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Paolo Boffetta - One of the best experts on this subject based on the ideXlab platform.
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validation of the diagnosis of mesothelioma and bap1 protein expression in a cohort of asbestos textile workers from northern italy
Annals of Oncology, 2018Co-Authors: Paolo Boffetta, Claudio Pelucchi, Luisella Righi, Catalina Ciocan, C La Vecchia, C Romano, Mauro Papotti, Enrico PiraAbstract:ABSTRACT Background Diagnosis of mesothelioma based on death certificate is subject to misclassification, which may bias the results of epidemiology studies. A high proportion of mesothelioma harbor mutations in the BRCA1-associated protein 1 (BAP1) gene. Methods We searched medical and pathology records and specimens for 127 workers from a textile-asbestos factory in Italy who died during 1963–2013 with a diagnosis of pleural or peritoneal neoplasm or mesothelioma on death certificate, to confirm the diagnosis with immunohistochemistry markers. We calculated the odds ratio of confirmation by selected characteristics and asbestos exposure variables. When sufficient pathology material was available, we analyzed BAP1 protein expression. Results The diagnosis of mesothelioma was histologically confirmed for 35 cases (27.6%); 5 cases were classified as non-mesothelioma (3.9%), for 33 cases a mention of mesothelioma was found on record but no sufficient material was available for revision (26.0%); no records were available for 54 cases (death-certificate-only 42.5%). Diagnostic confirmation was not associated with sex, location of the neoplasm, age, or Duration of Employment; however, there was a significant association with time since first Employment (P for linear trend 0.04). An association between Duration of Employment and time since first Employment was observed for confirmed cases but not for death-certificate-only cases. BAP1 protein was lost in 18/35 cases (51.4%), without an association with sex, location, age, indices of asbestos exposure, or survival. Conclusions We were able to confirm by immunohistochemistry a small proportion of mesothelioma diagnoses on certificates of deceased asbestos workers, and confirmation correlated with latency of asbestos exposure but not other characteristics. BAP1 protein loss is a frequent event in mesothelioma of asbestos-exposed workers, but does not correlate with exposure.
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0174 mortality due to asbestosis in a cohort of former asbestos textile workers
Occupational and Environmental Medicine, 2017Co-Authors: Andrea Farioli, Giovanna Spatari, Paolo Boffetta, Carlo La Vecchia, Francesco Saverio Violante, Claudio Pelucchi, Eva Negri, Enrico PiraAbstract:Background Knowledge on the role of the temporal pattern of exposure to asbestos in determining mortality from asbestosis is limited. We aim at investigating how the risk of death due to asbestosis changes according to the Duration of Employment and the time since the last Employment (TSLE). Methods An historical cohort of workers from a former asbestos textile factory (active between 1946 and 84) was followed up until November 2013. For each subjects, we collected information on Duration of the Employment, TSLE, age and year of first Employment, and sex. We estimated hazard ratios (HR) and 95% confidence intervals (CI) of death from asbestosis by fitting multivariable Cox regression models with age specified as the main temporal axis. Results We identified 51 deaths from asbestosis that occurred among 1823 workers (incidence rate of 74 cases per 1 00 000 person-years). The risk of death from asbestosis increased with increasing exposure Duration (HR 3.0 [95%CI 1.3–7.6] for Duration of Employment ≥15 years compared to Duration Conclusions Information on the temporal pattern of exposure to asbestos is fundamental to estimate the individual risk of asbestosis. On the opposite of what overserved in ecological studies, the risk of death due to asbestosis declines steadily after cessation of exposure to asbestos.
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mortality from cancer and other causes among italian chrysotile asbestos miners
Occupational and Environmental Medicine, 2017Co-Authors: E Pira, Carlo La Vecchia, Claudio Pelucchi, C Romano, Francesca Donato, Paolo BoffettaAbstract:Objective To investigate the long-term mortality of a cohort of Italian asbestos miners. Methods The cohort included 1056 men employed in a chrysotile mine between 1930 and 1990, who were followed up during 1946–2014, for a total of 37 471 person-years of observation. Expected deaths and SMRs were computed using national and local (after 1980, when available) reference. Results A total of 294 (27.8%) subjects were alive and at the end of follow-up, 722 (68.4%) were dead and 40 (3.8%) were lost to follow-up. The SMR for overall mortality was 1.35 (95%CI 1.25 to 1.45). The SMR for pleural cancer, based on seven observed deaths, was 5.54 (95% CI 2.22 to 11.4) and related to time since first exposure, but not to Duration of Employment, cumulative exposure or time since last exposure. The SMR for lung cancer was 1.16 (95% CI 0.87 to 1.52; 53 observed deaths), with no excess among workers with cumulative exposure below 100 fibre/mL-years (SMR 0.82; 95% CI 0.44 to 1.40). Conclusions The update of the follow-up of this cohort confirmed an increased mortality from pleural cancer mortality in miners exposed to chrysotile and a lack of significant increase in lung cancer mortality.
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mortality of talc miners and millers from val chisone northern italy an updated cohort study
Journal of Occupational and Environmental Medicine, 2017Co-Authors: Enrico Pira, Carlo La Vecchia, Claudio Pelucchi, Catalina Ciocan, C Romano, Maurizio Coggiola, Paolo BoffettaAbstract:Objective The aim of this study was to update the analysis of mortality of a cohort of talc miners and millers in Northern Italy. Methods We analyzed the mortality during 1946 to 2013 of 1722 male workers in an asbestos-free talc mine (1166 miners and 556 millers) employed during 1946 to 1995. Results The overall standardized mortality ratio (SMR) was 1.24 [95% confidence interval (95% CI) 1.17 to 1.32]; no deaths were observed from pleural cancer; mortality from lung cancer was not increased. Mortality from pneumoconiosis was increased (SMR 26.62; 95% CI 20.71 to 33.69), in particular among miners, and was associated with Duration of Employment and time since first Employment. Conclusions We confirmed the lack of association between exposure to asbestos-free talc, lung cancer, and mesothelioma. Increased mortality from pneumoconiosis among miners is attributable to past exposure to silica.
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cancer mortality in a cohort of continuous glass filament workers
Journal of Occupational and Environmental Medicine, 2009Co-Authors: Enrico Pira, Paolo Boffetta, Eva Negri, C Romano, M Manzari, Silvano Gallus, Cristina Bosetti, Joseph K Mclaughlin, Carlo La VecchiaAbstract:Objective. To examine cancer mortality in continuous glass filament workers. Methods. A cohort of 936 continuous glass filament workers employed in a plant from northern Italy since January 1976 was followed-up through December 2003, for a total of 19,987 man-years. Results. Overall, 144 deaths were observed compared with 160.8 expected based on regional death rates (standardized mortality ratio [SMR] = 0.90, 95% CI = 0.76 to 1.05). There were 53 deaths from all cancers (SMR = 1.01, 95% CI = 0.75 to 1.32), and 21 from lung cancer (SMR = 1.23, 95% CI = 0.76 to 1.89). There was no consistent relation with risk for age at first Employment, time since first or last Employment, or Duration of Employment for any of the causes considered. Conclusions. Although limited in size, this study provides no evidence that continuous glass filament workers experience a significant increased risk of cancer, including respiratory cancer.
Enrico Pira - One of the best experts on this subject based on the ideXlab platform.
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validation of the diagnosis of mesothelioma and bap1 protein expression in a cohort of asbestos textile workers from northern italy
Annals of Oncology, 2018Co-Authors: Paolo Boffetta, Claudio Pelucchi, Luisella Righi, Catalina Ciocan, C La Vecchia, C Romano, Mauro Papotti, Enrico PiraAbstract:ABSTRACT Background Diagnosis of mesothelioma based on death certificate is subject to misclassification, which may bias the results of epidemiology studies. A high proportion of mesothelioma harbor mutations in the BRCA1-associated protein 1 (BAP1) gene. Methods We searched medical and pathology records and specimens for 127 workers from a textile-asbestos factory in Italy who died during 1963–2013 with a diagnosis of pleural or peritoneal neoplasm or mesothelioma on death certificate, to confirm the diagnosis with immunohistochemistry markers. We calculated the odds ratio of confirmation by selected characteristics and asbestos exposure variables. When sufficient pathology material was available, we analyzed BAP1 protein expression. Results The diagnosis of mesothelioma was histologically confirmed for 35 cases (27.6%); 5 cases were classified as non-mesothelioma (3.9%), for 33 cases a mention of mesothelioma was found on record but no sufficient material was available for revision (26.0%); no records were available for 54 cases (death-certificate-only 42.5%). Diagnostic confirmation was not associated with sex, location of the neoplasm, age, or Duration of Employment; however, there was a significant association with time since first Employment (P for linear trend 0.04). An association between Duration of Employment and time since first Employment was observed for confirmed cases but not for death-certificate-only cases. BAP1 protein was lost in 18/35 cases (51.4%), without an association with sex, location, age, indices of asbestos exposure, or survival. Conclusions We were able to confirm by immunohistochemistry a small proportion of mesothelioma diagnoses on certificates of deceased asbestos workers, and confirmation correlated with latency of asbestos exposure but not other characteristics. BAP1 protein loss is a frequent event in mesothelioma of asbestos-exposed workers, but does not correlate with exposure.
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0174 mortality due to asbestosis in a cohort of former asbestos textile workers
Occupational and Environmental Medicine, 2017Co-Authors: Andrea Farioli, Giovanna Spatari, Paolo Boffetta, Carlo La Vecchia, Francesco Saverio Violante, Claudio Pelucchi, Eva Negri, Enrico PiraAbstract:Background Knowledge on the role of the temporal pattern of exposure to asbestos in determining mortality from asbestosis is limited. We aim at investigating how the risk of death due to asbestosis changes according to the Duration of Employment and the time since the last Employment (TSLE). Methods An historical cohort of workers from a former asbestos textile factory (active between 1946 and 84) was followed up until November 2013. For each subjects, we collected information on Duration of the Employment, TSLE, age and year of first Employment, and sex. We estimated hazard ratios (HR) and 95% confidence intervals (CI) of death from asbestosis by fitting multivariable Cox regression models with age specified as the main temporal axis. Results We identified 51 deaths from asbestosis that occurred among 1823 workers (incidence rate of 74 cases per 1 00 000 person-years). The risk of death from asbestosis increased with increasing exposure Duration (HR 3.0 [95%CI 1.3–7.6] for Duration of Employment ≥15 years compared to Duration Conclusions Information on the temporal pattern of exposure to asbestos is fundamental to estimate the individual risk of asbestosis. On the opposite of what overserved in ecological studies, the risk of death due to asbestosis declines steadily after cessation of exposure to asbestos.
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mortality of talc miners and millers from val chisone northern italy an updated cohort study
Journal of Occupational and Environmental Medicine, 2017Co-Authors: Enrico Pira, Carlo La Vecchia, Claudio Pelucchi, Catalina Ciocan, C Romano, Maurizio Coggiola, Paolo BoffettaAbstract:Objective The aim of this study was to update the analysis of mortality of a cohort of talc miners and millers in Northern Italy. Methods We analyzed the mortality during 1946 to 2013 of 1722 male workers in an asbestos-free talc mine (1166 miners and 556 millers) employed during 1946 to 1995. Results The overall standardized mortality ratio (SMR) was 1.24 [95% confidence interval (95% CI) 1.17 to 1.32]; no deaths were observed from pleural cancer; mortality from lung cancer was not increased. Mortality from pneumoconiosis was increased (SMR 26.62; 95% CI 20.71 to 33.69), in particular among miners, and was associated with Duration of Employment and time since first Employment. Conclusions We confirmed the lack of association between exposure to asbestos-free talc, lung cancer, and mesothelioma. Increased mortality from pneumoconiosis among miners is attributable to past exposure to silica.
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cancer mortality in a cohort of continuous glass filament workers
Journal of Occupational and Environmental Medicine, 2009Co-Authors: Enrico Pira, Paolo Boffetta, Eva Negri, C Romano, M Manzari, Silvano Gallus, Cristina Bosetti, Joseph K Mclaughlin, Carlo La VecchiaAbstract:Objective. To examine cancer mortality in continuous glass filament workers. Methods. A cohort of 936 continuous glass filament workers employed in a plant from northern Italy since January 1976 was followed-up through December 2003, for a total of 19,987 man-years. Results. Overall, 144 deaths were observed compared with 160.8 expected based on regional death rates (standardized mortality ratio [SMR] = 0.90, 95% CI = 0.76 to 1.05). There were 53 deaths from all cancers (SMR = 1.01, 95% CI = 0.75 to 1.32), and 21 from lung cancer (SMR = 1.23, 95% CI = 0.76 to 1.89). There was no consistent relation with risk for age at first Employment, time since first or last Employment, or Duration of Employment for any of the causes considered. Conclusions. Although limited in size, this study provides no evidence that continuous glass filament workers experience a significant increased risk of cancer, including respiratory cancer.
Ellen A Eisen - One of the best experts on this subject based on the ideXlab platform.
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occupational diesel exposure Duration of Employment and lung cancer an application of the parametric g formula
Epidemiology, 2016Co-Authors: Andreas M Neophytou, Sadie Costello, Sally Picciotto, Ellen A EisenAbstract:Adverse health effects, including lung cancer, have been associated with occupational exposure to diesel exhaust.1–5 Diesel exhaust is a mixture of elemental carbon, polycyclic aromatic hydrocarbons, condensed engine oil, other organic compounds, and exhaust gases. Elemental carbon is the component frequently used as a primary surrogate for diesel exhaust exposure.6–8 High exposures to diesel exhaust due to widespread use of diesel-powered engines have been common in industries such as trucking, mining, and railroads. Based in large part on exposure–response estimates for elemental carbon exposure and lung cancer risk from occupational studies of cohorts of workers employed in these industries,9–12 the International Agency for Research on Cancer has classified diesel exhaust as a human carcinogen.13,14 Previous studies have not accounted for the healthy worker survivor bias using methods that address time-varying confounding affected by previous exposure. Healthy worker survivor bias may occur if individuals who leave work, and thus are no longer exposed, are at greater risk of the adverse health outcome. With work status as a time-varying confounder, standard statistical methods will not be adequate to estimate an unbiased effect of the exposure on the outcome when work status is also affected by prior exposure. Thus, if termination of Employment is affected by exposure, the effect of diesel exhaust on lung cancer may be even higher than previously reported. We begin this reanalysis of the Diesel Exhaust in Miners Study (DEMS) by evaluating the relationship between respirable elemental carbon exposure and time to termination of Employment, a key potential component of healthy worker survivor bias. To accomplish this, we use an accelerated failure time model, a method particularly suited for time to event outcomes. We then use the parametric g-formula to assess the impacts of hypothetical respirable elemental carbon exposure limits on the risk of lung cancer, controlling for work status. The parametric g-formula is one of a broader group of “g-methods”15 first introduced by Robins16,17 to control for time-varying confounding affected by past exposure, a signature characteristic of healthy worker survivor bias in longitudinal occupational studies.18 The parametric g-formula has been applied in several longitudinal studies,19,20 but only recently in an occupational study of asbestos exposure and risk of lung cancer.21,22 It has also been used to assess occupational radon exposure interventions and cumulative risk of lung cancer.23 In the current study, we assess the possible impact of hypothetical interventions setting maximum levels of exposure to respirable elemental carbon in the DEMS ever-underground miners subcohort. To identify a range of relevant exposure limits, we considered a recent meta-regression analysis,24 as well as current and past exposure limits for elemental carbon, either as enforced by the Mine Safety and Health Administration (MSHA)25 or recommended by the American Conference of Governmental Industrial Hygienists (ACGIH).26 We also estimate the attributable fraction of lung cancers due to diesel exhaust exposure. This application assesses effects of different exposure limits on adverse health effects within a public health framework by simulating what would have happened if various exposure limits had been enforced in the whole subcohort.
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occupational diesel exposure Duration of Employment and lung cancer an application of the parametric g formula
Epidemiology, 2016Co-Authors: Andreas M Neophytou, Sadie Costello, Sally Picciotto, Ellen A EisenAbstract:BACKGROUND: If less healthy workers terminate Employment earlier, thus accumulating less exposure, yet remain at greater risk of the health outcome, estimated health effects of cumulative exposure will be biased downward. If exposure also affects termination of Employment, then the bias cannot be addressed using conventional methods. We examined these conditions as a prelude to a reanalysis of lung cancer mortality in the Diesel Exhaust in Miners Study. METHODS: We applied an accelerated failure time model to assess the effect of exposures to respirable elemental carbon (a surrogate for diesel) on time to termination of Employment among nonmetal miners who ever worked underground (n = 8,307). We then applied the parametric g-formula to assess how possible interventions setting respirable elemental carbon exposure limits would have changed lifetime risk of lung cancer, adjusting for time-varying Employment status. RESULTS: Median time to termination was 36% shorter (95% confidence interval = 33%, 39%), per interquartile range width increase in respirable elemental carbon exposure. Lung cancer risk decreased with more stringent interventions, with a risk ratio of 0.8 (95% confidence interval = 0.5, 1.1) comparing a limit of ≤25 µg/m respirable elemental carbon to no intervention. The fraction of cases attributable to diesel exposure was 27% in this population. CONCLUSIONS: The g-formula controlled for time-varying confounding by Employment status, the signature of healthy worker survivor bias, which was also affected by diesel exposure. It also offers an alternative approach to risk assessment for estimating excess cumulative risk, and the impact of interventions based entirely on an observed population.
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cox model setup garshick et al respond
Environmental Health Perspectives, 2012Co-Authors: Eric Garshick, Francine Laden, Jaime E Hart, Mary E Davis, Ellen A Eisen, Thomas J SmithAbstract:We appreciate the interest in our article (Garshick et al. 2012). In his letter, Morfeld suggests that the analytic approach used for Cox proportional hazard regression modeling included two similar adjustments for year of birth. We disagree with this comment. In the analysis, risk sets were generated using attained age as the timeline. An ordinal variable for calendar year was included as a covariate; thus, we do agree that our approach adjusted for exact year of birth. We also stratified the analysis on decade of hire (four groups) and age in 1985 (four groups). We stratified on decade of hire to adjust for different unmeasured work practices and vehicle characteristics. We stratified on age in 1985 because the age at which persons enter the study is a determinant of lung cancer risk; participants had to be healthy enough to remain employed to enter the cohort in 1985. Two of the survival curves for decade of hire overlap unless they are jointly stratified by age in 1985, indicating that joint stratification is important to maintain the proportional hazards assumption. This approach allows us to maintain the assumption of proportional hazards and to finely adjust for lung cancer secular trends and attained age but does not adjust twice for year of birth within the same model. Our analytic approach also included sensitivity analyses with and without total years of Employment as a time-dependent covariate to assess its effect as a potential confounder. Morfeld suggests that adjusting cumulative exposure by Duration of Employment time reduces cumulative exposure to an estimate of long-term average concentration. We agree that if exposure in our workers was relatively constant, cumulative exposure would be the simple product of Duration and average exposure. However, exposure varies considerably over time and between and within jobs. Therefore, it is not surprising that the results for Duration and average exposure are not similar to those for the cumulative exposure. In his letter, Morfeld states that “an adjustment of cumulative exposure by total Duration of Employment should not be confused with an approach adjusting for the healthy worker survivor bias.” However, our assessment (Garshick et al. 2012) identified years of Employment as a negative confounder because it was positively associated with cumulative exposure and negatively associated with lung cancer risk. Failure to account for this would result in the underestimation of lung cancer risk. Adjustment for total Duration of Employment strengthened effects with cumulative exposure and may be considered an assessment of the effects of cumulative exposure at varying Durations of Employment. Because lung cancer risk decreased with total Employment Duration, we can treat Duration as a surrogate of time-varying health status. As we noted in our article (Garshick et al. 2012), “this was likely due to bias caused by left truncation in a cohort composed of prevalent hires combined with a healthy worker survivor effect.” We were not surprised to note this relationship because of the structure of the cohort. As shown previously by Applebaum et al. (2011), left truncation results in downward bias with exposure Duration. In our article (Garshick et al. 2012), we extensively discussed a healthy worker survivor effect and left truncation and also cited studies where these effects have been observed. We also cited examples where adjustment for work Duration was used as a method to address bias due to a healthy worker survivor effect. As Morfeld noted in his letter, adjustment for the healthy worker survivor effect is complex. We do not claim that adjustment using Employment Duration completely adjusts for a healthy worker survivor effect, but our results provided evidence that it is present in this cohort and should be addressed.
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lung cancer and elemental carbon exposure in trucking industry workers
Environmental Health Perspectives, 2012Co-Authors: Eric Garshick, Francine Laden, Jaime E Hart, Mary E Davis, Ellen A Eisen, Thomas J SmithAbstract:Background: Diesel exhaust has been considered to be a probable lung carcinogen based on studies of occupationally exposed workers. Efforts to define lung cancer risk in these studies have been limited in part by lack of quantitative exposure estimates. Objective: We conducted a retrospective cohort study to assess lung cancer mortality risk among U.S. trucking industry workers. Elemental carbon (EC) was used as a surrogate of exposure to engine exhaust from diesel vehicles, traffic, and loading dock operations. Methods: Work records were available for 31,135 male workers employed in the unionized U.S. trucking industry in 1985. A statistical model based on a national exposure assessment was used to estimate historical work-related exposures to EC. Lung cancer mortality was ascertained through the year 2000, and associations with cumulative and average EC were estimated using proportional hazards models. Results: Duration of Employment was inversely associated with lung cancer risk consistent with a healthy worker survivor effect and a cohort composed of prevalent hires. After adjusting for Employment Duration, we noted a suggestion of a linear exposure–response relationship. For each 1,000-µg/m3 months of cumulative EC, based on a 5-year exposure lag, the hazard ratio (HR) was 1.07 [95% confidence interval (CI): 0.99, 1.15] with a similar association for a 10-year exposure lag [HR = 1.09 (95% CI: 0.99, 1.20)]. Average exposure was not associated with relative risk. Conclusions: Lung cancer mortality in trucking industry workers increased in association with cumulative exposure to EC after adjusting for negative confounding by Employment Duration.
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near miss reporting system as an occupational injury preventive intervention in manufacturing
American Journal of Industrial Medicine, 2011Co-Authors: Lina Lander, Ellen A Eisen, Terry L Stentz, Kathleen J Spanjer, Bryce Wendland, Melissa J PerryAbstract:BACKGROUND: A database of near-misses (NM), minor injuries, and OSHA recordable injuries was established at a mid-size electrical manufacturing plant as part of injury prevention efforts. The utility of a NM reporting system was evaluated by estimating its impact on the annual incidence of minor and OSHA recordable injuries. METHODS: Logistic regression was performed to examine the effects of predictor variables (year, age, Duration of Employment) on the type of event (NM, minor, OSHA recordable). Poisson regression was fit to model the annual rate of OSHA recordable injuries as a function of time. RESULTS: 1690 events were reported between 1999 and 2006 including 261 NM, 1205 minor, and 205 OSHA recordable injuries. The expected rate of OSHA recordable injuries decreased by 0.84 (95% CI: 0.73-0.97) annually. CONCLUSIONS: The implementation of a NM reporting system was associated with decrease in the rate of OSHA recordable injuries. NM reporting systems may be valuable injury interventions in manufacturing. Am. J. Ind. Med. © 2010 Wiley-Liss, Inc. Language: en
Claudio Pelucchi - One of the best experts on this subject based on the ideXlab platform.
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validation of the diagnosis of mesothelioma and bap1 protein expression in a cohort of asbestos textile workers from northern italy
Annals of Oncology, 2018Co-Authors: Paolo Boffetta, Claudio Pelucchi, Luisella Righi, Catalina Ciocan, C La Vecchia, C Romano, Mauro Papotti, Enrico PiraAbstract:ABSTRACT Background Diagnosis of mesothelioma based on death certificate is subject to misclassification, which may bias the results of epidemiology studies. A high proportion of mesothelioma harbor mutations in the BRCA1-associated protein 1 (BAP1) gene. Methods We searched medical and pathology records and specimens for 127 workers from a textile-asbestos factory in Italy who died during 1963–2013 with a diagnosis of pleural or peritoneal neoplasm or mesothelioma on death certificate, to confirm the diagnosis with immunohistochemistry markers. We calculated the odds ratio of confirmation by selected characteristics and asbestos exposure variables. When sufficient pathology material was available, we analyzed BAP1 protein expression. Results The diagnosis of mesothelioma was histologically confirmed for 35 cases (27.6%); 5 cases were classified as non-mesothelioma (3.9%), for 33 cases a mention of mesothelioma was found on record but no sufficient material was available for revision (26.0%); no records were available for 54 cases (death-certificate-only 42.5%). Diagnostic confirmation was not associated with sex, location of the neoplasm, age, or Duration of Employment; however, there was a significant association with time since first Employment (P for linear trend 0.04). An association between Duration of Employment and time since first Employment was observed for confirmed cases but not for death-certificate-only cases. BAP1 protein was lost in 18/35 cases (51.4%), without an association with sex, location, age, indices of asbestos exposure, or survival. Conclusions We were able to confirm by immunohistochemistry a small proportion of mesothelioma diagnoses on certificates of deceased asbestos workers, and confirmation correlated with latency of asbestos exposure but not other characteristics. BAP1 protein loss is a frequent event in mesothelioma of asbestos-exposed workers, but does not correlate with exposure.
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0174 mortality due to asbestosis in a cohort of former asbestos textile workers
Occupational and Environmental Medicine, 2017Co-Authors: Andrea Farioli, Giovanna Spatari, Paolo Boffetta, Carlo La Vecchia, Francesco Saverio Violante, Claudio Pelucchi, Eva Negri, Enrico PiraAbstract:Background Knowledge on the role of the temporal pattern of exposure to asbestos in determining mortality from asbestosis is limited. We aim at investigating how the risk of death due to asbestosis changes according to the Duration of Employment and the time since the last Employment (TSLE). Methods An historical cohort of workers from a former asbestos textile factory (active between 1946 and 84) was followed up until November 2013. For each subjects, we collected information on Duration of the Employment, TSLE, age and year of first Employment, and sex. We estimated hazard ratios (HR) and 95% confidence intervals (CI) of death from asbestosis by fitting multivariable Cox regression models with age specified as the main temporal axis. Results We identified 51 deaths from asbestosis that occurred among 1823 workers (incidence rate of 74 cases per 1 00 000 person-years). The risk of death from asbestosis increased with increasing exposure Duration (HR 3.0 [95%CI 1.3–7.6] for Duration of Employment ≥15 years compared to Duration Conclusions Information on the temporal pattern of exposure to asbestos is fundamental to estimate the individual risk of asbestosis. On the opposite of what overserved in ecological studies, the risk of death due to asbestosis declines steadily after cessation of exposure to asbestos.
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mortality from cancer and other causes among italian chrysotile asbestos miners
Occupational and Environmental Medicine, 2017Co-Authors: E Pira, Carlo La Vecchia, Claudio Pelucchi, C Romano, Francesca Donato, Paolo BoffettaAbstract:Objective To investigate the long-term mortality of a cohort of Italian asbestos miners. Methods The cohort included 1056 men employed in a chrysotile mine between 1930 and 1990, who were followed up during 1946–2014, for a total of 37 471 person-years of observation. Expected deaths and SMRs were computed using national and local (after 1980, when available) reference. Results A total of 294 (27.8%) subjects were alive and at the end of follow-up, 722 (68.4%) were dead and 40 (3.8%) were lost to follow-up. The SMR for overall mortality was 1.35 (95%CI 1.25 to 1.45). The SMR for pleural cancer, based on seven observed deaths, was 5.54 (95% CI 2.22 to 11.4) and related to time since first exposure, but not to Duration of Employment, cumulative exposure or time since last exposure. The SMR for lung cancer was 1.16 (95% CI 0.87 to 1.52; 53 observed deaths), with no excess among workers with cumulative exposure below 100 fibre/mL-years (SMR 0.82; 95% CI 0.44 to 1.40). Conclusions The update of the follow-up of this cohort confirmed an increased mortality from pleural cancer mortality in miners exposed to chrysotile and a lack of significant increase in lung cancer mortality.
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mortality of talc miners and millers from val chisone northern italy an updated cohort study
Journal of Occupational and Environmental Medicine, 2017Co-Authors: Enrico Pira, Carlo La Vecchia, Claudio Pelucchi, Catalina Ciocan, C Romano, Maurizio Coggiola, Paolo BoffettaAbstract:Objective The aim of this study was to update the analysis of mortality of a cohort of talc miners and millers in Northern Italy. Methods We analyzed the mortality during 1946 to 2013 of 1722 male workers in an asbestos-free talc mine (1166 miners and 556 millers) employed during 1946 to 1995. Results The overall standardized mortality ratio (SMR) was 1.24 [95% confidence interval (95% CI) 1.17 to 1.32]; no deaths were observed from pleural cancer; mortality from lung cancer was not increased. Mortality from pneumoconiosis was increased (SMR 26.62; 95% CI 20.71 to 33.69), in particular among miners, and was associated with Duration of Employment and time since first Employment. Conclusions We confirmed the lack of association between exposure to asbestos-free talc, lung cancer, and mesothelioma. Increased mortality from pneumoconiosis among miners is attributable to past exposure to silica.
C Romano - One of the best experts on this subject based on the ideXlab platform.
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validation of the diagnosis of mesothelioma and bap1 protein expression in a cohort of asbestos textile workers from northern italy
Annals of Oncology, 2018Co-Authors: Paolo Boffetta, Claudio Pelucchi, Luisella Righi, Catalina Ciocan, C La Vecchia, C Romano, Mauro Papotti, Enrico PiraAbstract:ABSTRACT Background Diagnosis of mesothelioma based on death certificate is subject to misclassification, which may bias the results of epidemiology studies. A high proportion of mesothelioma harbor mutations in the BRCA1-associated protein 1 (BAP1) gene. Methods We searched medical and pathology records and specimens for 127 workers from a textile-asbestos factory in Italy who died during 1963–2013 with a diagnosis of pleural or peritoneal neoplasm or mesothelioma on death certificate, to confirm the diagnosis with immunohistochemistry markers. We calculated the odds ratio of confirmation by selected characteristics and asbestos exposure variables. When sufficient pathology material was available, we analyzed BAP1 protein expression. Results The diagnosis of mesothelioma was histologically confirmed for 35 cases (27.6%); 5 cases were classified as non-mesothelioma (3.9%), for 33 cases a mention of mesothelioma was found on record but no sufficient material was available for revision (26.0%); no records were available for 54 cases (death-certificate-only 42.5%). Diagnostic confirmation was not associated with sex, location of the neoplasm, age, or Duration of Employment; however, there was a significant association with time since first Employment (P for linear trend 0.04). An association between Duration of Employment and time since first Employment was observed for confirmed cases but not for death-certificate-only cases. BAP1 protein was lost in 18/35 cases (51.4%), without an association with sex, location, age, indices of asbestos exposure, or survival. Conclusions We were able to confirm by immunohistochemistry a small proportion of mesothelioma diagnoses on certificates of deceased asbestos workers, and confirmation correlated with latency of asbestos exposure but not other characteristics. BAP1 protein loss is a frequent event in mesothelioma of asbestos-exposed workers, but does not correlate with exposure.
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mortality from cancer and other causes among italian chrysotile asbestos miners
Occupational and Environmental Medicine, 2017Co-Authors: E Pira, Carlo La Vecchia, Claudio Pelucchi, C Romano, Francesca Donato, Paolo BoffettaAbstract:Objective To investigate the long-term mortality of a cohort of Italian asbestos miners. Methods The cohort included 1056 men employed in a chrysotile mine between 1930 and 1990, who were followed up during 1946–2014, for a total of 37 471 person-years of observation. Expected deaths and SMRs were computed using national and local (after 1980, when available) reference. Results A total of 294 (27.8%) subjects were alive and at the end of follow-up, 722 (68.4%) were dead and 40 (3.8%) were lost to follow-up. The SMR for overall mortality was 1.35 (95%CI 1.25 to 1.45). The SMR for pleural cancer, based on seven observed deaths, was 5.54 (95% CI 2.22 to 11.4) and related to time since first exposure, but not to Duration of Employment, cumulative exposure or time since last exposure. The SMR for lung cancer was 1.16 (95% CI 0.87 to 1.52; 53 observed deaths), with no excess among workers with cumulative exposure below 100 fibre/mL-years (SMR 0.82; 95% CI 0.44 to 1.40). Conclusions The update of the follow-up of this cohort confirmed an increased mortality from pleural cancer mortality in miners exposed to chrysotile and a lack of significant increase in lung cancer mortality.
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mortality of talc miners and millers from val chisone northern italy an updated cohort study
Journal of Occupational and Environmental Medicine, 2017Co-Authors: Enrico Pira, Carlo La Vecchia, Claudio Pelucchi, Catalina Ciocan, C Romano, Maurizio Coggiola, Paolo BoffettaAbstract:Objective The aim of this study was to update the analysis of mortality of a cohort of talc miners and millers in Northern Italy. Methods We analyzed the mortality during 1946 to 2013 of 1722 male workers in an asbestos-free talc mine (1166 miners and 556 millers) employed during 1946 to 1995. Results The overall standardized mortality ratio (SMR) was 1.24 [95% confidence interval (95% CI) 1.17 to 1.32]; no deaths were observed from pleural cancer; mortality from lung cancer was not increased. Mortality from pneumoconiosis was increased (SMR 26.62; 95% CI 20.71 to 33.69), in particular among miners, and was associated with Duration of Employment and time since first Employment. Conclusions We confirmed the lack of association between exposure to asbestos-free talc, lung cancer, and mesothelioma. Increased mortality from pneumoconiosis among miners is attributable to past exposure to silica.
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cancer mortality in a cohort of continuous glass filament workers
Journal of Occupational and Environmental Medicine, 2009Co-Authors: Enrico Pira, Paolo Boffetta, Eva Negri, C Romano, M Manzari, Silvano Gallus, Cristina Bosetti, Joseph K Mclaughlin, Carlo La VecchiaAbstract:Objective. To examine cancer mortality in continuous glass filament workers. Methods. A cohort of 936 continuous glass filament workers employed in a plant from northern Italy since January 1976 was followed-up through December 2003, for a total of 19,987 man-years. Results. Overall, 144 deaths were observed compared with 160.8 expected based on regional death rates (standardized mortality ratio [SMR] = 0.90, 95% CI = 0.76 to 1.05). There were 53 deaths from all cancers (SMR = 1.01, 95% CI = 0.75 to 1.32), and 21 from lung cancer (SMR = 1.23, 95% CI = 0.76 to 1.89). There was no consistent relation with risk for age at first Employment, time since first or last Employment, or Duration of Employment for any of the causes considered. Conclusions. Although limited in size, this study provides no evidence that continuous glass filament workers experience a significant increased risk of cancer, including respiratory cancer.
