Abstract
OBJECTIVE: To estimate mortality from lung cancer and the risk attributable to asbestos separately for asbestos cement workers and for the general (non-occupationally exposed) population in the town of Casale Monferrato, where the largest Italian asbestos cement factory had been in operation in 1907-86. According to cancer registry data, in the same town the incidence of malignant mesothelioma in the general population is about 10 times higher than in comparable Italian provinces. METHOD: Decedents from lung cancer in 1989-95 were nominally identified in the list of decedents kept at the Local Health Authority of Casale Monferrato. Workers in the asbestos cement factory have been identified with a search in the nominal list of workers and the same was done for the wives of asbestos cement workers. These lists have already been used in cohort studies. Sensitivity and specificity of the linkage procedure with occupational activity in asbestos cement production have been evaluated in a previous study. Population at risk was estimated on the basis of official figures and on the results of the cohort study of asbestos cement workers. RESULTS: 227 deaths from lung cancer were included (184 men and 43 women). Among the asbestos cement workers mortalities were 234.0 x 100,000 person-years among men and 35.5 among women. Corresponding figures in the general (non- occupationally exposed) population in Casale Monferrato were 80.6 and 18.7. The rates in the general population were not higher than in the rest of the region. Attributable risk (AR) among the asbestos cement workers (and wives) is 67.5% (95% confidence interval (95% CI) 56.8 to 78.2) for men and 51.3% (95% CI 14.9 to 87.8) among women. Population AR to occupational or paraoccupational exposure in the asbestos cement production is 18.3% (95% CI 11.1 to 25.6) among men and 10.1% (95% CI 0 to 24.6) among women. CONCLUSION: This work did not show an increase in mortality from lung cancer for the population not exposed occupationally, but a large excess was found among men and women occupationally exposed in asbestos cement production. The total burden of lung cancer due to occupational exposure to asbestos may be underestimated, as only occupational exposure in asbestos cement production was taken into consideration. Nevertheless even a single factory can be responsible for a considerable proportion of deaths from lung cancer in a population.
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- Albin M., Shefer I., Magnani C., Krstev S. Asbestos and cancer. Med Lav. 1995 May-Jun;86(3):259–262. [PubMed] [Google Scholar]
- Botha J. L., Irwig L. M., Strebel P. M. Excess mortality from stomach cancer, lung cancer, and asbestosis and/or mesothelioma in crocidolite mining districts in South Africa. Am J Epidemiol. 1986 Jan;123(1):30–40. doi: 10.1093/oxfordjournals.aje.a114221. [DOI] [PubMed] [Google Scholar]
- Bovenzi M., Stanta G., Antiga G., Peruzzo P., Cavallieri F. Occupational exposure and lung cancer risk in a coastal area of northeastern Italy. Int Arch Occup Environ Health. 1993;65(1):35–41. doi: 10.1007/BF00586056. [DOI] [PubMed] [Google Scholar]
- Chiappino G., Sebastien P., Todaro A. L'inquinamento atmosferico da amianto nell'ambiente urbano: Milano, Casale Monferrato, Brescia, Ancona, Bologna, Firenze. Med Lav. 1991 Sep-Oct;82(5):424–438. [PubMed] [Google Scholar]
- De Vos Irvine H., Lamont D. W., Hole D. J., Gillis C. R. Asbestos and lung cancer in Glasgow and the west of Scotland. BMJ. 1993 Jun 5;306(6891):1503–1506. doi: 10.1136/bmj.306.6891.1503. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Greenland S. Variance estimators for attributable fraction estimates consistent in both large strata and sparse data. Stat Med. 1987 Sep;6(6):701–708. doi: 10.1002/sim.4780060607. [DOI] [PubMed] [Google Scholar]
- Hammond E. C., Garfinkel L., Selikoff I. J., Nicholson W. J. Mortality experience of residents in the neighborhood of an asbestos factory. Ann N Y Acad Sci. 1979;330:417–422. doi: 10.1111/j.1749-6632.1979.tb18743.x. [DOI] [PubMed] [Google Scholar]
- Kjuus H., Langård S., Skjaerven R. A case-referent study of lung cancer, occupational exposures and smoking. III. Etiologic fraction of occupational exposures. Scand J Work Environ Health. 1986 Jun;12(3):210–215. doi: 10.5271/sjweh.2156. [DOI] [PubMed] [Google Scholar]
- Magnani C., Terracini B., Ivaldi C., Botta M., Budel P., Mancini A., Zanetti R. A cohort study on mortality among wives of workers in the asbestos cement industry in Casale Monferrato, Italy. Br J Ind Med. 1993 Sep;50(9):779–784. doi: 10.1136/oem.50.9.779. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Magnani C., Terracini B., Ivaldi C., Botta M., Mancini A., Andrion A. Pleural malignant mesothelioma and non-occupational exposure to asbestos in Casale Monferrato, Italy. Occup Environ Med. 1995 Jun;52(6):362–367. doi: 10.1136/oem.52.6.362. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Magnani C., Terracini B., Ivaldi C., Mancini A., Botta M. Mortalità per tumori e altre cause tra i lavoratori del cemento-amianto a Casale Monferrato. Med Lav. 1996 Mar-Apr;87(2):133–146. [PubMed] [Google Scholar]
- Marconi A., Cecchetti G., Barbieri M. Airborne mineral fibre concentrations in an urban area near an asbestos-cement plant. IARC Sci Publ. 1989;(90):336–346. [PubMed] [Google Scholar]
- Parolari G., Merler E., Ricci P. Mortalità per tumore attribuibile all'esposizione lavorativa ad amianto-amosite in una communità. Epidemiol Prev. 1988 Dec;10(37):32–37. [PubMed] [Google Scholar]