no longer increases at long TSFE, consistent with with asbestos clearance from the lungs. Peritoneal neoplasm risk increased over all observation time.
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Affiliation(s)
- Daniela Ferrante
- Department of Translational Medicine, Università del Piemonte Orientale and CPO Piemonte, Novara, Italy
| | - Alessia Angelini
- Institute for Cancer Research, Prevention and Clinical Network (ISPRO), Florence, Italy
| | - Fabiano Barbiero
- Department of Medical Area (DAME), University of Udine, Udine, Italy
| | - Fabio Barbone
- Department of Medical Sciences, University of Trieste, Trieste, Italy
| | - Lisa Bauleo
- Department of Epidemiology, Lazio Regional Health Service, Rome, Italy
| | - Alessandra Binazzi
- Department of Occupational and Environmental Medicine, Epidemiology and Hygiene, Italian Workers' Compensation Authority, Rome, Italy
| | - Massimo Bovenzi
- Department of Medical Sciences, Clinical Unit of Occupational Medicine, University of Trieste, Trieste, Italy
| | - Caterina Bruno
- Department of Environment and Health, Istituto Superiore di Sanità, Roma, Italy
| | - Veronica Casotto
- Epidemiological Department, Azienda Zero, Padova, Veneto Region, Italy
| | | | - Marcello Ceppi
- Clinical Epidemiology Unit, IRCCS-Ospedale Policlinico San Martino, Genoa, Italy
| | - Daniela Cervino
- Department of Public Health, Azienda USL di Bologna, Bologna, Italy
| | | | - Stefania Curti
- Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy
| | - Marco De Santis
- Department of Environment and Health, Istituto Superiore di Sanità, Roma, Italy
| | - Lucia Fazzo
- Department of Environment and Health, Istituto Superiore di Sanità, Roma, Italy
| | - Ugo Fedeli
- Epidemiological Department, Azienda Zero, Padova, Veneto Region, Italy
| | - Germano Fiorillo
- Unit of Occupational Medicine-Istituto Nazionale Tumori-IRCCS-Fondazione G. Pascale, Napoli, Italy
| | - Alberto Franchi
- Department of Public Health, Azienda USL di Bologna, Bologna, Italy
| | - Manuela Gangemi
- Unit of Cancer Epidemiology, Regional Operating Center of Piemonte (COR Piemonte), University of Torino and CPO-Piemonte, Torino, Italy
| | - Manuela Giangreco
- Institute for Maternal and Child Health, IRCCS "Burlo Garofolo", Trieste, Italy
| | - Paolo Giorgi Rossi
- Epidemiology Unit, Azienda USL-IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | - Paolo Girardi
- Department of Environmental Sciences, Informatics and Statistics, Ca' Foscari University of Venice, Venice, Italy
| | - Ferdinando Luberto
- Epidemiology Unit, Azienda USL-IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | - Stefania Massari
- Department of Occupational and Environmental Medicine, Epidemiology and Hygiene, Italian Workers' Compensation Authority, Rome, Italy
| | - Stefano Mattioli
- Department of Environmental and Preventive Sciences, University of Ferrara, Ferrara, Italy
| | - Simona Menegozzo
- Unit of Occupational Medicine-Istituto Nazionale Tumori-IRCCS-Fondazione G. Pascale, Napoli, Italy
| | | | - Paola Michelozzi
- Department of Epidemiology, Lazio Regional Health Service, Rome, Italy
| | - Enrica Migliore
- Unit of Cancer Epidemiology, Regional Operating Center of Piemonte (COR Piemonte), University of Torino and CPO-Piemonte, Torino, Italy
| | - Lucia Miligi
- Institute for Cancer Research, Prevention and Clinical Network (ISPRO), Florence, Italy
| | - Enrico Oddone
- Department of Public Health, Experimental and Forensic Medicine-University of Pavia, Pavia, Italy
| | - Roberta Pernetti
- Department of Public Health, Experimental and Forensic Medicine-University of Pavia, Pavia, Italy
| | | | - Sara Piro
- Institute for Cancer Research, Prevention and Clinical Network (ISPRO), Florence, Italy
| | | | - Elisa Romeo
- Department of Epidemiology, Lazio Regional Health Service, Rome, Italy
| | | | - Stefano Silvestri
- Department of Translational Medicine, Università del Piemonte Orientale and CPO Piemonte, Novara, Italy
| | - Cinzia Storchi
- Epidemiology Unit, Azienda USL-IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | - Amerigo Zona
- Department of Environment and Health, Istituto Superiore di Sanità, Roma, Italy
| | - Corrado Magnani
- Department of Translational Medicine, Università del Piemonte Orientale and CPO Piemonte, Novara, Italy
| | - Alessandro Marinaccio
- Department of Occupational and Environmental Medicine, Epidemiology and Hygiene, Italian Workers' Compensation Authority, Rome, Italy
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Girardi P, Barbiero F, Baccini M, Comba P, Pirastu R, Mastrangelo G, Ballarin MN, Biggeri A, Fedeli U. Mortality for Lung Cancer among PVC Baggers Employed in the Vinyl Chloride Industry. Int J Environ Res Public Health 2022; 19:ijerph19106246. [PMID: 35627783 PMCID: PMC9141742 DOI: 10.3390/ijerph19106246] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/11/2022] [Revised: 05/11/2022] [Accepted: 05/17/2022] [Indexed: 02/04/2023]
Abstract
Vinyl-chloride monomer (VCM) is classified as a known carcinogen of the liver; for lung cancer, some results suggest a potential association with polyvinyl chloride (PVC) dust. We evaluated the relationship between lung cancer mortality and exposure as PVC baggers in a cohort of workers involved in VCM production and polymerization in Porto Marghera (Venice, Italy) considering both employment status and smoking habits. The workers were studied between 1973 and 2017. A subset of them (848 over 1658) was interviewed in the 2000s to collect information about smoking habits and alcohol consumption. Missing values were imputed by the Multivariate Imputation by Chained Equations (MICE) algorithm. We calculated standardized mortality ratios (SMR) and 95% confidence intervals (95% CIs) using regional reference rates by task (never, ever, and exclusively baggers) and by smoking habits. Mortality rate ratios (MRR), adjusted for age, calendar time, time since first exposure, and smoking habits, were obtained via Poisson regression using Rubin’s rule to combine results from imputed datasets calculating the fraction of information due to non-response. Lung cancer mortality was lower than the regional reference in the whole cohort (lung cancer SMR = 0.92; 95% CI 0.75–1.11). PVC baggers showed a 50% increase in lung cancer mortality compared to regional rates (SMR = 1.48; 95% CI 0.82–2.68). In the cohort analyses, a doubled risk of lung cancer mortality among PVC baggers was confirmed after adjustment for smoking and time-dependent covariates (MRR = 1.99, 95% CI 1.04–3.81). Exposure to PVC dust resulting from activity as bagger in a polymerization PVC plant was associated with an increase in lung cancer mortality risk after adjustment for smoking habits.
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Affiliation(s)
- Paolo Girardi
- Department of Environmental Sciences, Informatics and Statistics, Ca’ Foscari University of Venice, 30172 Venice, Italy;
| | - Fabiano Barbiero
- Department of Medical Area (DAME), University of Udine, 33100 Udine, Italy;
| | - Michela Baccini
- Department of Statistics, Computer Science, Applications, University of Florence, 50134 Florence, Italy;
| | - Pietro Comba
- Department of Environment and Health, Istituto Superiore di Sanità, 00161 Roma, Italy;
| | - Roberta Pirastu
- Department of Biology and Biotechnology “Charles Darwin”, Sapienza Rome University, 00185 Roma, Italy;
| | - Giuseppe Mastrangelo
- Section of Occupational Medicine, Department of Cardiac, Thoracic, Vascular Sciences & Public Health, University of Padova, 35128 Padova, Italy;
| | | | - Annibale Biggeri
- Unit of Biostatistics, Epidemiology and Public Health, Department of Cardiac, Thoracic, Vascular Sciences and Public Health, University of Padova, 35128 Padova, Italy;
| | - Ugo Fedeli
- Epidemiological Department, Azienda Zero, Veneto Region, 35132 Padova, Italy
- Correspondence: ; Tel.: +39-049-877-8251
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Castriotta L, Rosolen V, Barbiero F, Tomietto M, de Dottori M, Barbone F, Zamaro G. [Impact of the COVID-19 epidemic in Friuli Venezia Giulia Region (Northern Italy): assessment of factors associated with the risk of death by competing risks analysis]. Epidemiol Prev 2021; 44:128-135. [PMID: 33412803 DOI: 10.19191/ep20.5-6.s2.111] [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] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
OBJECTIVES to investigate the role of gender, age, province of residence, and nursing home residency on the risk of death for residents in the Friuli Venezia Giulia (FVG) Region (Northern Italy) tested positive for Covid-19, considering recovery as a competing event. The secondary objective is to describe the impact of the Covid-19 epidemic in FVG and in the Regions of Northern and Central Italy in terms of incidence and mortality compared to the national data. DESIGN retrospective cohort study. SETTING AND PARTICIPANTS resident population in FVG in the period between 29 February and 25 June 2020. MAIN OUTCOME MEASURES in order to describe the impact of the Covid-19 outbreak in FVG, in terms of incidence and mortality compared to the national data, the standardized incidence (SIR) and mortality (SMR) ratios and their respective 95% confidence intervals (95%CI) were calculated compared to the Italian population for the northern and central Regions of Italy and the autonomous Provinces (PA) of Trento and Bolzano. A retrospective cohort study was conducted on subjects residing in FVG to whom at least one naso-oropharyngeal swab (hereafter, named swab) resulted positive for Covid-19. For each subject included in the cohort, the observation period started with the first positive swab and ended with the first of the following events: death, recovery or censored, which means that at the end of the observation period the subject was still alive and positive. The cause of death was assigned to Covid-19 if a subject had not yet recovered at the time when the event occurred. Cohort members were considered recovered after two negative consecutive swabs. The sub-hazard ratio (SHR) was estimated by applying the regression model of competing risks by Fine and Gray, in which the event of interest was the death caused by Covid-19 and the competing event was recovery. The explanatory variables included in the multiple models are: gender, age at the beginning of the observation period, the Province of residence, and nursing home residency. The cause-specific hazard was estimated using Cox proportional hazard regression. RESULTS during the observation period, 3,305 cases and 345 deaths were recorded in FVG; SIR and SMR resulted, respectively, equal to 0.64 (95%CI 0.61-0.68) and 0.43 (95%CI 0.37-0.50). The FVG was the Northern Region one with the lowest incidence and mortality. The cohort consisted of 3,121 residents in FVG with at least one swab with a positive Covid-19 result during the study period. The SHR of dying for Covid-19 is equal to 16.13 (95%CI 9.73-26.74) for people with age 70-79 years and 35.58 (95%CI 21.77-58.15) with age >=80 years respect those with age <70 years. It is higher in males (SHR 1.71; 95%CI 1.34-2.17). There is no evidence that being resident in a nursing home affects the SHR (SHR 0.91 and 95%CI 0.69-1.20). As regards the province as an explanatory variable, the sub-hazard of death in the province of Trieste appears to overlap to the sub-hazard of Pordenone used as a reference; for the provinces of Udine and Gorizia the sub-hazards seem lower than the reference. CONCLUSIONS while other Northern Regions and autonomous Provinces show higher standardized incidence and mortality compared with Italy, FVG and Veneto do not. In FVG, male gender and age are important determinants of death while there is no evidence that the condition of guest in a nursing home increases the sub-hazard of death.
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Affiliation(s)
- Luigi Castriotta
- Direzione centrale salute, politiche sociali e disabilità, Regione Friuli Venezia Giulia, Trieste.,Istituto di igiene ed epidemiologia clinica, Azienda sanitaria universitaria Friuli centrale, Udine
| | - Valentina Rosolen
- Direzione centrale salute, politiche sociali e disabilità, Regione Friuli Venezia Giulia, Trieste.,IRCCS materno infantile Burlo Garofolo, Trieste;
| | | | - Marco Tomietto
- Direzione centrale salute, politiche sociali e disabilità, Regione Friuli Venezia Giulia, Trieste
| | | | - Fabio Barbone
- Direzione centrale salute, politiche sociali e disabilità, Regione Friuli Venezia Giulia, Trieste.,Dipartimento di area medica, Università degli Studi di Udine
| | - Gianna Zamaro
- Direzione centrale salute, politiche sociali e disabilità, Regione Friuli Venezia Giulia, Trieste
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Barbone F, Barbiero F, Fasola G. Comment on: "Low-dose computed tomography screening for lung cancer in people with workplace exposure to asbestos". Lung Cancer 2019; 136:150. [PMID: 31377003 DOI: 10.1016/j.lungcan.2019.07.022] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2019] [Accepted: 07/22/2019] [Indexed: 10/26/2022]
Affiliation(s)
- Fabio Barbone
- Dipartimento di Area Medica, University of Udine, Udine, Italy; Institute of Hygiene and Clinical Epidemiology, Azienda Sanitaria Universitaria Integrata, Udine, Italy.
| | | | - Gianpiero Fasola
- Dipartimento ad Attivita` Integrata di Oncologia, Azienda Sanitaria Universitaria Integrata, Udine, Italy.
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Barbone F, Barbiero F, Belvedere O, Rosolen V, Giangreco M, Zanin T, Pisa FE, Meduri S, Follador A, Grossi F, Fasola G. Impact of low-dose computed tomography screening on lung cancer mortality among asbestos-exposed workers. Int J Epidemiol 2019; 47:1981-1991. [PMID: 30325420 DOI: 10.1093/ije/dyy212] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/10/2018] [Indexed: 12/17/2022] Open
Abstract
Background We previously showed that low-dose computed tomography (LDCT) screening in asbestos-exposed workers is effective in detecting lung cancer (LC) at an early stage. Here, we evaluate whether LDCT screening could reduce mortality from LC in such a high-risk population. Methods Within a cohort of 2433 asbestos-exposed men enrolled in an Occupational Health surveillance programme, we compared mortality between the participants in the ATOM002 study (LDCT-P, N = 926) and contemporary non-participants (LDCT-NP, N = 1507). We estimated standardized mortality ratios for the LDCT-P and LDCT-NP populations using regional and national rates (SMR_FVG and SMR_ITA, respectively). We compared survival for all causes, all neoplasms, LC and malignant neoplasm of pleura (MNP) between LDCT-P and LDCT-NP using Cox proportional hazard models adjusted for age, smoking history, asbestos exposure level and comorbidities. Results A reduction in mortality from LC was observed in the LDCT-P group compared with regional and national figures (SMR_FVG = 0.55, 95% confidence interval (CI) 0.24-1.09; SMR_ITA = 0.51, 95% CI 0.22-1.01); this was not the case for the LDCT-NP group (SMR_FVG = 2.07, 95% CI 1.53-2.73; SMR_ITA = 1.98, 95% CI 1.47-2.61). A strong reduction in LC mortality was observed for the LDCT-P compared with the LDCT-NP [hazard ratio (HR) = 0.41, 95% CI 0.17-0.96]. Mortality was also reduced for all causes (HR = 0.61, 95% CI 0.44-0.84), but not for all neoplasms (HR = 0.97, 95% CI 0.62-1.50) and MNP (HR = 0.86, 95% CI 0.31-2.41) within the LDCT-P population. Conclusions In our cohort, participation in the LDCT screening study was associated with reduced mortality from LC. This finding supports the use of LDCT in surveillance programmes for asbestos-exposed workers.
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Affiliation(s)
- Fabio Barbone
- Dipartimento di Area Medica, University of Udine, Udine, Italy.,Institute of Hygiene and Clinical Epidemiology, Azienda Sanitaria Universitaria Integrata, Udine, Italy
| | - Fabiano Barbiero
- Dipartimento di Area Medica, University of Udine, Udine, Italy.,Occupational Health and Safety Department, Local Health Authority No 3 'SERENISSIMA', Veneto Region, Mestre, Italy
| | - Ornella Belvedere
- Department of Oncology, York Teaching Hospitals NHS Foundation Trust, York, UK
| | | | | | - Tina Zanin
- Occupational Health and Safety Department, Local Health Authority No 2 (ASS2), Friuli Venezia Giulia Region, Gorizia, Italy
| | - Federica E Pisa
- Institute of Hygiene and Clinical Epidemiology, Azienda Sanitaria Universitaria Integrata, Udine, Italy.,Department of Clinical Epidemiology, Leibniz Institute for Prevention Research and Epidemiology BIPS, Bremen, Germany
| | - Stefano Meduri
- Department of Radiology, Latisana Hospital, Latisana, Italy
| | - Alessandro Follador
- Dipartimento ad Attività Integrata di Oncologia, Azienda Sanitaria Universitaria Integrata, Udine, Italy
| | - Francesco Grossi
- Division of Medical Oncology, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Gianpiero Fasola
- Dipartimento ad Attività Integrata di Oncologia, Azienda Sanitaria Universitaria Integrata, Udine, Italy
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Barbiero F, Zanin T, Pisa FE, Casetta A, Rosolen V, Giangreco M, Negro C, Bovenzi M, Barbone F. Cancer incidence in a cohort of asbestos-exposed workers undergoing health surveillance. Int Arch Occup Environ Health 2018; 91:831-841. [PMID: 29869702 DOI: 10.1007/s00420-018-1326-3] [Citation(s) in RCA: 5] [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: 12/04/2017] [Accepted: 05/22/2018] [Indexed: 01/18/2023]
Abstract
OBJECTIVES To compare a local cohort of 2488 men occupationally exposed to asbestos and enrolled in a public health surveillance program with the 1995-2009 cancer incidence of the general population of Friuli Venezia Giulia (FVG) region, Northeast Italy, we conducted a historical cohort study. METHODS Standardized incidence ratios (SIRs), with 95% confidence interval (95% CI), for specific cancer sites were estimated in the cohort and in subgroups of workers employed in shipbuilding between 1974 and 1994. For internal comparisons, we calculated incidence rate ratios (IRRs) for all cancers, lung cancer and mesothelioma, by level of exposure to asbestos and sector of employment adjusted for smoking habits and age at start of follow-up. RESULTS Among cohort members the SIR was 8.82 (95% CI 5.95-12.61) for mesothelioma and 1.61 (95% CI 1.26-2.04) for lung cancer. In subgroup analyses, the SIR for lung cancer in subjects hired in shipbuilding between 1974 and 1984 was 2.09 (95% CI 1.32-3.13). In the overall cohort, a borderline increased incidence was also found for stomach cancer (SIR = 1.53 95% CI 0.96-2.31). Internal comparisons within the cohort show that among men with high asbestos exposure level the relative risk was almost threefold for lung cancer (IRR = 2.94 95% CI 1.01-8.57). CONCLUSIONS This cohort experienced an excess in the incidence of both mesothelioma and lung cancer, showing increasing incidence rates at higher level of asbestos exposure. For lung cancer, the relative incidence was highest among workers hired in shipbuilding between 1974 and 1984.
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Affiliation(s)
- Fabiano Barbiero
- Dipartimento di Area Medica, University of Udine, Via Colugna 50, 33100, Udine, Italy.,Health and Safety at Work Department (SPISAL), Local Health Authority No 12, Region of Veneto, Mestre, Italy
| | - Tina Zanin
- Health and Safety at Work Department, Local Health Authority No 2 (ASS2), Region of Friuli Venezia Giulia, Gorizia, Italy
| | - Federica E Pisa
- Dipartimento di Area Medica, University of Udine, Via Colugna 50, 33100, Udine, Italy.,Institute of Hygiene and Clinical Epidemiology, Azienda Sanitaria Universitaria Integrata, Udine, Italy
| | - Anica Casetta
- Dipartimento di Area Medica, University of Udine, Via Colugna 50, 33100, Udine, Italy
| | - Valentina Rosolen
- Dipartimento di Area Medica, University of Udine, Via Colugna 50, 33100, Udine, Italy
| | - Manuela Giangreco
- Dipartimento di Area Medica, University of Udine, Via Colugna 50, 33100, Udine, Italy
| | - Corrado Negro
- Department of Medical Sciences, University of Trieste, Trieste, Italy
| | - Massimo Bovenzi
- Department of Medical Sciences, University of Trieste, Trieste, Italy
| | - Fabio Barbone
- Dipartimento di Area Medica, University of Udine, Via Colugna 50, 33100, Udine, Italy. .,Institute of Hygiene and Clinical Epidemiology, Azienda Sanitaria Universitaria Integrata, Udine, Italy. .,Department of Medical Sciences, University of Trieste, Trieste, Italy.
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Barbiero F, Zanin T, Pisa FE, Casetta A, Rosolen V, Giangreco M, Negro C, Bovenzi M, Barbone F. Mortality in a cohort of asbestos-exposed workers undergoing health surveillance. Med Lav 2018; 109:83-86. [PMID: 29701625 PMCID: PMC7682175 DOI: 10.23749/mdl.v109i2.5865] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/28/2016] [Accepted: 01/17/2018] [Indexed: 11/18/2022]
Abstract
Background: The coastal area of Friuli Venezia Giulia (FVG) region, north-eastern Italy, was characterized by work activities in which asbestos was used until the early 1990s, particularly in shipbuilding. A public health surveillance program (PHSP) for asbestos-exposed workers was established, although limited evidence exists about the efficacy of such programs in reducing disease occurrence and mortality. Objectives: To compare mortality in a cohort of 2,488 men occupationally exposed to asbestos, enrolled in a PHSP in FVG between the early 1990s and 2008, with that of the general population of FVG and Italy. Methods: Standardized Mortality Ratios (SMR), with 95% Confidence Interval (95% CI), for all causes, all cancers, lung (LC) and pleural cancer (PC) were estimated in the cohort and in subgroups of workers with the first hire in shipbuilding that caused asbestos exposure (<1974, 1974-1984, 1985-1994). Results: A strong excess in mortality for PC with reference to FVG (SMR=6.87, 95% CI 4.45-10.17) and Italian population (SMR=13.95, 95% CI 9.02-20.64) was observed. For LC, the FVG-based SMR was 1.49 (95% CI 1.17-1.89) and the Italy-based 1.43 (95% CI 1.12-1.81). Mortality among workers with the first hire in shipbuilding before 1974 was high for PC (FVG-based SMR=8.98, 95% CI 5.56-13.75; Italy-based SMR=18.41, 95% CI 11.40-28.17) and for LC (FVG-based SMR =1.60, 95% CI 1.18-2.11; Italy-based SMR=1.54, 95% CI 1.14-2.03). Further, for LC between 1974 and 1984, the FVG-based SMR was 2.45 (95% CI 1.06-4.82), and the Italy-based SMR was 2.33 (95% CI 1.01-4.60). Conclusions: This cohort experienced an excess mortality for pleural and lung cancer, compared with regional and national populations. For lung cancer, the excess was stronger in workers with the first hire in shipbuilding before 1985, suggesting a key role of asbestos exposure.
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Affiliation(s)
- Fabiano Barbiero
- Department of Medical Area (DAME), University of Udine, Udine, Italy Health and Health and Safety at Work Department (SPISAL), Local Health Authority N. 12, Region of Veneto, Mestre, Italy.
| | - Tina Zanin
- Health and Safety at Work Department. Local Health Authority No 2 (ASS2), Region of Friuli Venezia Giulia, Gorizia, Italy.
| | - Federica Edith Pisa
- Department Clinical Epidemiology, Leibniz Institute for Prevention Research and Epidemiology BIPS, Bremen, Germany and Institute of Hygiene and Clinical Epidemiology, University Hospital of Udine, Udine, Italy.
| | - Anica Casetta
- Department of Medical Area (DAME), University of Udine, Udine, Italy.
| | - Valentina Rosolen
- Department of Medical Area (DAME), University of Udine, Udine, Italy.
| | - Manuela Giangreco
- Department of Medical Area (DAME), University of Udine, Udine, Italy.
| | - Corrado Negro
- Clinical Unit of Occupational Medicine, Department of Medical Sciences, University of Trieste, Trieste, Italy.
| | - Massimo Bovenzi
- Clinical Unit of Occupational Medicine, Department of Medical Sciences, University of Trieste, Trieste, Italy.
| | - Fabio Barbone
- Department of Medical Area (DAME), University of Udine, Udine, Italy.
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Fasola G, Follador A, Barbiero F, Rosolen V, Belvedere O, Grossi F, Rossetto C, Rizzato S, Giavarra M, Gerratana L, Barbone F. Low dose CT scan screening versus empiric surveillance in asbestos exposed subjects: Update of ATOM 002 study. Ann Oncol 2016. [DOI: 10.1093/annonc/mdw381.02] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Barbiero F. P21.13 Perineurial spread from a leiomyosarcoma of the infratemporal fossa. Neuro Oncol 2016. [DOI: 10.1093/neuonc/now188.301] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Fasola G, Follador A, Barbiero F, Rosolen V, Belvedere O, Grossi F, Rossetto C, Rizzato S, Giavarra M, Gerratana L, Barbone F. Low dose computed tomography scan (LDCT) screening versus empiric surveillance in asbestos exposed subjects: an update from the ATOM002 study. Ann Oncol 2016. [DOI: 10.1093/annonc/mdw332.02] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Barbiero F, Giangreco M, Pisa FE, Negro C, Bovenzi M, Rosolen V, Barbone F. [Not Available]. Med Lav 2016; 107:307-314. [PMID: 27468090] [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] [Subscribe] [Scholar Register] [Received: 03/10/2016] [Revised: 05/31/2016] [Accepted: 06/22/2016] [Indexed: 06/06/2023]
Abstract
INTRODUCTION The incidence of mesothelioma in Italy shows wide geographical variation, with the highest incidence rates in Genoa and Friuli Venezia Giulia (FVG). For mesothelioma, national standard incidence rates are not available prior to the calendar year 2006. OBJECTIVES To estimate the Standardized Incidence rate Ratio (SIR) of mesothelioma in a cohort of former workers undergoing health surveillance because of previous asbestos exposure, when sex-, age-, and calendar year-specific rates of the national standard are not available and the number of expected cases calculated from the regional rates is biased by the size of the study cohort. METHODS We conducted a sensitivity analysis in a cohort of 2,488 men. We considered every Italian cancer registry available with complete data in the period 1995-2007 (N=14). We calculated, for each year and age group, the corresponding weighted mean rate of 10 registries of North-Italy (Mean W10), the weighted mean rate of all 14 registries available (Mean W14) and considered FVG standard rate. RESULTS During the period 1995-2007, we observed 25 incident cases of mesothelioma with expected cases that varied between 2.00 (Mean W14) and 2.56 (FVG standard rate), with a SIR of 12.49 (CI95% 8.08-18.48) and 9.76 (CI95% 6.32-14.45) respectively. CONCLUSIONS Our results show that the use of FVG rates as standard does not lead to significant distortions in the calculation of the expected cases. However, distortion is remarkable in the SIRs estimation. Using a weighted mean standard incidence rate may be a valid alternative for SIR estimate when national standard rates are not available.
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Affiliation(s)
- Fabiano Barbiero
- Dipartimento di Scienze Mediche e Biologiche, Università di Udine, Udine, Italia Dipartimento di Medicina Clinica e Sperimentale, Università di Parma, Parma, Italia Servizio Prevenzione Igiene e Sicurezza negli Ambienti di Lavoro (SPISAL), ULSS n. 12, Mestre, Italia.
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Fasola G, Grossi F, Belvedere O, Follador A, Zanin T, Cassetti P, Meduri S, Cattaneo M, Giavarra M, Pelizzari G, Giangreco M, Pisa FE, Rosolen V, Barbiero F, Barbone F. Screening with low-dose computed tomography (LDCT) of asbestos-exposed subjects and lung cancer (LC) mortality. J Clin Oncol 2016. [DOI: 10.1200/jco.2016.34.15_suppl.1554] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
- Gianpiero Fasola
- Department of Oncology, University Hospital of Udine, Udine, Italy
| | | | | | | | - Tina Zanin
- University of Udine, San Giorgio Di Nogaro, Italy
| | | | | | - Monica Cattaneo
- Department of Oncology, University Hospital of Udine, Udine, Italy
| | - Marco Giavarra
- Department of Oncology, University Hospital of Udine, Udine, Italy
| | | | - Manuela Giangreco
- Dept. of Medical and Biological Sciences, Udine University, Udine, Italy
| | | | - Valentina Rosolen
- Dept. of Medical and Biological Sciences, Udine University, Udine, Italy
| | - Fabiano Barbiero
- Dept.of Medical and Biological Sciences, Udine University, Udine, Italy
| | - Fabio Barbone
- Dept. of Medical and Biological Sciences, Udine University, Udine, Italy
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Barbiero F, Guidi M. [Value of lymph gland biopsy in pneumological diagnosis]. G Pneumol 1970; 14:278-85. [PMID: 5526265] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
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Barbiero F. [Aneurysm of the ascending aorta with involvement of the right upper pulmonary lobe]. Minerva Med 1968; 59:5517-23. [PMID: 5718840] [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: 01/16/2023]
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