A cohort of 889 men and 1077 women employed for at least 1 month between 1946 and 1984 by a former Italian leading asbestos (mainly textile) company, characterised by extremely heavy exposures often for short durations, was followed up to 1996, for a total of 53 024 person-years of observation. Employment data were obtained from factory personnel records, while vital status and causes of death were ascertained through municipality registers and local health units. We observed 222 cancer deaths compared with 116.4 expected (standardized mortality ratio, SMR ¼ 191). The highest ratios were found for pleural (SMR ¼ 4105), peritoneal (SMR ¼ 1817) and lung (SMR ¼ 282) cancers. We observed direct relationships with duration of employment for lung and peritoneal cancer, and with time since first employment for lung cancer and mesothelioma. Pleural cancer risk was independent from duration (SMR ¼ 3428 for employment o1 year, 7659 for 1 -4 years, 2979 for 5 -9 years and 2130 for X10 years). Corresponding SMRs for lung cancer were 139, 251, 233 and 531. Nonsignificantly increased ratios were found for ovarian (SMR ¼ 261), laryngeal (SMR ¼ 238) and oro-pharyngeal (SMR ¼ 226) cancers. This study confirms and further quantifies the central role of latency in pleural mesothelioma and of cumulative exposure in lung cancer.
We analysed data from a cohort of 1966 subjects (889 men and 1077 women) employed by an Italian asbestos (mainly textile) company in the period 1946 -1984, who were followed-up to 2004. A total of 62 025 person-years of observation were recorded. We computed standardised mortality ratios (SMR) for all causes and selected cancer sites using national death rates for each 5-year calendar period and age group. There were 68 deaths from mesothelioma (25 men and 43 women, 39 pleural and 29 peritoneal) vs 1.6 expected (SMR ¼ 4159), and 109 from lung cancer vs 35.1 expected (SMR ¼ 310). The SMRs of pleural/peritoneal cancer were 6661 for subjects exposed only before 30 years of age, 8019 for those first exposed before 30 and still employed at 30 -39 years of age and 5786 for those first exposed before 30 and still employed at 40 or more years of age. The corresponding SMRs for lung cancer were 227, 446 and 562. The SMR of mesothelioma was strongly related to time since first exposure. The SMR of lung cancer, but not of mesothelioma, appeared to be related to subsequent exposures.
This updated analysis, with almost 60% of the cohort having died, confirmed the excess mortality from pleural and peritoneal cancers and from several alcohol-related causes.
This study provides additional support for an association between talc in mining and milling and non-neoplastic respiratory diseases, while showing no significant excess risk for lung cancer and mesothelioma. The results also provide additional information of interest to evaluate the potential association between silica and lung cancer.
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