Academic journal article Environmental Health Perspectives

Cancer Mortality and Incidence of Mesothelioma in a Cohort of Wives of Asbestos Workers in Casale Monferrato, Italy

Academic journal article Environmental Health Perspectives

Cancer Mortality and Incidence of Mesothelioma in a Cohort of Wives of Asbestos Workers in Casale Monferrato, Italy

Article excerpt

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.

Key words: asbestos, domestic exposure, epidemiology, mesothelioma. Environ Health Perspect 115:1401-1405 (2007). doi:10.1289/ehp.10195 available via http://dx.doi.org/ [Online 17 July 2007]

Family members of asbestos workers are at increased risk of malignant mesothelioma (MM); although the evidence of association is sufficient [International Agency for Research on Cancer (IARC) 1987], the magnitude of the risk is uncertain. Moreover, the influence of potential determinants of household exposures, such as fiber type and specific activities involving the materials carried home by workers, is poorly understood. Furthermore, it is unclear whether the risk of other asbestos-related malignancies is increased. Evidence of pleural MM in relation to domestic exposure to asbestos has been presented in several case reports and case-control studies (Bourdes et al. 2000; Howel et al. 1997; Magnani et al. 2000, 2001). In contrast, only two cohort studies have been conducted: a cohort study on household contacts of amosite workers (Anderson 1982), and one that we carried out on mortality among the wives of asbestos-cement (AC) workers (Magnani et al. 1993). Our study showed a statistically significant excess in deaths from pleural malignancy, whereas results on lung cancer were not clear-cut because of the limited numbers.

In this article we present the updated results on cause-specific mortality and MM incidence in the cohort of wives of workers employed at the "Eternit" plant in Casale Monferrato (Piedmont, Italy), with > 40 years of follow-up. We also examine the effects of domestic exposure according to duration of exposure and latency.

Methods

This study was based on a cohort of the wives of AC workers employed at the "Eternit" plant in Casale Monferrato (Italy) on 1 January 1950 or hired between 1950 and 1986. The plant was one of the most important in Italy for the manufacture of AC products, such as high-pressure pipes, plain and corrugated sheets, and chimney tubes. Both chrysotile and crocidolite were used throughout the entire period of activity. Details of the cohort of AC workers and of the factory have been reported previously (Magnani et al. 1996). The factory did not provide laundry facilities, so work clothes were taken home for cleaning. …

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