1,721,006 research outputs found
A mortality study on male subjects exposed to polyfluoroalkyl acids with high internal dose of perfluorooctanoic acid
No full textAbstract Objectives The aim of the present study was to examine the association between exposure to polyfluoroalkyl substances (PFASs) and mortality (1970–2018) in a cohort of 462 male employees who had worked at least six months before 2009 for a factory (14,658 person-years; 107 deaths, average follow-up time 31.7 years), which had been producing perfluorooctanoic acid (PFOA), perfluorooctanesulfonyl fluoride (PFOS) and other chemicals since 1968. Methods Employees were classified as follows: 1) by probability of exposure to PFASs; 2) by tertiles of PFOA serum concentrations. In a fraction (n = 120) of workers measurements of internal PFOA serum concentration were used to predict a cumulative serum PFOA concentration of each cohort member. Mortality rates were compared to that of the regional population using the standardized mortality ratio (SMR), and to that of the workers of a nearby metalworking factory in terms of risk ratio (RR), across categories of probability of PFASs exposure and tertiles of cumulative serum PFOA concentrations. Results Internal PFOA serum concentration among 120 workers in the 2000–2013 period was very high (Geometric Mean: 4048 ng/mL; range 19–91,900 ng/mL). The mortality of the chemical cohort was increased for liver cancer (SMR: 2.32; CI: 1.11–4.87), malignant neoplasm of lymphatic and haematopoietic tissue (SMR: 2.26; CI: 1.08–4.73). In the comparison with the cohort of workers from the metalworking factory, the RRs for mortality of the cohort were increased for overall mortality (RR: 1.42; CI: 1.12–1.79), diabetes (RR: 5.95; CI: 1.08–32.8), liver cancer (RR: 6.69; CI: 1.71–26.2) and liver cirrhosis (RR: 3.87; CI: 1.18–12.7). Mortality for these causes increased in association with probability of PFASs exposure and with tertiles of cumulative PFOA serum concentrations. Conclusion The present is a small observational study with limited control over confounding factors. The cohort showed increased mortality for all causes and subjects in the highest cumulative internal dose of PFOA had a statistically significant increase for mortality of liver cancer, liver cirrhosis, diabetes, malignant neoplasms of lymphatic and haematopoietic tissue in both comparisons. Toxicological studies on PFOA and PFOS provide support for causality for the observed association with the risk for liver cirrhosis and liver cancer
Mortality study of a cohort of chemical workers producing perfluorinated derivatives and other chemicals
Full text linkSince 1968 a single factory (Veneto Region, Italy) has been the
largest manufacturer of perfluorinated derivates (PF) in UE.
Intermediates for pharmaceutical and crop protection chemicals
have been also produced. In total 609 subjects have been
employed since production began. PF are manufactured by electrochemical fluorination. Higher homologues are no longer produced since 2012. Nowadays, a groundwater pollution of PF is
involving the water supplies for a population of about 1 10 000
inhabitants.
As a first step for an evaluation of long-term health effects,
we conducted a retrospective cohort mortality study on male
employees, hired before year 2004, at work for at least one
year, followed up until June 2016 (415 subjects), using the
regional mortality rates as a reference.
High serum levels of perfluorooctanoic acid (PFOA) have
been detected since year 2000 covering 121 workers (median
PFOA concentration, 1817 ng/g; range, 166 ng/g for nonexposed workers to 5101 ng/g for directly exposed workers).
The cohort as a whole (12,449 PYs, 79 deaths) expresses
an unexpected over-mortality (SMR: 1.07; 95% CI: 0.86–
1.34), mainly due to liver cirrhosis and liver tumours. The
subset of employees with a certain exposure to PFOA (plant
operator, maintenance and laboratory workers) (2,351 PYs, 22
deaths) shows an higher overall mortality (SMR=1.48 95% CI
0.98–2.33) and a statistically significant excess of deaths from
diseases of the circulatory system (infarct; SMR: 7.21;
95% CI: 1.80–28.85) and diabetes (SMR: 6.75; 95% CI:
1.69–26.99).
The study suffers from the limited size, and mortality is
not an appropriate end-point for some diseases of interest
A mortality study on male subjects exposed to polyfluoroalkyl acids with high internal dose of perfluorooctanoic acid
No full textObjectives: The aim of the present study was to examine the association between exposure to polyfluoroalkyl
substances (PFASs) and mortality (1970–2018) in a cohort of 462 male employees who had worked at least six
months before 2009 for a factory (14,658 person-years; 107 deaths, average follow-up time 31.7 years), which
had been producing perfluorooctanoic acid (PFOA), perfluorooctanesulfonyl fluoride (PFOS) and other chemi-
cals since 1968.
Methods: Employees were classified as follows: 1) by probability of exposure to PFASs; 2) by tertiles of PFOA
serum concentrations. In a fraction (n = 120) of workers measurements of internal PFOA serum concentration
were used to predict a cumulative serum PFOA concentration of each cohort member. Mortality rates were
compared to that of the regional population using the standardized mortality ratio (SMR), and to that of the
workers of a nearby metalworking factory in terms of risk ratio (RR), across categories of probability of PFASs
exposure and tertiles of cumulative serum PFOA concentrations.
Results: Internal PFOA serum concentration among 120 workers in the 2000–2013 period was very high
(Geometric Mean: 4048 ng/mL; range 19–91,900 ng/mL). The mortality of the chemical cohort was increased for
liver cancer (SMR: 2.32; CI: 1.11–4.87), malignant neoplasm of lymphatic and haematopoietic tissue (SMR: 2.26;
CI: 1.08–4.73). In the comparison with the cohort of workers from the metalworking factory, the RRs for
mortality of the cohort were increased for overall mortality (RR: 1.42; CI: 1.12–1.79), diabetes (RR: 5.95; CI:
1.08–32.8), liver cancer (RR: 6.69; CI: 1.71–26.2) and liver cirrhosis (RR: 3.87; CI: 1.18–12.7). Mortality for
these causes increased in association with probability of PFASs exposure and with tertiles of cumulative PFOA
serum concentrations.
Conclusion: The present is a small observational study with limited control over confounding factors. The cohort
showed increased mortality for all causes and subjects in the highest cumulative internal dose of PFOA had a
statistically significant increase for mortality of liver cancer, liver cirrhosis, diabetes, malignant neoplasms of
lymphatic and haematopoietic tissue in both comparisons. Toxicological studies on PFOA and PFOS provide
support for causality for the observed association with the risk for liver cirrhosis and liver cance
Past trends and future prediction of mesothelioma incidence in an industrialized area of Italy, the Veneto Region
No full textBACKGROUND: Malignant Mesothelioma (MM) is so associated with (professional, familial or environmental) asbestos exposure that trends in incidence and mortality parallel, after 30-40 years, the trend in asbestos consumption. In recent decades, the industrialized countries have witnessed a steady growth of pleural MM (MPM), following a stabilization or decline in rates in the countries that first adopted restrictive policies. The aim of this study was to evaluate the temporal variations of pleural MM incidence in the Veneto Region of Italy in the period 1987-2010. METHODS: We included only MPM with histological or cytological diagnosis. Age-Period-Cohort (APC) models were used to assess the trend in the incidence of MPM in both genders. Future predictions were evaluated by using a Bayesian APC model. RESULTS: In the period 1987-2010, 1600 MPMs have occurred. We observe a positive trend in the incidence in the whole period considered. The APC model showed that in both genders the cohort at higher risk is the one born between the years 1940-1945. Future projections indicate that the trend will decrease after the incidence peak of 2010; yet 1234 men are expected to develop a mesothelioma between 2011 and 2026. Among women, the future MPM rates will be stable or slightly decreasing. CONCLUSIONS: The asbestos ban introduced in Italy in the year 1992 as a prospective result will certainly determine a decreasing incidence. However, the extremely long latency of MPM means that its influence is not yet observable
Past trends and future prediction of mesothelioma incidence in an industrialized area of Italy, the Veneto Region
Full text linkBackground Malignant Mesothelioma (MM) is so associated with (professional, familial or environmental) asbestos exposure that trends in incidence and mortality parallel, after 30–40 years, the trend in asbestos consumption. In recent decades, the industrialized countries have witnessed a steady growth of pleural MM (MPM), following a stabilization or decline in rates in the countries that first adopted restrictive policies. The aim of this study was to evaluate the temporal variations of pleural MM incidence in the Veneto Region of Italy in the period 1987–2010. Methods We included only MPM with histological or cytological diagnosis. Age-Period-Cohort (APC) models were used to assess the trend in the incidence of MPM in both genders. Future predictions were evaluated by using a Bayesian APC model. Results In the period 1987–2010, 1600 MPMs have occurred. We observe a positive trend in the incidence in the whole period considered. The APC model showed that in both genders the cohort at higher risk is the one born between the years 1940–1945. Future projections indicate that the trend will decrease after the incidence peak of 2010; yet 1234 men are expected to develop a mesothelioma between 2011 and 2026. Among women, the future MPM rates will be stable or slightly decreasing. Conclusions The asbestos ban introduced in Italy in the year 1992 as a prospective result will certainly determine a decreasing incidence. However, the extremely long latency of MPM means that its influence is not yet observable
Ricostruzione retrospettiva della dose interna in una coorte lavorativa esposta a PFOA
Full text linkIntroduzione
La ditta MITENI di Trissino (VI), già attiva fin dal 1960 con il nome RIMAR, è stata la maggiore produttrice di perfluorurati
(PF) in Europa. I dipendenti sono stati esposti a sostanze perfluorurate, in particolare a PFOA (acido perfluorottanoico) e
le misurazioni delle concentrazioni ematiche cominciate dal 2000 hanno rilevato alti livelli di PFOA tra i lavoratori analizzati
(n=123). Sulla base di questi valori, l’obiettivo è di stimare una dose cumulativa sierica di PFOA per tutti circa i 700 soggetti
che sono stati dipendenti della ditta RIMAR-MITENI.
Metodi
Dal 2000 sono disponibili i livelli sierici di PFOA (in ng/mL) dei lavoratori inclusi nella sorveglianza aziendale annuale. Un
totale di 693 campioni di sangue sono stati prelevati dal 2000 al 2013 da 123 lavoratori (Media Geometrica (MG): 4003
ng/mL; min-max: 19-91900 ng/mL); i livelli più elevati riguardano gli addetti ai PFOA (MG: 8826 ng/mL), i manutentori (MG:
1970 ng/mL), i magazzinieri (MG: 1107 ng/mL) e i tecnici di laboratorio (MG: 1084 ng/mL). Ogni dipendente è stato
classificato in tre categorie mutuamente esclusive: “Ever PF” con 497 misure su 55 lavoratori, “Never PF” con 177 misure
e 60 lavoratori ed infine "Uffici" con 19 misure tra 8 lavoratori. Per ogni categoria è stato stimato un modello di regressione
lineare robusto ad effetti misti modellando il logaritmo dei valori sierici di PFOA del periodo 2000-2013 ed includendo le
covariate più significative. La robustezza è stata ottenuta con uno stimatore di Huber con parametri k=1.345 e s=10 che
garantiscono un'efficienza del 95%.
Risultati
A seconda del modello sono state incluse le covariate risultate significative: l’anno di rilevazione, la durata lavorativa nei
PF, in altri dipartimenti o in ufficio; la produzione media annuale di PFOA dell’azienda nel periodo 2000-2013; il tempo
dall’ultimo lavoro ai PF; l'assunzione dopo il 2005; lavori occasionali presso il reparto PF ed il lavoro come addetto alla
manutenzione. I fattori fissi spiegano una discreta quota di variabilità (R2 marginale "Ever PF": 42,1%; "Never PF": 47,6%;
"Uffici": 59,1%). Attraverso il calcolo iterativo delle covariate tempo dipendenti è stato possibile stimare la concentrazione
sierica di PFOA nel periodo 1970-2013 per tutti i lavoratori.
Conclusioni
L’attività di ricostruzione retrospettiva della dose di PFOA ha permesso di attribuire ad ogni dipendente RIMAR/MITENI
una concentrazione sierica di PFOA permettendo il calcolo di una dose cumulativa. Come conseguenza della presenza di
valori anomali, l’utilizzo di modelli robusti porta a minor adattamento del modello ai dati rispetto ai modelli classici, tuttavia
le stime sono influenzate in maniera minore dalla presenza di valori anomali
Increased risk of mesothelioma and lung cancer among workers exposed to asbestos who could require an anticipated retirement
Full text linkOBIETTIVI: valutare l’associazione tra mesotelioma maligno pleurico (MMP) e tumore del polmone (TP) in ex-esposti ad amianto che avevano la possibilità di richiedere il prepensionamento, grazie alla legge n.257 del 1992 che ha bandito l’amianto, nel quadro dei programmi per la loro sorveglianza epidemiologica in corso in Regione Veneto. SETTING E PARTECIPANTI: in una coorte di lavoratori esposti all’amianto e vivi nel 1992, composta da addetti di un insieme di aziende, seguiti dal 1992 al 2012, sono stati identificati i casi di mesotelioma utilizzando il Registro regionale veneto dei casi di mesotelioma, e i casi di tumore del polmone attraverso il Registro tumori del Veneto, le schede di dimissione ospedaliere e le schede di morte. Il rischio di tumore connesso con l’esposizione all’amianto è stato calcolato attraverso regressione di Poisson a effetti misti. RISULTATI: sia il rischio di mesotelioma pleurico sia quello per il tumore del polmone risultano aumentare all’incremento della durata del lavoro. Il rischio dimesotelioma raggiunge valori estremamentemarcati con le durate lavorative più lunghe, mentre triplica in queste stesse condizioni il rischio per il tumore del polmone. Le domande di prepensionamento sono molto inferiori a quelle potenziali e il rischio non è risultato circoscritto a chi ha avanzato domanda. CONCLUSIONE: l’insieme dei soggetti che sono stati esposti ad amianto dovrebbe essere oggetto di sorveglianza epidemiologica e di approfondimenti che portino a identificare i soggetti amaggior rischio di tumore del polmone sulla base dell’intensità dell’esposizione ad amianto e dell’abitudine al fumo, attualmente non note, con l’obiettivo di sviluppare, per quanto possibile, attività di contrasto del rischio accumulato e di diagnosi precoce. Parole chiave: amianto, esposizione lavorativa, mesotelioma, tumore del polmone, studio di coorte OBJECTIVES: to assess the association among malignant pleural mesothelioma (MPM) and lung cancer (LC) among workers who have been exposed to asbestos and have or not have required an anticipated leave from work, a possibility offered by the 1992 law banning asbestos in Italy, in the framework of the health surveillance programmes on going in the Veneto Region (Northern Italy). SETTING AND PARTICIPANTS: a cohort of asbestos workers derived from the rosters of selected factories and alive in 1992, followed from 1992 to 2012.MPMcases have been identified through the Regional Mesothelioma Registry, while LC cases through a link with the Regional Cancer Registry, hospital discharges, and death certificates. Risks related to asbestos exposure were calculated by mixed effects Poisson regression model. RESULTS: the risk of MPMand LC increases at any additional duration of work, up to very high values for long term durations of work for MPM, and up to a three fold increase for LC. Early retirements have been requested by a fraction only in the position of submitting it. CONCLUSION: subjects who have been exposed to asbestos should be the target of a post-occupational surveillance, and further work is suggested to identify subjects at high risk of LC because of smoking habits and more heavy exposure to asbestos, in order to develop programmes for primary and secondary cancer prevention
Increased risk of mesothelioma and lung cancer among workers exposed to asbestos who could require an anticipated retirement
Full text linkOBJECTIVES: to assess the association among malignant pleural mesothelioma (MPM) and lung cancer (LC) among workers who have been exposed to asbestos and have or not have required an anticipated leave from work, a possibility offered by the 1992 law banning asbestos in Italy, in the framework of the health surveillance programmes on going in the Veneto Region (Northern Italy).
SETTING AND PARTICIPANTS: a cohort of asbestos workers derived from the rosters of selected factories and alive in 1992, followed from 1992 to 2012.MPMcases have been identified through the Regional Mesothelioma Registry, while LC cases through a link with the Regional Cancer Registry, hospital discharges, and death certificates. Risks related to asbestos exposure were calculated by mixed effects Poisson regression model.
RESULTS: the risk of MPMand LC increases at any additional duration of work, up to very high values for long term durations of work for MPM, and up to a three fold increase for LC. Early retirements have been requested by a fraction only in the position of submitting it.
CONCLUSION: subjects who have been exposed to asbestos should be the target of a post-occupational surveillance, and further work is suggested to identify subjects at high risk of LC because of smoking habits and more heavy exposure to asbestos, in order to develop programmes for primary and secondary cancer prevention
Risk of pleural mm and residual asbestos burden in the lung: a retrospective case-control study
Full text linkIntroduction Results of Malignant Pleural Mesothelioma
(MPM) occurrence (mortality and incidence) by cumulative
exposure dose clearly showed a proportional relation of MPM
risk with dose, confirmed among studies by fibre burden. We
evaluated the association between residual fibre content and
MPM risk by circumstance of asbestos exposure.
Methods and materials Lung samples obtained from pleuropneumonectomies or autopsies (349 MPMs, and 41 controls)
among subjects investigated for probability and circumstance
of asbestos exposure were examined through Scanning Electron Microscopy; 291 cases had an occupational asbestos
exposure, 38 MPMs a non-occupational exposure (familiar or
environmental), whereas among 20 MPM an asbestos exposure
was not identified. The MPM risk was evaluated by means of
Odds Ratio (OR).
Results The residual asbestos fibre burden was higher among
MPMs occupationally exposed (Geometric Mean:2.10 Million
fibres/gram of dried tissue; 95% CI:1.5–2.58) in comparison
with non-occupational (GM:0.66 Mff/gdt; 95% CI:0.47–0.95)
or with unknown exposures (GM:0.59 Mff/gdt; 95% CI:0.34–
1.03) and controls (GM:0.26 Mff/gdt; 95% CI:0.20–0.34).
Among occupationally exposed, the MPM risk increased
according to the asbestos fibre burden reaching an OR of
36.8 (95%CI:11.9–113.5) for concentrations higher than 1
Mff/g dt, compared to the reference level (<0.25 Mff/gdt).
Higher ORs were observed at any concentration of amphibole
fibres in comparison those for chrysotile fibres.
Conclusions The MPM risk was strongly associated to the
residual asbestos fibre lung burden. The MPM risk due to
non-occupational exposure shows a magnitude comparable
with that with unknown asbestos exposures. The residual lung
burden of chrysotile is strongly influenced by clearance and
time since exposures ceased
Residual fibre lung burden among patients with pleural mesothelioma who have been occupationally exposed to asbestos
Full text linkObjectives To evaluate the lungs asbestos fibres concentration in participants with malignant pleural mesothelioma (MPM) who have been occupationally exposed.
Methods The lung samples were obtained from pleuropneumonectomies or autopsies of 271 male MPMs. The lung samples were examined through scanning electron microscopy. Retrospective assessment was used to assess for asbestos exposure. This study includes 248 MPMs with an occupational exposure defined as either ‘definite’ or ‘probable’ or ‘possible’.
Results The participants had finished working in asbestos exposure conditions more than 20 years ago (on average 26.1±11.0 years). The fibre burden resulted with a geometric mean equal to 2.0 (95% CI 1.6 to 2.4) million fibres per gram of dry lung tissue. The burden was higher among participants employed in asbestos textiles industry and in shipyards with insulation material, if compared with construction workers or non-asbestos textile workers or participants working in chemicals or as auto mechanics. 91.3% of MPMs had a detectable amount of amphibole fibres. A strong lung clearance capability was evident among workers exposed to chrysotile fibres. Owing to that, the 1997 Helsinki Criteria for occupational exposure were reached in <35% of cases among participant working in construction, in metallurgical industry, in chemical or textile industry and among those performing brake repair activities.
Conclusions The MPM cases are now occurring in Italy in participants who ceased occupational asbestos exposure decades before the analysis. A large majority still shows a residual content of amphibole fibres, but given the lung clearance capability, attribution to occupational exposure cannot rely only on fibres detection
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