[Mortality in a cohort of railway rolling stock construction and repair workers in Bologna]. / Mortalità in una coorte di addetti alla costruzione e riparazione di carrozze ferroviarie in un'azienda di Bologna.

BACKGROUND: A private company in Bologna worked for the Italian State Railways (FS) from 1919 to 1998; since the early '60s it used asbestos for new carriage insulation and renovation of carriages already circulating which were entirely spray-coated with asbestos. OBJECTIVES: The study aimed to investigate all causes mortality, in particular mortality from asbestos-related neoplasms in blue-collar workers. METHODS: The cohort consisted of 1,849 people, active in 1960 or hired in 1960-86: 1,704 (92.2%) blue-collar workers and 145 (7.8%) white-collar workers. The end date of the follow up was established as 31/12/2008. Regional reference mortality rates were used. RESULTS: Mortality from all causes (SMR = 1.16; 95% CI 1.08-1.25) and from malignant neoplasms (SMR = 1.20; 95% CI 1.06-1.35) significantly exceeded expected rates. In particular, a statistically significant increase was observed for pleural malignant cancer (SMR = 24.43; 95% CI 17.37-34.37), lung cancer (SMR = 1.24; 95% CI 1.00-1.53), peritoneal cancer (SMR = 6.35; 95% CI 2.64-15.25) and bladder cancer (SMR = 1.71; 95% CI 1.03-2.84). The excess lung cancer SMR was highly significant after 20 years of exposure and with a latency longer than 40 years. An association between pleural malignant cancer and duration of exposure and latency (trend test p value < 0,0001) was observed CONCLUSION: This study on a cohort of asbestos-exposed workers showed an increase in lung cancer SMRs by risk that was statistically significant in workers exposed for at least 20 years and after 40 years of latency. The neoplasm of pleura was strongly associated with both duration of exposure and latency.

The relationship between ambient particulate matter and respiratory mortality: a multi-city study in Italy.

The association of air pollutants with natural and respiratory mortality has been consistently reported. However, several aspects of the relationship between particulate matter with a 50% cut-off aerodynamic diameter of 10 µm (PM(10)) and respiratory mortality require further investigation. The aim of the present study was to assess the PM(10)-respiratory mortality association in Italy and examine potentially susceptible groups. All deaths from natural (n=276,205) and respiratory (n=19,629) causes among subjects aged ≥ 35 yrs in 10 northern, central and southern Italian cities in 2001-2005 were included in the study. Pollution data for PM(10), nitrogen dioxide and ozone were also obtained. A time-stratified case-crossover analysis was carried out. Different cumulative lags were selected to analyse immediate, delayed, prolonged and best-time effects of air pollution. The shape of the exposure-response curve was analysed. Age, sex, chronic conditions and death site were investigated as potential effect modifiers. We found a 2.29% (95% CI 1.03-3.58%) increase in respiratory mortality at 0-3 days lag. The increase in respiratory mortality was higher in summer (7.57%). The exposure-response curve had a linear shape without any threshold. Sex and chronic diseases modified the relationship between particular matter (PM) and respiratory mortality. The effect of PM on respiratory mortality was stronger and more persistent than that on natural mortality. Females and chronic disease sufferers were more likely to die of a respiratory disease caused by air pollution than males and healthy people.