Italian pool of asbestos workers cohorts: mortality trends of asbestos-related neoplasms after long time since first exposure

Daniela Ferrante, Elisabetta Chellini, Enzo Merler, Venere Pavone, Stefano Silvestri, Lucia Miligi, Giuseppe Gorini, Vittoria Bressan, Paolo Girardi, Laura Ancona, Elisa Romeo, Ferdinando Luberto, Orietta Sala, Corrado Scarnato, Simona Menegozzo, Enrico Oddone, Sara Tunesi, Patrizia Perticaroli, Aldo Pettinari, Francesco CuccaroStefano Mattioli, Antonio Baldassarre, Francesco Barone-Adesi, Tiziana Cena, Patrizia Legittimo, Alessandro Marinaccio, Dario Mirabelli, Marina Musti, Roberta Pirastu, Alessandra Ranucci, Corrado Magnani, and the working group

Research output: Contribution to journalArticle

24 Citations (Scopus)

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.

Original languageEnglish
Pages (from-to)887-898
Number of pages12
JournalOccupational and Environmental Medicine
Volume74
Issue number12
DOIs
Publication statusPublished - Dec 2017

Fingerprint

Asbestos
Mortality
Ovarian Neoplasms
Neoplasms
Larynx
Lung Neoplasms
Asbestosis
Pleura
Peritoneum
Lost to Follow-Up
Carcinogens
Italy
Gastrointestinal Tract
Lung

Keywords

  • Adult
  • Aged
  • Asbestos
  • Asbestosis
  • Carcinogens
  • Cause of Death
  • Cohort Studies
  • Construction Materials
  • Female
  • Humans
  • Italy
  • Lung
  • Lung Neoplasms
  • Male
  • Mesothelioma
  • Middle Aged
  • Occupational Diseases
  • Occupational Exposure
  • Ovarian Neoplasms
  • Ovary
  • Peritoneal Neoplasms
  • Peritoneum
  • Pleura
  • Pleural Neoplasms
  • Journal Article

Cite this

Italian pool of asbestos workers cohorts : mortality trends of asbestos-related neoplasms after long time since first exposure. / Ferrante, Daniela; Chellini, Elisabetta; Merler, Enzo; Pavone, Venere; Silvestri, Stefano; Miligi, Lucia; Gorini, Giuseppe; Bressan, Vittoria; Girardi, Paolo; Ancona, Laura; Romeo, Elisa; Luberto, Ferdinando; Sala, Orietta; Scarnato, Corrado; Menegozzo, Simona; Oddone, Enrico; Tunesi, Sara; Perticaroli, Patrizia; Pettinari, Aldo; Cuccaro, Francesco; Mattioli, Stefano; Baldassarre, Antonio; Barone-Adesi, Francesco; Cena, Tiziana; Legittimo, Patrizia; Marinaccio, Alessandro; Mirabelli, Dario; Musti, Marina; Pirastu, Roberta; Ranucci, Alessandra; Magnani, Corrado; and the working group.

In: Occupational and Environmental Medicine, Vol. 74, No. 12, 12.2017, p. 887-898.

Research output: Contribution to journalArticle

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 & and the working group 2017, 'Italian pool of asbestos workers cohorts: mortality trends of asbestos-related neoplasms after long time since first exposure', Occupational and Environmental Medicine, vol. 74, no. 12, pp. 887-898. https://doi.org/10.1136/oemed-2016-104100
Ferrante, Daniela ; Chellini, Elisabetta ; Merler, Enzo ; Pavone, Venere ; Silvestri, Stefano ; Miligi, Lucia ; Gorini, Giuseppe ; Bressan, Vittoria ; Girardi, Paolo ; Ancona, Laura ; Romeo, Elisa ; Luberto, Ferdinando ; Sala, Orietta ; Scarnato, Corrado ; Menegozzo, Simona ; Oddone, Enrico ; Tunesi, Sara ; Perticaroli, Patrizia ; Pettinari, Aldo ; Cuccaro, Francesco ; Mattioli, Stefano ; Baldassarre, Antonio ; Barone-Adesi, Francesco ; Cena, Tiziana ; Legittimo, Patrizia ; Marinaccio, Alessandro ; Mirabelli, Dario ; Musti, Marina ; Pirastu, Roberta ; Ranucci, Alessandra ; Magnani, Corrado ; and the working group. / Italian pool of asbestos workers cohorts : mortality trends of asbestos-related neoplasms after long time since first exposure. In: Occupational and Environmental Medicine. 2017 ; Vol. 74, No. 12. pp. 887-898.
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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 1970{\^a}€{"}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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author = "Daniela Ferrante and Elisabetta Chellini and Enzo Merler and Venere Pavone and Stefano Silvestri and Lucia Miligi and Giuseppe Gorini and Vittoria Bressan and Paolo Girardi and Laura Ancona and Elisa Romeo and Ferdinando Luberto and Orietta Sala and Corrado Scarnato and Simona Menegozzo and Enrico Oddone and Sara Tunesi and Patrizia Perticaroli and Aldo Pettinari and Francesco Cuccaro and Stefano Mattioli and Antonio Baldassarre and Francesco Barone-Adesi and Tiziana Cena and Patrizia Legittimo and Alessandro Marinaccio and Dario Mirabelli and Marina Musti and Roberta Pirastu and Alessandra Ranucci and Corrado Magnani and {and the working group}",
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TY - JOUR

T1 - Italian pool of asbestos workers cohorts

T2 - mortality trends of asbestos-related neoplasms after long time since first exposure

AU - Ferrante, Daniela

AU - Chellini, Elisabetta

AU - Merler, Enzo

AU - Pavone, Venere

AU - Silvestri, Stefano

AU - Miligi, Lucia

AU - Gorini, Giuseppe

AU - Bressan, Vittoria

AU - Girardi, Paolo

AU - Ancona, Laura

AU - Romeo, Elisa

AU - Luberto, Ferdinando

AU - Sala, Orietta

AU - Scarnato, Corrado

AU - Menegozzo, Simona

AU - Oddone, Enrico

AU - Tunesi, Sara

AU - Perticaroli, Patrizia

AU - Pettinari, Aldo

AU - Cuccaro, Francesco

AU - Mattioli, Stefano

AU - Baldassarre, Antonio

AU - Barone-Adesi, Francesco

AU - Cena, Tiziana

AU - Legittimo, Patrizia

AU - Marinaccio, Alessandro

AU - Mirabelli, Dario

AU - Musti, Marina

AU - Pirastu, Roberta

AU - Ranucci, Alessandra

AU - Magnani, Corrado

AU - and the working group

N1 - © 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.

PY - 2017/12

Y1 - 2017/12

N2 - 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.

AB - 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.

KW - Adult

KW - Aged

KW - Asbestos

KW - Asbestosis

KW - Carcinogens

KW - Cause of Death

KW - Cohort Studies

KW - Construction Materials

KW - Female

KW - Humans

KW - Italy

KW - Lung

KW - Lung Neoplasms

KW - Male

KW - Mesothelioma

KW - Middle Aged

KW - Occupational Diseases

KW - Occupational Exposure

KW - Ovarian Neoplasms

KW - Ovary

KW - Peritoneal Neoplasms

KW - Peritoneum

KW - Pleura

KW - Pleural Neoplasms

KW - Journal Article

U2 - 10.1136/oemed-2016-104100

DO - 10.1136/oemed-2016-104100

M3 - Article

C2 - 28775133

VL - 74

SP - 887

EP - 898

JO - Occupational and Environmental Medicine

JF - Occupational and Environmental Medicine

SN - 1351-0711

IS - 12

ER -