Cumulative asbestos exposure and mortality from asbestos related diseases in a pooled analysis of 21 asbestos cement cohorts in Italy

Autor: Luberto F., Ferrante D., Silvestri S., Angelini A., Cuccaro F., Nannavecchia A. M., Oddone E., Vicentini M., Barone-Adesi F., Cena T., Mirabelli D., Mangone L., Roncaglia F., Sala O., Menegozzo S., Pirastu R., Azzolina D., Tunesi S., Chellini E., Miligi L., Perticaroli P., Pettinari A., Bressan V., Merler E., Girardi P., Bisceglia L., Marinaccio A., Massari S., Magnani C., Working group, Curti S., Mattioli S.
Přispěvatelé: Luberto F., Ferrante D., Silvestri S., Angelini A., Cuccaro F., Nannavecchia A.M., Oddone E., Vicentini M., Barone-Adesi F., Cena T., Mirabelli D., Mangone L., Roncaglia F., Sala O., Menegozzo S., Pirastu R., Azzolina D., Tunesi S., Chellini E., Miligi L., Perticaroli P., Pettinari A., Bressan V., Merler E., Girardi P., Bisceglia L., Marinaccio A., Massari S., Magnani C., Working group, Curti S., Mattioli S.
Jazyk: angličtina
Rok vydání: 2019
Předmět:
Male
Mesothelioma
Asbestos
Asbestos-cement
Dose response relationship
Mesothelioma
Lung cancer
Ovarian Cancer
Epidemiology
Time Factors
Epidemiology
Health
Toxicology and Mutagenesis
Asbestosis
Physiology
Cumulative Exposure
medicine.disease_cause
Cohort Studies
Neoplasms
Chrysotile
Asbestos-related diseases
0303 health sciences
lcsh:Public aspects of medicine
Middle Aged
Asbestos-cement
Asbestos cement
Ovarian Cancer
Italy
Dose response relationship
lcsh:Industrial medicine. Industrial hygiene
Female
Lung cancer
Settore SECS-S/01 - Statistica
Adult
Asbesto
Asbestos
Settore MED/01 - Statistica Medica
NO
03 medical and health sciences
lcsh:RC963-969
Young Adult
Sex Factors
Occupational Exposure
medicine
Humans
business.industry
Research
Public Health
Environmental and Occupational Health
030311 toxicology
lcsh:RA1-1270
medicine.disease
business
Zdroj: Environmental Health
Environmental Health, Vol 18, Iss 1, Pp 1-19 (2019)
Popis: Background Despite the available information on cancer risk, asbestos is used in large areas in the world, mostly in the production of asbestos cement. Moreover, questions are raised regarding the shape of the dose response relation, the relation with time since exposure and the association with neoplasms in various organs. We conducted a study on the relationship between cumulative asbestos exposure and mortality from asbestos related diseases in a large Italian pool of 21 cohorts of asbestos-cement workers with protracted exposure to both chrysotile and amphibole asbestos. Methods The cohort included 13,076 workers, 81.9% men and 18.1% women, working in 21 Italian asbestos-cement factories, with over 40 years of observation. Exposure was estimated by plant and period, and weighted for the type of asbestos used. Data were analysed with consideration of cause of death, cumulative exposure and time since first exposure (TSFE), and by gender. SMRs were computed using reference rates by region, gender and calendar time. Poisson regression models including cubic splines were used to analyse the effect of cumulative exposure to asbestos and TSFE on mortality for asbestos-related diseases. 95% Confidence Intervals (CI) were computed according to the Poisson distribution. Results Mortality was significantly increased for ‘All Causes’ and ‘All Malignant Neoplasm (MN)’, in both genders. Considering asbestos related diseases (ARDs), statistically significant excesses were observed for MN of peritoneum (SMR: men 14.19; women 15.14), pleura (SMR: 22.35 and 48.10), lung (SMR: 1.67 and 1.67), ovary (in the highest exposure class SMR 2.45), and asbestosis (SMR: 507 and 1023). Mortality for ARDs, in particular pleural and peritoneal malignancies, lung cancer, ovarian cancer and asbestosis increased monotonically with cumulative exposure. Pleural MN mortality increased progressively in the first 40 years of TSFE, then reached a plateau, while peritoneal MN showed a continuous increase. The trend of lung cancer SMRs also showed a flattening after 40 years of TSFE. Attributable proportions for pleural, peritoneal, and lung MN were respectively 96, 93 and 40%. Conclusions Mortality for ARDs was associated with cumulative exposure to asbestos. Risk of death from pleural MN did not increase indefinitely with TSFE but eventually reached a plateau, consistently with reports from other recent studies. Electronic supplementary material The online version of this article (10.1186/s12940-019-0510-6) contains supplementary material, which is available to authorized users.
Databáze: OpenAIRE
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