ABSTRACT
A cohort of 166 employees in the SNIA viscosa rayon production plant in Padua was followed up for mortality up to 1989. The study detected a statistically significant increase in total mortality mainly due to an excess of deaths from ischaemic heart diseases (ICD 410-414). Workers affected by occupational disease in the age group 50-64 years had the highest risk with a threefold increase in mortality compared to the general population. An increasing pattern of lung cancer mortality with time since first exposure was observed. The SMR for lung cancer was 192 for smokers with occupational disease.
Subject(s)
Occupational Diseases/mortality , Textile Industry , Adult , Age Factors , Aged , Cohort Studies , Coronary Disease/mortality , Female , Humans , Italy , Lung Diseases/mortality , Lung Neoplasms/mortality , Male , Middle Aged , Neoplasms/mortality , Risk Factors , SmokingABSTRACT
AIMS AND BACKGROUND: Patients treated for Hodgkin's disease with chemotherapy or with the association of chemotherapy and radiotherapy have an increased risk of secondary leukemia. The aim of this study was to evaluate the leukemogenic risk due to these treatment modalities. METHODS: We performed a case-control study on a population of 1410 patients treated for Hodgkin's disease from 1970 to 1990 in our Institute. Among these patients, we identified 25 cases of secondary leukemia and 3 cases of myelodysplasia, all occurring more than one year after the diagnosis of Hodgkin's disease. Three cases occurred among the patients treated with radiotherapy alone. When we analyzed the risk in relation to the type of treatment (radiotherapy, chemotherapy, or both), the comparisons were relative to patients treated with radiotherapy alone. RESULTS: We found that chemotherapy alone is associated with a fivefold increased risk (odds ratio = 5.4) compared with radiotherapy alone. When both treatments are used, the risk is not further increased (odds ratio = 4.4). Patients receiving more than 6 courses of chemotherapy have an excess risk (relative risk = 2.5) compared with those treated with 6 courses or less. No increased risk was observed after splenectomy. CONCLUSIONS: This study confirms an increased incidence of secondary leukemia occurring in patients treated for Hodgkin's disease. The increased risk seems to be correlated with the number of courses of alkylating agent therapy, whereas it is unaffected by the addition of radiotherapy.