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Background: On September 1976, due to the explosion of an ammonia-washing column at the petrochemical plant in Manfredonia (Italy), 39 tonnes of arsenic were released into the atmosphere, contaminating the plants and the neighbourhoods close to it. The aim of this study is to present the results of a 45-year follow up of exposed workers with a focus on residential exposure., Methods: We contacted Italian General Registries Offices and updated the vital status of persons involved in the clean-up activities following the disaster. The outcome of interest was the overall and cause-specific mortality. An accelerated failure time (AFT) approach was used when appropriate to model the risk of mortality., Results: 1772 workers contributing 67,743 person years were considered in the analysis. For overall mortality, results of the age-adjusted AFT model show an accelerator factor of 0.89 (95%CI 0.80-0.99) among contract workers, which means a shortening of survival in comparison to the reference category (plastic area workers). When accounting for latency greater than 20 years, higher mortality rates for lung cancer were observed among workers residing in Manfredonia., Discussion: An increased risk of mortality among workers who were more exposed to arsenic during the clean-up activities has been observed. In fact, a loss of 5 years of life among more exposed workers was calculated. Furthermore, the mortality rates of residents in Manfredonia were higher than those of workers residing elsewhere., Competing Interests: Declaration of competing interest All of the authors declare that they do not have any competing interests., (Copyright © 2024 The Authors. Published by Elsevier GmbH.. All rights reserved.)

Since the beginning of the COVID-19 pandemic, data have been accumulated to examine excess mortality in the first half of 2020. Mortality in the preceding year or years is used to calculate the expected number of deaths, which is then compared with the actual number of deaths in 2020. We calculated weekly age- and sex-specific mortality rates for 93.1% of the Italian municipalities for the years 2015-2019 and for the first 26 weeks in 2020. We assumed the mortality experience during 2015-2019 as the reference period to calculate standardised mortality ratios. Furthermore, in order to compare the mortality experience of males and females, we calculated sex- and age- specific weekly direct standardised mortality rates and differences between the observed and expected number of deaths. We observed considerable changes in the demographics in the Italian population between the years 2015 and 2020, particularly among people 60 years and older and among males. The population is aging and the proportion of elderly males has increased, which was not reflected adequately in previous estimates of excess mortality. Standardized excess mortality results show that in Italy between the 8th and 26th weeks in 2020, there were 33,035 excess deaths, which is only 643 fewer deaths than the official COVID-19 death toll for this time period. A comparative increase in the mortality rates was observed in March among both sexes, but particularly for males. Comparisons with recently published data show considerably higher excess deaths, but these data were either not covering the complete country or did not account for age and sex. Neglecting the demographic changes in a region, even over a short time span, can result in biased estimates.

Background: In 1976 in Manfredonia (Italy), arsenic was released into the atmosphere due to an accident in a petrochemical plant. We aimed to analyze the mortality of workers involved in the factory for the site cleaning activities., Methods: The cohort consisted of 1467 workers grouped into contract, fertilizer, and plastic workers. The outcome of interest was mortality for specific causes. Standardized mortality ratios (SMR) and 95% confidence intervals (95%CI) were computed., Results: For all workers and all causes of death combined, the SMR was less than 1.0. Mortality ratios were increased for malignant neoplasms of the pleura, bone and melanoma of the skin. Contract workers, the group mostly exposed to arsenic, showed statistically significant SMRs for several malignancies, in particular for lung cancer (SMR = 1.26; 95%CI: 1.05-1.54)., Conclusions: Overall, the results reported here on mortality among persons occupationally exposed to arsenic are consistent with the literature and biologically plausible., (© 2019 Wiley Periodicals, Inc.)

Introduction: in 1976, a major chemical accident occurred in Manfredonia (Apulia Region, Southern Italy) due to an explosion in the fertilizer area. More than 10 tons of arsenic were released into the atmosphere, contaminating the plant and the surrounding areas. At the end of the 90s, criminal proceedings were initiated and a cohort study was conducted within the trial., Objectives: to update the vital status of workers enrolled within the trial; some relevant results are also given., Methods: two different approaches were used to update the vital status depending on the residence of the individuals in the cohort. We computed cause-specific standardised mortality ratios (SMRs), stratified according to the type of employment (urea sector, caprolactam sector, and contract workers), with 95% confidence intervals (95%CI). For internal comparison purpose, Cox regression models were used and hazard ratios (HRs) were calculated, considering workers from the caprolactam area as a reference category., Results: the cohort consisted of 1,467 workers; 114 were dead at the end of the previous follow-up. Among 728 workers residing in Manfredonia, we identified 619 people still alive and 93 deceased. Among 625 not-residents, 508 were alive and 93 deceased. For 285 cases out of 306, cause of death was ascertained. Contract workers show a statistically significant SMR for lung cancer (SMR: 1.26; 95%CI 1.05-1.54) and an increased risk for overall mortality (HR: 2.3; 95%CI 1.1-4.9). Workers residing in Manfredonia show a higher risk of lung cancer mortality in comparison to not-residents (HR: 2.3; 95%CI 1.1-4.9)., Conclusions: workers who were most exposed to arsenic during the site cleaning show an increased risk of overall mortality compared to the least exposed and an increased risk of lung cancer compared to the general population.