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Italian pool of asbestos workers cohorts: mortality trends of asbestos-related neoplasms after long time since first exposure.
- Source :
-
Occupational and environmental medicine [Occup Environ Med] 2017 Dec; Vol. 74 (12), pp. 887-898. Date of Electronic Publication: 2017 Aug 03. - Publication Year :
- 2017
-
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.<br />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.<br />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.<br />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.<br />Competing Interests: Competing interests: The following authors reported that they served as expert witness for the public prosecutor in court trials on asbestos related diseases: CM, EM, DM, EO, SS.<br /> (© Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.)
- Subjects :
- Adult
Aged
Asbestosis mortality
Carcinogens
Cause of Death trends
Cohort Studies
Construction Materials
Female
Humans
Italy epidemiology
Lung
Lung Neoplasms etiology
Male
Mesothelioma etiology
Mesothelioma, Malignant
Middle Aged
Occupational Diseases etiology
Ovarian Neoplasms etiology
Ovary
Peritoneal Neoplasms etiology
Peritoneum
Pleura
Pleural Neoplasms etiology
Asbestos adverse effects
Lung Neoplasms mortality
Mesothelioma mortality
Occupational Diseases mortality
Occupational Exposure adverse effects
Ovarian Neoplasms mortality
Peritoneal Neoplasms mortality
Pleural Neoplasms mortality
Subjects
Details
- Language :
- English
- ISSN :
- 1470-7926
- Volume :
- 74
- Issue :
- 12
- Database :
- MEDLINE
- Journal :
- Occupational and environmental medicine
- Publication Type :
- Academic Journal
- Accession number :
- 28775133
- Full Text :
- https://doi.org/10.1136/oemed-2016-104100