TY - JOUR
T1 - Mortality from cancer and other diseases of the respiratory apparatus among asbestos-cement workers in Casale Monferrato (Italy)
T2 - Historical cohort study
AU - Magnani, C.
AU - Terracini, B.
AU - Bertolone, G. P.
AU - Castagneto, B.
AU - Cocito, V.
AU - De Giovanni, D.
AU - Paglieri, P.
AU - Botta, M.
PY - 1987
Y1 - 1987
N2 - The paper describes a historical cohort study on the mortality of blue-collar workers in an asbestos-cement production plant located in the Piedmont Region (North Western Italy). The plant had been in operation since the beginning of the century but the available data on concentrations of airborne asbestos fibres in the workplace were scanty and insufficient to estimate individual exposures. It was reported that 10% of the asbestos used in 1980 was crocidolite and the rest chrysotile, and that working conditions had improved after 1973. The plant ceased operations in 1986. The cohort included blue-collar workers in the plant on 1 January 1950 or hired subsequently up to 31 December 1980, for a total of 2608 men and 759 women. The follow-up ended on 15 April 1986 with 97.9% of the cohort members traced. The expected numbers of deaths were estimated from the regional age- and sex-specific mortality rates of the population of Piedmont in the period 1969-81. Regional rates for 1969-74 were applied to the pool of person-years for 1964-68, and the 1975-81 rates to 1982-86. Subjects who died (134) or were lost to follow-up (41) before 1 January 1964 were excluded from the study. Person-years at risk on which SMRs were estimated were 43002 for men and 14494 for women. A statistically significant increase was found in both sexes for mortality from all causes, all cancers, respiratory cancers and asbestosis; 728 men died during the study period (608 expected), 28 from pleural tumours (1 expected) and 85 from asbesosis (< 1 expected). The corresponding figures for women were: all causes - 136 deaths versus 102 expected; all cancers - 79 versus 32 expected; lung cancer - 7 versus 2 expected; pleural tumours - 15 versus 0 expected; asbestosis - 4 versus 0 expected. Deaths from digestive cancers were close to the expected numbers among males (60 versus 55) but not among females (18 versus 10); these figures included 10 deaths from peritoneal cancer among men and 4 among women. No excess was found for deaths from laryngeal cancer. Other cancer sites have not yet been analysed separately. SMRs for lung cancer among males showed a clear increase with length of follow-up. On the contrary SMRs for cardiovascular diseases were below 100 even after a follow-up period of more than 30 years. Among male workers employed for less than 1 year, 28 deaths from lung cancer (10.4 expected), 5 from pleural tumours and 22 from asbestosis were observed; the corresponding figures for females were 3 (0.8 expected), 3 and 4. Among males, lung cancer SMRs according to length of employment were: 234 for 10-19 years service, 363 to 20-29 years service, and 256 for persons employed for 30 years or more (all statistically significant, p < 0.05 or lower). No data on smoking or individual job histories were available but the excess mortality did not seem to be due to uncontrolled confounding factors only.
AB - The paper describes a historical cohort study on the mortality of blue-collar workers in an asbestos-cement production plant located in the Piedmont Region (North Western Italy). The plant had been in operation since the beginning of the century but the available data on concentrations of airborne asbestos fibres in the workplace were scanty and insufficient to estimate individual exposures. It was reported that 10% of the asbestos used in 1980 was crocidolite and the rest chrysotile, and that working conditions had improved after 1973. The plant ceased operations in 1986. The cohort included blue-collar workers in the plant on 1 January 1950 or hired subsequently up to 31 December 1980, for a total of 2608 men and 759 women. The follow-up ended on 15 April 1986 with 97.9% of the cohort members traced. The expected numbers of deaths were estimated from the regional age- and sex-specific mortality rates of the population of Piedmont in the period 1969-81. Regional rates for 1969-74 were applied to the pool of person-years for 1964-68, and the 1975-81 rates to 1982-86. Subjects who died (134) or were lost to follow-up (41) before 1 January 1964 were excluded from the study. Person-years at risk on which SMRs were estimated were 43002 for men and 14494 for women. A statistically significant increase was found in both sexes for mortality from all causes, all cancers, respiratory cancers and asbestosis; 728 men died during the study period (608 expected), 28 from pleural tumours (1 expected) and 85 from asbesosis (< 1 expected). The corresponding figures for women were: all causes - 136 deaths versus 102 expected; all cancers - 79 versus 32 expected; lung cancer - 7 versus 2 expected; pleural tumours - 15 versus 0 expected; asbestosis - 4 versus 0 expected. Deaths from digestive cancers were close to the expected numbers among males (60 versus 55) but not among females (18 versus 10); these figures included 10 deaths from peritoneal cancer among men and 4 among women. No excess was found for deaths from laryngeal cancer. Other cancer sites have not yet been analysed separately. SMRs for lung cancer among males showed a clear increase with length of follow-up. On the contrary SMRs for cardiovascular diseases were below 100 even after a follow-up period of more than 30 years. Among male workers employed for less than 1 year, 28 deaths from lung cancer (10.4 expected), 5 from pleural tumours and 22 from asbestosis were observed; the corresponding figures for females were 3 (0.8 expected), 3 and 4. Among males, lung cancer SMRs according to length of employment were: 234 for 10-19 years service, 363 to 20-29 years service, and 256 for persons employed for 30 years or more (all statistically significant, p < 0.05 or lower). No data on smoking or individual job histories were available but the excess mortality did not seem to be due to uncontrolled confounding factors only.
UR - http://www.scopus.com/inward/record.url?scp=0023447598&partnerID=8YFLogxK
M3 - Article
SN - 0025-7818
VL - 78
SP - 441
EP - 453
JO - Medicina del Lavoro
JF - Medicina del Lavoro
IS - 6
ER -