Temporal Patterns of Exposure to Asbestos and Risk of Asbestosis

Farioli, Andrea; Violante, Francesco Saverio; Vecchia, Carlo La; Negri, Eva; Pelucchi, Claudio; Spatari, Giovanna; Boffetta, Paolo; Pira, Enrico

doi:10.1097/jom.0000000000001260

Cited by 7 publications

(7 citation statements)

References 24 publications

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“…The results obtained in this study suggest that the higher SMR for asbestosis among females with respect to males does not reflect a real higher risk, but a larger impact of the AC sector on rates of the reference female population compared with males. This is supported by the internal analysis based on relative risks demonstrating a lower mortality risk for asbestosis among female workers, consistent with previous reports (Darnton et al, 2012;Farioli et al, 2018). This result, stemming also from the analyses adjusted for cumulative exposure and time since first exposure, may be could not take into account the jobs of cohort members, whereas women were mainly employed in specific tasks, with less demand for physical strength (such as manufacture of 'special' products) and, presumably, different exposure patterns.…”

Section: Discussionsupporting

confidence: 91%

“…In the absence of detailed information on exposure, most epidemiological studies have reported a birth cohort effect on asbestosis rate (Harding et al, 2009;Harding and Darnton, 2010;Darnton et al, 2012), with a strong decline for recent birth cohorts (Hanley et al, 2011;Farioli et al, 2018). The present study is a part of a large project on epidemiological surveillance of asbestos workers (Ferrante et al, 2017).…”

Section: Introductionmentioning

confidence: 85%

“…For each worker, the CAEI was calculated by summing up all indices assigned to the factory where the study participants worked through their period of employment. The effect of the exposure was measured by means of diverse and complementary analyses (SMR and APC regression model) in order to explore mortality patterns, not as thoroughly evaluated in the previous studies (Harding et al, 2009;Deng et al, 2012;Farioli et al, 2018); Our study, however, was restricted to a single occupational sector. SMR analysis is commonly used in mortality studies, but SMRs from asbestosis are strongly influenced by the proportion of asbestos workers in the reference population, When this proportion varies across the strata of the reference population, for example by gender or geography, caution is needed in making inferences based on SMR comparisons, as it may not be a reliable measure of risk.…”

Section: Discussionmentioning

confidence: 99%

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Factors Affecting Asbestosis Mortality Among Asbestos-Cement Workers in Italy

Girardi

Merler

Ferrante

et al. 2020

Annals of Work Exposures and Health

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Abstract Objectives This study was performed with the aim of investigating the temporal patterns and determinants associated with mortality from asbestosis among 21 cohorts of Asbestos-Cement (AC) workers who were heavily exposed to asbestos fibres. Methods Mortality for asbestosis was analysed for a cohort of 13 076 Italian AC workers (18.1% women). Individual cumulative asbestos exposure index was calculated by factory and period of work weighting by the different composition of asbestos used (crocidolite, amosite, and chrysotile). Two different approaches to analysis, based on Standardized Mortality Ratios (SMRs) and Age-Period-Cohort (APC) models were applied. Results Among the considered AC facilities, asbestos exposure was extremely high until the end of the 1970s and, due to the long latency, a peak of asbestosis mortality was observed after the 1990s. Mortality for asbestosis reached extremely high SMR values [SMR: males 508, 95% confidence interval (CI): 446–563; females 1027, 95% CI: 771–1336]. SMR increased steeply with the increasing values of cumulative asbestos exposure and with Time Since the First Exposure. APC analysis reported a clear age effect with a mortality peak at 75–80 years; the mortality for asbestosis increased in the last three quintiles of the cumulative exposure; calendar period did not have a significant temporal component while the cohort effect disappeared if we included in the model the cumulative exposure to asbestos. Conclusions Among heaviest exposed workers, mortality risk for asbestosis began to increase before 50 years of age. Mortality for asbestosis was mainly determined by cumulative exposure to asbestos.

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Section: Discussionsupporting

confidence: 91%

Section: Introductionmentioning

confidence: 85%

Section: Discussionmentioning

confidence: 99%

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Factors Affecting Asbestosis Mortality Among Asbestos-Cement Workers in Italy

Girardi

Merler

Ferrante

et al. 2020

Annals of Work Exposures and Health

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“…The most common symptom of all ILDs is shortness of breath or dyspnea, often accompanied by a dry cough, chest discomfort, fatigue, and occasionally weight loss. Examples of ILDs include sarcoidosis, asbestosis, hypersensitivity pneumonitis, idiopathic pulmonary fibrosis (IPF), non-specific interstitial pneumonia (NSIP), and acute interstitial pneumonitis ( 14 , 15 ). Some of the risk factors of ILDs are genetics; exposure to hazardous material, such as asbestos; prior infection with microorganisms, including tuberculosis and hepatitis C; radiation and chemotherapy treatments; smoking; connective tissue diseases; and chronic inflammatory diseases like rheumatoid arthritis ( 16 ).…”

Section: Introductionmentioning

confidence: 99%

Role of the Microbiome in Interstitial Lung Diseases

et al. 2021

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There are trillions of microorganisms in the human body, consisting of bacteria, viruses, fungi, and archaea; these collectively make up the microbiome. Recent studies suggest that the microbiome may serve as a biomarker for disease, a therapeutic target, or provide an explanation for pathophysiology in lung diseases. Studies describing the impact of the microorganisms found in the respiratory tract on lung health have been published and are discussed here in the context of interstitial lung diseases. Additionally, epidemiological and experimental evidence highlights the importance of cross-talk between the gut microbiota and the lungs, called the gut–lung axis. The gut-lung axis postulates that alterations in gut microbial communities may have a profound effect on lung disease. Dysbiosis in the microbial community of the gut is linked with changes in immune responses, homeostasis in the airways, and inflammatory conditions in the gastrointestinal tract itself. In this review, we summarize studies describing the role of the microbiome in interstitial lung disease and discuss the implications of these findings on the diagnosis and treatment of these diseases. This paper describes the impact of the microbial communities on the pathogenesis of lung diseases by assessing recent original research and identifying remaining gaps in knowledge.

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“…In a cohort study from Italy, conducted in a group of 1,823 asbestos workers in the textile industry who were professionally active from 1946-1984, 51 asbestosis deaths were reported until November 2013. In the decades after the last exposure, the risk of death from asbestosis decreased significantly [38]. However, data on asbestos-related disease cases in one region in China in 1988-2014 showed mortality at the level of 38.74% [27].…”

Section: Discussionmentioning

confidence: 99%

Asbestosis hospitalizations in Poland (2006–2016): results from the National Hospital Discharge Registry

Kanecki

Kosińska

Tyszko

et al. 2020

Ann Agric Environ Med.

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Introduction and objective. Occupational asbestos exposure is one of the major public health issues. Although asbestos use in Poland has decreased, asbestosis continues to remain an important health concern in the area of occupational medicine. The aim of the study is to perform a descriptive analysis of hospitalization cases in patients suffering from asbestosis in Poland. Materials and method. The authors used hospital discharge records to conduct a retrospective, population-based study. To estimate the asbestosis hospitalization rate, data from the Nationwide General Hospital Morbidity Study conducted by the National Institute of Public Health were used. Events were defined as in-patient hospital discharges during 2006-2016. 1,101 hospitalization records of 764 patients were included in the study. Results. In the study group of first-time hospitalized patients, the mean and median ages were 68.1 and 69 years, respectively; CI: 67.3-68.9; SD: 11.1, min-max:16-99 years. In this group, significant gender differences were observed (560 males vs. 204 female; P<0.001). No statistical differences were observed regarding the place of residence. During the observation period, 61 in-hospital deaths were reported (8% of all patients), 40 of whom (5.2 % of all patients) took place during the first-time hospitalizations. Asbestosis hospitalizations were mainly clustered in the southwestern region, whereas the highest hospitalization rates were clustered in several areas of Poland. Conclusions. The authors believe this study to be the first evaluation of asbestosis in Poland made on the basis of the hospital morbidity database. The data presented may be helpful in comparative studies on the epidemiology of asbestosis across European countries.

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Temporal Patterns of Exposure to Asbestos and Risk of Asbestosis

Cited by 7 publications

References 24 publications

Factors Affecting Asbestosis Mortality Among Asbestos-Cement Workers in Italy

Factors Affecting Asbestosis Mortality Among Asbestos-Cement Workers in Italy

Role of the Microbiome in Interstitial Lung Diseases

Asbestosis hospitalizations in Poland (2006–2016): results from the National Hospital Discharge Registry

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