Mortality from lung cancer and other diseases related to smoking among fishermen in north east Italy.

OBJECTIVES--To study the mortality of fishermen. This was suggested by a cluster of cases of lung cancer in Chioggia, a large fishing harbour in the Veneto. The aim was to weight occupation against smoking with respect to risk of lung cancer. METHODS--7530 fishermen registered in the 1971-86 port authority registers of Chioggia and Venice were followed up for mortality from 1971 to 1989. Of 475 causes of death, 460 were traced. Standardised mortality ratio (SMR) was calculated with the regional population as a reference. A nested case-control study was carried out in Chioggia decedents only by interviewing next of kin. Complete data were obtained in 172 (70% response). Cases (lung cancer deaths) and controls (other causes of death) were compared for smoking and occupation, as a group of non-fishermen was available in the cohort. Logistic regression analysis was used to adjust for confounding factors. RESULTS--SMRs were high for lung cancer but low for other diseases related to smoking: circulatory and respiratory disease, tumours of the mouth, pharynx, oesophagus, and bladder. Likewise, SMRs were high for liver cancer but low for other diseases related to alcohol: digestive and circulatory disease, buccal, pharyngeal, and oesophageal tumours. In the case-control study, the risk of lung cancer was found to be related to smoking, and there was no interaction between occupation and smoking. When adjusted for age and smoking, the occupational indicators had no influence on the risk of mortality from lung cancer. CONCLUSIONS--Among fishermen in north east Italy the greatest health hazard is lung cancer, and the factor involved in this risk is smoking, not occupation. Smoking, however, was linked with long hours at sea in another study.