Cumulative Asbestos Exposure In Addition To Mortality From Asbestos Related Diseases Inward A Pooled Analysis Of 21 Asbestos Cement Cohorts Inward Italy.

Environmental Health 2019 August vii [Link]

Luberto F, Ferrante D, Silvestri S, Angelini A, Cuccaro F, Nannavecchia AM, 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

Abstract

BACKGROUND:

Despite the available data on cancer risk, asbestos is used inwards large areas inwards the world, generally inwards the production of asbestos cement. Moreover, questions are raised regarding the shape of the dose reply relation, the relation amongst fourth dimension since exposure together with the association amongst neoplasms inwards diverse organs. We conducted a study on the human relationship betwixt cumulative asbestos exposure together with mortality from asbestos related diseases inwards a large Italian puddle of 21 cohorts of asbestos-cement workers amongst protracted exposure to both chrysotile together with amphibole asbestos.

METHODS:

The cohort included 13,076 workers, 81.9% men together with 18.1% women, working inwards 21 Italian asbestos-cement factories, amongst over 40 years of observation. Exposure was estimated yesteryear constitute together with period, together with weighted for the type of asbestos used. Data were analysed amongst consideration of drive of death, cumulative exposure together with fourth dimension since get-go exposure (TSFE), together with yesteryear gender. SMRs were computed using reference rates yesteryear region, sex together with calendar time. Poisson regression models including cubic splines were used to analyse the number of cumulative exposure to asbestos together with 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’ together with ‘All Malignant Neoplasm (MN)’, inwards both genders. Considering asbestos related diseases (ARDs), statistically meaning excesses were observed for MN of peritoneum (SMR: men 14.19; women 15.14), pleura (SMR: 22.35 together with 48.10), lung (SMR: 1.67 together with 1.67), ovary (in the highest exposure shape SMR 2.45), together with asbestosis (SMR: 507 together with 1023). Mortality for ARDs, inwards detail pleural together with peritoneal malignancies, lung cancer, ovarian cancer together with asbestosis increased monotonically amongst cumulative exposure. Pleural MN mortality increased progressively inwards the get-go 40 years of TSFE, together with thence reached a plateau, piece peritoneal MN showed a continuous increase. The tendency of lung cancer SMRs besides showed a flattening subsequently 40 years of TSFE. Attributable proportions for pleural, peritoneal, together with lung MN were respectively 96, 93 together with 40%.

CONCLUSIONS:

Mortality for ARDs was associated amongst cumulative exposure to asbestos. Risk of decease from pleural MN did non increment indefinitely amongst TSFE simply eventually reached a plateau, consistently amongst reports from other recent studies.



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