High risk of pleural mesothelioma among the state railroad carriage repair workers

Exposure to asbestos in a facility for the repair of railroad carriages in Bologna was initially studied in 1980, when the Local Health Unit started a program of primary prevention on request of the Unions. At that time workers employed in jobs with high exposure to asbestos were identified. The mortality experience of these 173 subjects was investigated from 01.01.1979 through 31.12.1997, and compared to that of the population of Emilia Romagna. SMR for all causes was 69, with upper limit of the confidence interval lower than 100; this was largely due to a significant decrease of cardiovascular mortality. Among neoplasms, there was a significant excess of pleural mesothelioma (6 observed, 0.09 expected); one more subject died for peritoneal mesothelioma and one for malignant mesothelioma of unspecified site. About half of the subjects deceased for neoplastic disease (8/17) were affected by mesothelioma.     

Bronchial carcinoma mortality in the German chromate-producing industry: the effects of process modification

Summary This study updates a 1982 report on mortality at two German chromate-producing factories. The main objective of the study was to establish whether the change-over to a production process using lime-free conversion of chromite ore, thus eliminating the formation of calcium chromate, had resulted in a distinct reduction in bronchial carcinoma mortality among workers exposed for the first time after the change-over (completed in 1958 in Leverkusen and 1964 in Uerdingen). A total of 1417 workers with at least 1 year of exposure were enrolled in the study. The observation period ended on 31 December 1988. The expected number of deaths was calculated using population statistics for North Rhine-Westphalia. The risk was determined in the form of a standardised mortality ratio (SMR), i.e. the ratio of observed deaths to expected deaths. In the group of 739 workers exposed before the process change-over was completed, 432 died during the observation period, 66 of them from bronchial carcinoma. This significant excess produced an SMR of 2.27 (95% confidence interval: 1.78–2.85). Where the cause of death was unknown, cases were allocated to a cause of death on the basis of the percentage occurrence of various causes of death in the specific subcohort. The cohort of 678 workers first exposed after the process modification had been completed had a slightly increased SMR for lung cancer of 1.26 (95% confidence interval: 0.58–2.38) based on nine cases. The SMR was considerably lower than in the pre change cohort, indicating the probable success of the process modification. The different age distributions in both cohorts were adjusted by analysis according to latency period. In the pre-change cohort the SMRs were 1.90 ( 10 years), 2.93 (11–20 years) and 2.14 (> 20 years). The corresponding values in the post-change cohort were 1.32, 1.32 and 0.91 (the last figure based on only one case). The SMR of 1.26 in the post-change cohort has to be seen in the light of a number of factors: smoking is more common in industrial cohorts than in the general population; the cause of death was ascertained using the best available information; there was additional exposure to asbestos; the latency period was short; and the SMR decreased with increasing latency period. There was no significant excess of deaths from nasal cancer.     

Cancer mortality among chemical workers in an Italian plant

Objective of this study was to assess the mortality experience of a cohort of chemical workers at a plant located in central Italy. Subjects employed for any time between 1954 and 1970 at the chemical plant were included in the cohort and followed up to June 1991. The workers were classified as having ever/never worked in one of the following work processes: organic chemicals, acid mixtures, cleansing agents and insecticides. Mortality experience of the cohort was compared with that of the regional population by computing SMRs (standardized mortality ratios) and 90% CI (confidence intervals). Vital status was ascertained for 96% of the 505 cohort members. All causes of mortality for the entire cohort were lower than expected (Obs: 176; SMR: 0.90; 90% CI: 0.79–1.03). Analysis by work process revealed an increased mortality for lymphatic and hematopoietic tissue neoplasm in the cleansing agents department (Obs: 3; SMR: 5.00; 90% CI: 1.36–12.9); peritoneum and retropertioneum neoplasm in the organic compounds production (Obs: 2; SMR: 13.33; 90% CI: 2.37–42.0), and bladder cancer in the insecticides process (Obs: 3; SMR: 3.53; 90% CI: 0.96–9.12). Although the study had a low statistical power, the increased cancer risks detected are consistent with previous observations and may be of etiologic interest.     

Reanalysis of mortality from lung cancer among diatomaceous earth industry workers, with consideration of potential confounding by asbestos exposure.

OBJECTIVE: To evaluate the potential for confounding from asbestos exposure, primarily chrysotile, on the relation between crystalline silica and mortality from lung cancer among diatomaceous earth (diatomite) workers. METHODS: A reanalysis of a cohort mortality study of diatomite workers was performed to take into account quantitative estimates of asbestos exposure. The reanalysis was limited to a subset of the original cohort, comprising 2266 white men for whom asbestos exposure could be reconstructed with greatest confidence. Comparisons between mortality from lung cancer (standardised mortality ratios (SMR)) were made between rates for 1942-87 for United States white men, and workers cross classified according to cumulative exposures to crystalline silica and asbestos. Comparisons of internal rates, involving Poisson regression modeling, were conducted for exposure to crystalline silica, with and without adjustment for asbestos exposure. Exposures were lagged by 15 years to take into account disease latency. RESULTS: There was an overall excess of lung cancer (SMR 1.41; 52 observed). The SMRs for four categories of increasing crystalline silica among the workers not exposed to asbestos were 1.13, 0.87, 2.14, 2.00. An SMR of 8.31 (three observed) was found for workers with the highest cumulative exposure to both dusts. Internal analysis, after adjustment for asbestos exposure, yielded rate ratios for categories of exposure to crystalline silica: 1.00 (reference), 1.37, 1.80, and 1.79. CONCLUSIONS: Asbestos exposure was not an important confounder of the association between crystalline silica and mortality from lung cancer in this cohort. Although based on a small number of deaths from lung cancer, the data suggest possible synergy between these exposures. An extended follow up of this cohort is in progress and should enable better assessments of independent and combined effects on risk of lung cancer.     

Mortality of workers at two asbestos-cement plants in Poland

To assess mortality rate among workers occupationally exposed to asbestos, cohort studies were carried out in two asbestos cement plants operating since the 1960s. Asbestos cement sheets for roofing and siding have been manufactured there, using mostly chrisotile, and since 1985 also crocidolite for pressure pipes. In all, the cohort comprised 3,220 workers, including 2,616 male workers. Subject to consideration were the workers employed for at least three months in the period between the onset of the production and 1980. The vital status of the subjects was traced up to 31 December 1991. The availability of the cohort was 96.8%. Workers' mortality was analysed using standardized mortality ratio (SMR). The reference group was the general population of Poland. In the male cohort, 385 cases of death were recorded. Statistically significant excess of mortality from large intestine cancer (7 cases, SMR = 264) and pleural mesothelioma (5 cases, SMR = 2846) was found. In male workers who died from pleural mesothelioma the work history ranged from 12 to 26 years. An excess mortality from pleural mesothelioma was also noted among the female workers (2 cases, SMR = 11,275). No malignant neoplasms of other locations produced significant excess mortality either in the male or female workers.     

Mortality due to asbestos-related causes among railway carriage construction and repair workers

The objective of this study was to further clarify the cancer risk associated with asbestos exposure in railway carriage construction and repair. The cohort included 734 subjects employed between 1 January 1945 and 31 December 1969. Vital status was ascertained at 31 December 1997. Mortality was investigated in the time span 1970-97. Forty-two subjects (6%) were lost to follow-up and eight causes of death (4%) could not be ascertained. The overall mortality was not above the expected value. Among neoplastic diseases, excesses were observed for lung ?tandardized mortality ratio (SMR) = 124; 90% confidence interval (CI) = 87-172; 26 obs), pleura (SMR = 1,327; CI = 523-2,790; 5 obs), larynx (SMR = 240; CI = 95-505; 5 obs), liver (SMR = 241; CI = 126-420; 9 obs), pancreas (SMR = 224; CI = 98-443; 6 obs) and multiple myeloma (SMR = 429; CI = 117-1,109; 3 obs). The observed excess of lung and pleural neoplasms can be causally related to asbestos exposure in the manufacture of railway carriages. A causal role of asbestos exposure in the raised SMRs from laryngeal and pancreatic neoplasms and multiple myeloma cannot be conclusively proven.     

An updated cohort mortality study of workers at a northeastern United States petroleum refinery

An update of a cohort study of 4855 employees at a Paulsboro, New Jersey refinery was conducted to further examine mortality patterns. The earlier study investigated refinery workers employed for a minimum of 1 year between 1 January 1946 and 1 January 1979. The vital status of these workers was ascertained through 1979. The update extended enrollment in the study and vital status follow-up for an additional 8 years (1980–1987). As in the previous study, mortality from all causes [standardized mortality ratio (SMR) = 87; 95% confidence interval (95% CI): 83–91] was significantly lower than expected compared with the general population. Total cancer mortality was also lower than expected (SMR = 96; 95% CI: 86–106). A borderline significant mortality increase in prostatic cancer was found (SMR = 144; 95% CI: 106–190). This increase was similar to the nonsignificant increase reported in the original study (SMR = 135; 95% CI: 90–196). The excess was of comparable magnitude among white males and nonwhite males, although it was not significant for the latter. Detailed analysis indicated that the prostatic cancer was not likely to be related to employment at the refinery. Mortality from lymphatic and hematopoietic cancers was similar to the expected mortality. Mortality from overall leukemia was as expected and detailed analyses by specific cell type showed no increase. An increase in mortality occurred from non-Hodgkin's lymphoma among male workers (SMR = 132; 95% CI: 74–217). The increase was not statistically significant and unlikely to be associated with refinery employment. Mortality from multiple myeloma among male employees was lower than expected (SMR = 74; 95% CI: 20–190). Mortality from asbestos-related diseases (pulmonary fibrosis, lung cancer, malignant mesothelioma) was also lower than expected among male workers. No cause-specific mortality was found to be associated with duration of employment at the refinery, including several causes which have been reported to be elevated in previous studies. The findings of this updated study indicate, as in the previous report, the generally favorable mortality experience of Paulsboro refinery workers.The work for this study was performed at Mobil Corporate Medical Department     

Mortality among workers at the Savannah River Site

BACKGROUND: Workers employed at the Savannah River Site (SRS) were potentially exposed to a range of chemical and physical hazards, many of which are poorly characterized. We therefore compared the observed deaths among workers to expectations based upon death rates for referent populations. METHODS: The cohort included 18,883 SRS workers hired between 1950 and 1986. Vital status and cause of death information were ascertained through 2002. Sex-specific standardized mortality ratios (SMR) were computed using U.S. and South Carolina mortality rates. SMRs were tabulated separately for monthly-, weekly-, and hourly-paid men. RESULTS: Males had fewer deaths from all causes [SMR=0.80, 90% confidence interval (CI): 0.78, 0.82], all cancers (SMR=0.85, 90% CI: 0.81, 0.89), and lung cancer (SMR=0.88, 90% CI: 0.82, 0.95) than expected based upon US mortality rates. The SMR for cancer of the pleura was 4.25 (90% CI: 1.99, 7.97) for men. The SMR for leukemia was greater than unity for monthly-paid (SMR=1.33, 90% CI: 0.88, 1.93) and hourly-paid (SMR=1.36, 90% CI: 1.02, 1.78) men. Female workers had fewer deaths from all causes (SMR=0.75, 90% CI: 0.69, 0.82) than expected, but more deaths than expected from cancer of the kidney (SMR=2.58, 90% CI: 1.21, 4.84) and skin (SMR=3.90, 90% CI: 2.11, 6.61). CONCLUSIONS: While the observed numbers of deaths in most categories of cause of death were less than expected, there are greater than expected numbers of deaths due to cancer of the pleura and leukemia, particularly among hourly-paid male workers. It is plausible that occupational hazards, including asbestos and ionizing radiation, contribute to these excesses.     

Mortality of auto mechanics. A ten-year follow-up

This study was set up to investigate whether work in car repair workshops is associated with an increased risk of ischemic heart disease and specific malignant neoplasms. For this purpose, a cohort of auto mechanics has been followed through 10 years with regard to cause-specific mortality. Comparisons were made with another cohort of skilled male workers who were not exposed to asbestos or petrochemical substances. The auto mechanics' mortality was increased for ischemic heart disease [standardized mortality ratio (SMR) 121, 95% confidence interval (95% CI) 102-145], other cardiovascular diseases (SMR 112, 95% CI 82-150), cancer (SMR 115, 95% CI 97-136), other diseases (SMR 119, 95% CI 94-149), and external causes (SMR 131, 95% CI 113-153). For specific cancer sites, increases were seen for pancreatic cancer, urinary cancer outside the bladder, and pleural mesothelioma.     

Cohort mortality and cancer incidence survey of recent entrants (1982-91) to the United Kingdom rubber industry: preliminary findings

OBJECTIVES—To monitor the occurrence of stomach and lung cancer in a newly defined cohort of United Kingdom rubber workers and to report findings for other cancers in an early period of follow up.
METHODS—A prospective cohort of 9031 male and female workers from 42 United Kingdom rubber factories has been enumerated. All employees had a minimum of 12 months employment and were first employed at one of the participating factories in the period 1982-91. Mortality data were available for the period 1983-98 and cancer registration data for the period 1983-94. The mortality and cancer incidence experienced by the cohort were compared with expected values based on national rates defined by period, age, and sex.
RESULTS—Mortality from lung cancer was close to expectation (men: observed (obs) 11, expected (exp) 12.70, standardised mortality ratio (SMR) 87, 95% confidence interval (95% CI) 43 to 155; women: obs 0, exp 1.34, SMR 0, 95% CI 0 to 275). Mortality from stomach cancer was unexceptional (men: obs 1, exp 2.69, SMR 37, 95% CI 1 to 207; women: obs 0, exp 0.24, SMR 0, 95% CI 0 to 1537). Many statistical comparisons were made both for mortality data and for cancer registration data; only one difference between observed and expected numbers was significant (mortality from cancer of the testis: obs 3 exp 0.51, SMR 589, 95% CI 122 to 1722). Corresponding findings for incident cancers of the testis were unexceptional (obs 5, exp 5.13, standardised registration ratio (SRR) 97, 95% CI 32 to 227).
CONCLUSION—The findings should be treated with caution as they relate to an early period of follow up. Nevertheless, they hold out the prospect that the increased SMRs for stomach and lung cancers reported for historical cohorts of United Kingdom rubber workers may not be apparent in more recent cohorts.


Keywords: rubber workers; lung cancer; stomach cancer; cohort study     

Historical cohort study of a New Zealand foundry and heavy engineering plant

OBJECTIVES: To investigate the mortality of workers who had been exposed to asbestos, machining fluids and foundry work in a foundry and heavy engineering plant in the railway rolling stock manufacturing industry in New Zealand. METHODS: Historical cohort study design. RESULTS: For the total workforce of 3522 men employed between 1945 and 1991, follow up was 90% of person-years to 31 December 1991. Significantly increased standardised mortality ratios (SMRs) were found for all causes of death combined (SMR 1.07; 95% confidence interval (95% CI) 1.01 to 1.14), all malignancies (SMR 1.15; 95% CI 1.01 to 1.31), circulatory (SMR 1.16; 95% CI 1.07 to 1.27) and musculoskeletal diseases (SMR 3.06; 95% CI 1.39 to 5.84), all digestive cancers (SMR 1.29; 95% CI 1.04 to 1.59), all respiratory cancers (SMR 1.34; 95% CI 1.08 to 1.65), cancer of the oesophagus (SMR 1.97; 95% CI 1.01 to 3.45), and mesothelioma of the pleura (SMR 6.58; 95% CI 1.24 to 19.49). Three deaths from pleural mesothelioma were recorded, with latency times of 51, 53, and 57 years. There were no dose-response relations between exposure to asbestos, machining fluids or foundry work, or by duration of employment in the plant, and any cause of death. CONCLUSIONS: This study found small increases in risk for several causes of death among foundry and heavy engineering workers; however, these increases were small and the possible effects of smoking and other lifestyle factors could not be excluded. There was evidence of asbestos related disease in those involved in engineering work in the past.

 

     

Mortality in a cohort of asbestos cement workers in Carrara, Italy

BACKGROUND AND OBJECTIVES: The aim of this study was to investigate the mortality of 262 workers (200 men and 62 women) employed in an asbestos cement plant located in Carrara, Italy, exposed to a mixture of chrysotile and crocidolite asbestos in a ratio of 2:5. METHODS: Follow-up started on 1 January, 1963. The vital status and causes of death were ascertained on 31 December, 2003. The Tuscany population mortality was used as reference. The relative risk was estimated by Standardized Mortality Ratio (SMR) and the confidence intervals were calculated at 95% level [95%CI]. RESULTS: Among men, a significant increase in mortality was observed for respiratory disease (14 deaths; SMR = 244.1; IC95% = 133.4-409.5), particularly for pneumoconiosis (10 deaths; SMR= 1,800; IC95% = 856.9-3,300.0; of which 5 deaths due to asbestosis; SMR = 120,000; IC95% = 37,000-270,000), and for pleural cancer (4 deaths; SMR = 2,500; IC95% = 676.8-6,400.0). Non-significant increases were also observed for lung cancer (10 deaths; SMR = 114.2; IC95% = 54.8-209.9), and gastric cancer (7 deaths; SMR= 167.1; IC95% = 67.2-344.3). Among women, significant increases were observed for pneumoconiosis (1 death; SMR = 17,000; 95%CI = 425-93,000), and for liver cancer (3 deaths; SMR = 765.0; IC95% = 157.8-2,200.0). CONCLUSIONS: For males our results were consistent with other mortality studies on asbestos-cement workers. No other cohort studies on asbestos cement workers have dealt with mortality of female workers.     

Epidemiologic study of cancer mortality among Israeli asphalt workers

BACKGROUND: We describe the results of a cancer mortality study among asphalt workers in Israel. METHODS: Personal identifiers and employment histories of 2,176 workers were extracted from company records. RESULTS: Mortality from all malignant neoplasms was significantly reduced in the whole cohort (SMR 0.68, 95% confidence interval (CI) 0.56-0.83). SMR for lung cancer was elevated in workers exposed to bitumen (SMR 1.05, 95% CI 0.62-1.66). No significant elevation or reduction in mortality was observed in relation to a specific site. SMRs for lung cancer was higher among ever exposed to bitumen than among unexposed. There was no association between lung cancer risk and estimated exposure to bitumen fume, and no dose-response was apparent. CONCLUSIONS: While the results of this cohort study indicate a slightly increased SMR for lung cancer, it did not produce evidence of a causal link between lung cancer and exposure to bitumen fume.     

An updated historical cohort mortality study of workers exposed to asbestos in a refitting shipyard, 1947�C2007

Purpose

To evaluate the long-term health effects of occupational asbestos exposure, an updated historical cohort mortality study of workers at a refitting shipyard was undertaken.

Methods

The cohort consisted of 249 male ship repair workers (90 laggers, 159 boiler repairers). To determine relative excess mortality, standardized mortality ratios (SMRs) were calculated using mortality rates among the Japanese male population. Mortality follow-up of study subjects was performed for the period from 1947 till the end of 2007.

Results

We identified the vital status of 87 (96.7%) laggers and 150 (94.3%) boiler repairers. Of these, 63 (72.4%) and 95 (63.3%), respectively, died. Laggers, who had handled asbestos materials directly, showed a significantly elevated SMR of 2.64 (95% confidence interval [CI]: 1.06?C5.44) for lung cancer and 2.49 (95% CI: 1.36?C4.18) for nonmalignant respiratory diseases. Boiler repairers, who had many opportunities for secondary exposure to asbestos and a few for direct exposure, showed no significant elevation in SMR for lung cancer but a significantly elevated SMR of 1.78 (95% CI: 1.06?C2.81) for nonmalignant respiratory diseases. In an analysis according to duration of employment, there was a significantly elevated SMR of nonmalignant respiratory diseases in the longer working years group. Among workers from both jobs, no deaths caused by mesothelioma in addition to those in the original study were found and no subject died from larynx cancer.

Conclusion

This updated study confirmed a significant excess of asbestos-related mortality from diseases such as lung cancer and nonmalignant respiratory diseases among workers in a refitting shipyard in Japan.     

Vermiculite, respiratory disease, and asbestos exposure in Libby, Montana: update of a cohort mortality study

BACKGROUND: Vermiculite from the mine near Libby, Montana, is contaminated with tremolite asbestos and other amphibole fibers (winchite and richterite). Asbestos-contaminated Libby vermiculite was used in loose-fill attic insulation that remains in millions of homes in the United States, Canada, and other countries. OBJECTIVE: This report describes asbestos-related occupational respiratory disease mortality among workers who mined, milled, and processed the Libby vermiculite. METHODS: This historical cohort mortality study uses life table analysis methods to compare the age-adjusted mortality experience through 2001 of 1,672 Libby workers to that of white men in the U.S. population. RESULTS: Libby workers were significantly more likely to die from asbestosis [standardized mortality ratio (SMR) = 165.8; 95% confidence interval (CI), 103.9-251.1], lung cancer (SMR = 1.7; 95% CI, 1.4-2.1), cancer of the pleura (SMR = 23.3; 95% CI, 6.3-59.5), and mesothelioma. Mortality from asbestosis and lung cancer increased with increasing duration and cumulative exposure to airborne tremolite asbestos and other amphibole fibers. CONCLUSIONS: The observed dose-related increases in asbestosis and lung cancer mortality highlight the need for better understanding and control of exposures that may occur when homeowners or construction workers (including plumbers, cable installers, electricians, telephone repair personnel, and insulators) disturb loose-fill attic insulation made with asbestos-contaminated vermiculite from Libby, Montana.     

Mortality in a cohort of asbestos cement workers in Bari

The study describes the mortality of 417 workers employed in a asbestos-cement plant, located in Bari, Puglia, Southern Italy. Follow up started on February 1st 1972. The vital status and cause of death were ascertained at 1995. The mortality experience of the Apulian population was used as comparison. Using 90% confidence limits (CLs), a significant increase in mortality was observed in our cohort from: all causes of death (SMR 118, CL 100-139), pneumoconiosis (SMR 14810, CL 10298-20683), all types of cancer (SMR 139, CL 105-181), lung (SMR 191, CL 126-277), pleural (SMR 1560 CL 431-4081) and peritoneum (SMR 1705, CL 303-5367) malignant neoplasms. In our cohort, the discrepancy between observed and expected mortality for lung and pleural cancer occurred 30 years after the first exposure, after 40 years for all neoplasms and peritoneum cancer. Under the Cox regression model, lung cancer SMR showed a curvilinear trend along time since first exposure, the peak being detected at 35 years. Finally, SMRs from our cohort were compared to a previously described cohort including workers from the same plant compensated for asbestosis by INAIL.     

A mortality study among mild steel and stainless steel welders.

A mortality study was carried out in conjunction with the European mortality study among welders coordinated by the International Agency for Research on Cancer (IARC). The study was aimed at assessing risks for lung cancer in relation to exposure to asbestos, welding fumes containing chromium and nickel, and tobacco smoke. The study included a cohort of 2721 welders and an internal comparison group of 6683 manual workers employed in 13 factories in France. The mortality of the two cohorts was studied from 1975 to 1988 by the historical prospective method. Job histories of welders were traced including welding processes used, metals welded, and proportion of worktime spent in welding. Data on smoking habits were collected from medical records. The observed number of deaths were compared with those expected (standardised mortality ratio (SMR)) based on national rates with adjustments for age, sex, and calendar time. The smoking habits of 87% of the whole study population were known. The distribution of welders and controls according to smoking was not statistically different. The overall mortality was slightly higher for welders (SMR = 1.02, 95% confidence interval (95% CI) 0.89-1.18) than for controls (SMR = 0.91, 95% CI 0.84-0.99). For lung cancer, the SMR was 1.24 (95% CI 0.75-1.94) for welders, whereas the corresponding value was lower for controls (SMR = 0.94, 95% CI 0.68-1.26). The SMR for lung cancer was 1.59 among non-shipyard mild steel welders (95% CI 0.73-3.02). This contrasted with the results for all stainless steel welders (SMR = 0.92, 95% CI 0.19-2.69), and for stainless steel welders predominantly exposed to chromium VI (SMR = 1.03, 95% CI 0.12-3.71). Moreover, SMRs for lung cancer for mild steel welders tended to increase with duration of exposure and time since first exposure, leading to significant excesses for duration > or = 20 years and latency > or = 20 years. Such a pattern was not found for stainless steel welders.     

Cancer mortality and incidence of mesothelioma in a cohort of wives of asbestos workers in Casale Monferrato, Italy

BACKGROUND: Family members of asbestos workers are at increased risk of malignant mesothelioma (MM). Although the hazard is established, the magnitude of the risk is uncertain, and it is unclear whether risk is also increased for other cancers. Few cohort studies have been reported. OBJECTIVE: The "Eternit" factory of Casale Monferrato (Italy), active from 1907 to 1986, was among the most important Italian plants producing asbestos-cement (AC) goods. In this article we present updated results on mortality and MM incidence in the wives of workers at the factory. METHODS: We studied a cohort of 1,780 women, each married to an AC worker during his employment at the factory but not personally occupationally exposed to asbestos. Cohort membership was defined starting from the marital status of each worker, which was ascertained in 1988 from the Registrar's Office in the town where workers lived. At the end of follow-up (April 2003), 67% of women were alive, 32.3% dead, and 0.7% lost to follow-up. Duration of exposure was computed from the husband's period of employment. Latency was the interval from first exposure to the end of follow-up. RESULTS: The standardized mortality ratio (SMR) for pleural cancer [21 observed vs. 1.2 expected; SMR = 18.00; 95% confidence interval (CI), 11.14-27.52] was significantly increased. Mortality for lung cancer was not increased (12 observed vs. 10.3 expected; SMR = 1.17; 95% CI, 0.60-2.04). Eleven incident cases of pleural MM were observed (standardized incidence ratio = 25.19; 95% CI, 12.57-45.07). CONCLUSIONS: Household exposure, as experienced by these AC workers' wives, increases risk for pleural MM but not for lung cancer.     

Mortality study of workers employed in the construction of railway cars in Collefero

The mortality of 276 workers employed in a facility for the manufacturing and maintenance of railroad equipment has been studied in the town of Colleferro (province of Rome). The cohort was based on the 1968 payrolls, and follow-up was conducted up to 1988. Exposure to asbestos took place both during insulation (performed by specialized companies in the same workplaces where study subjects were operating) and during repair work. Mortality for all causes was lower than expected (45 observed, SMR: 71), while mortality from all neoplasms was consistent with expected figures (21 observed, SMR: 107). An increase for respiratory neoplasms was observed (10 observed, SMR: 138); the increase was statistically significant allowing for 20-30 years of latency (7 observed, SMR: 337).     

Mortality and cancer incidence in a Swedish art glassworks—an updated cohort study

Aim: To study mortality and cancer incidence, in a Swedish art glassworks producing both heavy and semi-crystal glassware, in an extended cohort of workers over a long time period during which some preventive actions had taken place.Methods: In the updated study, 1,229 men and women were eligible as cohort members during the period 1964–1997. The observed number of cases was compared with expected numbers, as calculated from cause-, age-, gender- and calendar year-specific national rates for mortality and cancer incidence.Results: Among men only, a significant risk was seen for cancer incidence in the colon and rectum [standardised incidence ratio (SIR) 1.92, 95% confidence interval (CI) 1.05–3.23; 14 cases] and increased, but statistically non-significant, risks were also seen for male cases of tumours in the liver/bile ducts and brain. Among women, statistically non-significant risks were seen for tumours in the liver/bile ducts and in the lymphatic and haematopoietic systems. No increased risk for cancer of the lung was found in this updated study. The risk for cancer in the colon/rectum was slightly increased in all work categories, and the increase was statistically significant among male and female unspecified glassworkers (SIR 3.13, 95% CI 1.35–6.16; five male and three female cases). A statistically significantly increased risk for cancer in the liver/bile ducts was seen among refinement workers (SIR 3.96, 95% CI 1.07–10.14; two male and two female cases).Conclusion: Most of the causes of death associated with an elevated standardised mortality ratio (SMR) in the 1985 cohort resulted in lower SMRs in this updated cohort, maybe as a consequence of preventive actions taken at the glassworks. On the other hand, the risk for cancers in the digestive system seems to remain, perhaps due to past asbestos exposure or inhalation/digestion of larger particles in the ambient air.