[Occupational exposure to asbestos and incidence of malignant mesothelioma in the Lazio region, years 2001-2009: results of the activities of the regional register]. / Esposizione ad amianto e incidenza di mesoteliomi maligni nel Lazio, anni 2001-2009: risultati delle attività del registro regionale.

BACKGROUND: The Lazio Regional Mesothelioma Registry records the incident cases of Malignant Mesothelioma (MM) in residents in the Region since 2001. OBJECTIVES: Estimate the incidence of MM in the Lazio Region (2001-2009) and assess possible asbestos exposures. METHODS: The MM cases, notified by hospitals, regional protection and workplace safety units, Italian Workers' Compensation Authority, other regions, or extracted from hospital information systems and the regional registry of causes of death, are included in the register after analysis of diagnostic procedures (CT scan, chest X-ray, pathology reports and patients' records). Possible asbestos exposure is investigated by standardized interview and thereafter defined by a panel of experts, according to RENAM guidelines. The incidence of MM of the pleura and peritoneum (per 100,000 inhabitants) for the period 2001-2009 is calculated. RESULTS: The incidence of MM among Lazio residents in the period 2001-2009 (600 cases) was estimated to be 1.8 among men and 0.5 among women per 100,000 inhabitants. Information on exposures was collectedfor 54% of the cases (251 men and 78 women); 72% of men (n. 179) and 9% of women (n. 7) had been occupationally exposed to asbestos. The study found that the largest number of cases with occupational exposure was among workers in the construction industry. The number of cases with unknown exposure was very high. CONCLUSIONS: The registry's work revealed the existence of asbestos exposure circumstances that were not sufficiently characterized,for which it is suggested that more detailed industrial hygiene investigations be performed, as well as measurement of asbestos bodies and/or fibres in lung tissue.

Industry and job-specific mortality after occupational exposure to silica dust.

BACKGROUND: Occupational exposure to silica dust occurs in many workplaces and is well known to cause silicosis. However, the link between silica exposure, silicosis and other diseases is still disputed. AIMS: To evaluate cause-specific mortality in a cohort of Italian silicotics. METHODS: The cohort included 2034 male compensated for silicosis between 1943 and 1986, alive on 1 January 1987 and resident in the Latium region (Italy). Mortality follow-up was from 1987 to 2006. Vital status and death causes were ascertained from the regional mortality archive. Standardized mortality ratios (SMRs) were computed assuming a Poisson distribution of observed deaths. RESULTS: Significant excess mortality was observed from all causes (SMR: 1.17, 95% CI: 1.11-1.24), cancer of trachea, bronchus and lung (SMR: 1.39, 95% CI: 1.17-1.64), cancer of larynx (SMR: 2.18, 95% CI: 1.32-3.60) and tuberculosis (SMR: 5.85, 95% CI: 3.03-11.30). Higher risks were observed for masons (lung cancer, SMR: 2.46, 95% CI: 1.65-3.66) and miners (larynx cancer, SMR: 5.31, 95% CI: 1.88-15.03). In a Poisson regression analysis, the relative risk of death from lung cancer and silicosis increased with silicosis severity and decreased in more recent compensation periods. CONCLUSIONS: The excess mortality from respiratory tract cancers and other diseases detected among Italian workers compensated for silicosis confirms previous epidemiological findings.

[Exposure to crystalline silica in the air during renovation of residential buildings]. / Esposizione a silice libera cristallina nelle attività di ristrutturazione in edilizia abitativa.

Exposure to respirable cristalline silica dust during construction activities can cause silicosis and, in accordance with International Agency for Research on Cancer (IARC), even lung cancer. Among the different facets of construction, residential buildings are of particular interest because the lack of exposure data for workers employed. In this sector a dry sand-blasting of brick ceiling and renewal activities has been investigated. The survey has been carried out in a civil dwelling and 58 samples have been collected using the SKC aluminium cyclone and Door-Oliver plastic cyclone at flow-rate 2.2-1.7 l/min. The respirable dust samples were analysed by x-ray diffraction using NIOSH Method 7500. Even if the results of this study should be considered preliminary, they showed SLC respirable concentrations even many time above TLV-TWA during a sand-blasting activities and some times also during the other activities. Awaiting the correct classification from European Community, it would be desiderable that the workers would had appropriate information and prevention on the specific risks associated to the dust in the construction activities.

[Silica in ceramic industry: exposition and pulmonary diseases]. / Esposizione a silice cristallina nel comparto ceramico di Civita Castellana (Viterbo) ed evidenze radiologiche e spirometriche di danno polmonare.

Since 1990, a cohort survey has been carried out among workers employed in pottery workers by the Local Health Unit of Viterbo, Latium (Italy). Cumulative exposure to silica containing dust has been assessed for 808 workers, who were also screened with a questionnaire on respiratory symptoms, chest radiography and lungfunction tests. The prevalence of small opacities 1/0 and 1/1+ was 3.0% and 4.1% respectively and the prevalence increased with the cumulative exposure. A close relationship has been found between silica dose and decrease in lung function.

[Assessment of exposure to ceramic fibers during insulation operations in a thermoelectric power plant]. / Valutazione dell'esposizione a fibre ceramiche durante la coibentazione degli impianti di una centrale termoelettrica in costruzione.

Refractory ceramic fibre concentrations were measured during renewal of the insulation lining of a turbine located in a large power plant. Personal and stationary samples were collected during operations, which involved installing and ripping out standard and pre-coated and pre-shaped ceramic fibre blankets. Operation-length average (OLA) and TWA exposure levels were about 500 F/l and about 100 F/l, respectively, for installing and ripping out operations where non-coated blankets were handled. In these cases specific task-associated personal exposure levels up to 1000 F/l were measured. Personal exposure levels up to as much as 10 times lower were observed in operations involving pre-coated and pre-shaped blankets. The average concentration levels from area samples were always lower than those from personal samples, and showed a downward gradient with the distance from the source. Given the current carcinogenic classification of refractory ceramic fibres (class 2, European), the necessity is stressed of introducing adequate working practices and control measures (adoption of pre-coated and pre-shaped fibrous materials whenever possible, confinement of working area, use of local air extractions ventilation with HEPA filter unit, use of garments for personal protection and respirators, use of wetting or binding liquids prior to removal, quick cleaning of debris from working area), in order to keep the exposure levels and the number of potentially exposed workers to the minimum.

End stage renal disease among ceramic workers exposed to silica.

OBJECTIVES: To evaluate whether ceramic workers exposed to silica experience an excess of end stage renal disease. METHODS: On the basis of a health surveillance programme, a cohort of 2980 male ceramic workers has been enrolled during the period 1974-91 in Civitacastellana, Lazio, Italy. For each worker, employment history, smoking data, and x ray film readings were available. The vital status was ascertained for all cohort members. All 2820 people still alive and resident in the Lazio region as in June 1994 were searched for a match in the regional end stage renal diseases registry, which records (since June, 1994) all patients undergoing dialysis treatment in public and private facilities of the region. Expected numbers of prevalent cases from the cohort were computed by applying the rate of patients on dialysis treatment by the age distribution of the cohort. RESULTS: A total of six cases was detected when 1.87 were expected (observed/expected (O/E) = 3.21; 95% confidence interval (95% CI) 1.17 to 6.98). The excess risk was present among non-smokers (O = 2; O/E = 4.34) and smokers (O = 4; O/E = 2.83), as well as among workers without silicosis (O = 4; O/E = 2.78) and workers with silicosis (O = 2; O/E = 4.54). The risk was higher among subjects with < 20 years since first employment (O = 4; O/E = 4.65) than among those employed > 20 years. CONCLUSION: These results provide further evidence that exposure to silica dust among ceramic workers is associated with nephrotoxic effects.

Incidence of silicosis among ceramic workers in central Italy.

The incidence of radiological silicosis was studied among 2480 male workers employed in the ceramics industry. The subjects entered the surveillance program during 1974-1987 and were followed through 1991 with annual chest radiographs. The cumulative risk of silicosis (1/1 or greater; p,q,r) reached 48% (95% confidence interval 41.5-54.9) after 30 years of employment. In a multivariate Cox's proportional hazards model, the effect of duration of exposure increased linearly up to the category of 25-29 years; an extremely high hazard risk of 14.6 was found among those with 30 years or more of exposure in comparison with those employed 10 years or less. Smoking habit also significantly contributed to the model, although its role in the biological process is unclear. In conclusion, exposure to silica dust has been associated with a high incidence of silicosis among ceramics workers. The risk estimates are consistent with the recent findings of silicosis incidence among South African gold miners.

Cancer among farmers in central Italy.

This case-referent study evaluated cancer risks among farmers in central Italy. Cancer cases (N = 1674, 17 sites) were selected from all deceased men aged 35-80 years; a random sample of 480 decedents formed the reference series. Farmers had a decreased risk of lung and bladder cancer and melanoma and nonsignificant excess risks for stomach, rectal, kidney, and nonmelanoma skin cancer. Stomach and kidney cancer were significantly increased among the farmers with > 10 years' experience, and stomach, rectal, and pancreatic cancer were increased among licensed pesticide users with > 10 years' experience. Possible relationships emerged between specific crops and cancer: fruit and colon and bladder cancer, wheat and prostate cancer, olives and kidney cancer, and potato and kidney cancer. The results regarding stomach, pancreatic, lung, bladder, and prostate cancer and melanoma congrue with earlier results. The kidney cancer excess, the association of colon and bladder cancer with orchard farming, and the excess of rectal cancer among licensed farmers are new and unexpected findings.

A case-referent study on lung cancer mortality among ceramic workers.

A case-referent study has been carried out to test the hypothesis that silica-exposed ceramic workers have an increased risk of lung cancer. Next-of-kin interviews were conducted for 72 lung cancer cases and 319 referents, all deceased, to collect work histories and smoking habits. The diagnosis of silicosis was ascertained by checking the individual files of cases of silicosis where compensation had been received. It was found that, after controlling for age, period of death and smoking, workers in the ceramic industry had a higher lung cancer risk than those in other occupations in which there was no exposure to silica (Mantel-Haenszel rate ratio = 2.0; 95% confidence interval (CI) = 1.1-3.5). This increased risk was mainly due to a rate ratio of 3.9 (95% CI = 1.8-8.3) for silicotic individuals, while for non-silicotic ceramic workers it was only 1.4 (95% CI = 0.7-2.8). Exposure to other carcinogens in the workplace seems not to play any role in the development of lung cancer. Furthermore, the data do not suggest an increased risk for silicotic non-smokers. The results of the study tend to confirm previous evidence of an excess risk among silicotic subjects and points to a possible etiological role of the silicotic process itself in lung cancer.

Silica, silicosis and lung cancer among ceramic workers: a case-referent study.

A case-referent study has been carried out regarding a possible connection between silica exposure and lung cancer (ICD 162) in Central Italy, where the pottery industry has a long tradition. Silicosis among 72 cases of lung cancer and among 314 referents, all deceased, was ascertained through checking the individual files of compensated cases of silicosis. Questionnaires on past employments and smoking habits were blindly administered to the next-of-kin of the deceased subjects. Controlling for age, period of death, and smoking, workers in the ceramic industry were found to have a higher lung cancer risk than workers in other occupations free from silica exposure (Mantel-Haenszel rate ratio = 2.0; 95% confidence interval (CI) = 1.1-3.5). This increased risk was mainly due to a rate ratio of 3.9 (95% CI = 1.8-8.3) for silicotic individuals, while for nonsilicotic ceramic workers it was only 1.4 (95% CI = 0.7-2.8). The result of this study seems to suggest that lung cancer might be merely indirectly associated with exposure to silica through the silicotic process, although the dose may differ for silicotic and nonsilicotic individuals.