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L Richiardi

Publications and source records attributed to L Richiardi.

10 recordsLinked to original sources

Occupational exposure to diesel exhausts and risk for lung cancer in a population-based case-control study in Italy.

BACKGROUND: We studied the effect of exposure to diesel exhausts on lung cancer risk in a population-based case-control study in the city of Turin, Italy. PATIENTS AND METHODS: Information on occupational histories of 595 incident lung cancer cases diagnosed in 1991-1992 and 845 population controls was obtained. During the interviews, diesel job-specific modules (D-JSMs) were administered whenever subjects had worked in occupations included in the following nine categories: railroad workers, miners, professional drivers and transport conductors, heavy-machine operators, mechanics and testers, filling station attendants, motor-vehicle park attendants, transport equipment operators, and occupations carried out in/near urban roads. All D-JSMs were evaluated for probability, intensity and frequency of exposure. RESULTS: The odds ratio for ever exposure to diesel exhausts was 1.04 (95% confidence interval 0.79-1.37), after adjusting for age, sex, smoking and having worked in occupations entailing exposure to known lung carcinogens. No association was found with intensity, probability and duration of exposure. CONCLUSIONS: Although misclassification of the exposure may have contributed to the negative results, we did not find an association between occupational exposure to diesel exhausts and lung cancer risk.

Case-Control Studies↗

Effect of different approaches to treatment of smoking as a potential confounder in a case-control study on occupational exposures.

AIM: To evaluate the effect of different approaches to treatment of smoking as a potential confounder in an occupational study of lung cancer. METHODS: Data were used from a case-control study on 956 men with lung cancer and 1253 population controls recruited in two northern Italian areas during 1990-1992. The risk of lung cancer associated with 11 selected job titles and eight selected industrial activities was estimated using seven different methods to treat smoking history. To evaluate the confounding effect of smoking, odds ratios obtained using the first six models were compared with estimates from the seventh and most complex model, in which cumulative tobacco consumption and time since cessation were considered. RESULTS: Although crude odds ratios for some of the occupational categories were biased by up to 25%, such bias decreased to less than 10% when a simple model including smoking status (never, ex-, current) was used. CONCLUSIONS: In occupational studies on lung cancer risk, information on smoking status may allow satisfactory control of the potential confounding effect of the habit.

Case-Control Studies↗

Risk of oral squamous cell carcinoma in 402 patients with oral lichen planus: a follow-up study in an Italian population.

The most important complication of oral lichen planus (OLP) is the development of oral squamous cell carcinoma (OSCC) but this is a very controversial matter. The aim of the study was to estimate in a Northern Italian cohort of OLP patients the risk for OSCC. Four hundred and two patients with histologically confirmed OLP diagnosed from January 1988 to July 1999, were followed-up to the end of February 2001. The standardized incidence ratio (SIR) of OSCC was calculated for the entire cohort and specific for gender, type of OLP, therapy for OLP and hepatitis C virus (HCV) infection. The relative risk (RR) of OSCC according to HCV infection was also estimated in the cohort. During the follow-up period, two men (1.3%) and seven women (2.9%) developed an OSCC. The SIR was 44.9 (95% CI: 20.5-85.2), being higher among women, but statistically significant in both genders. The RR of OSCC for patients with HCV as compared with those without HCV infection was 3.16 (0.8-12.5). Patients with OLP had a significantly increased risk of OSCC, irrespective of the clinical type of OLP and therapy. HCV infection apparently increased the risk for OSCC although this result could reflect the role of confounders, such as liver cirrhosis.

Aged↗

Perinatal determinants of germ-cell testicular cancer in relation to histological subtypes.

We aimed to investigate the role of perinatal determinants on the risk for germ-cell testicular cancer, with respect to the aetiological heterogeneity between seminomas and non-seminomas. A case-control study of 628 case patients with testicular cancer (308 seminomas and 320 non-seminomas) and 2309 individually matched controls was nested within a cohort of boys born from 1920 to 1980 in two Swedish regions (Uppsala-Orebro Health Care Region and Stockholm). Cases were diagnosed from 1958 to 1998 and were identified through the Swedish National Cancer Registry. Perinatal information on cases and controls was collected through charts available at maternity wards. Gestational duration, categorised in three categories (<37, 37-41, >41 weeks), was negatively associated with the risk for testicular cancer (P value for linear trend=0.008). A protective effect of long gestational duration and an increased risk for high birth weight were found for seminomas. Non-seminomas were associated with short gestational duration, particularly among those with low birth order (odds ratio: 3.02, 95% confidence intervals: 1.53-5.97) and high maternal age (odds ratio: 2.33, 95% confidence intervals: 1.19-4.55). No significant differences were found in tests for heterogeneity between the two histological groups. Our data support the hypothesis that intrauterine environment affects the risk for germ-cell testicular cancer. Seminomas and non-seminomas seemed to have similar risk patterns, although they are not entirely congruent.

Adult↗

Lung cancer and cigarette smoking in women: a multicenter case-control study in Europe.

The association between cigarette smoking and lung cancer risk in women was investigated within the framework of a case-control study in 9 centres from 6 European countries. Cases were 1,556 women up to 75 years of age with histologically confirmed primary lung cancer; 2, 450 controls with age distribution similar to cases were selected. The predominant cell type was adenocarcinoma (33.5%), with similar proportions for squamous-cell type (26.4%) and small-cell carcinoma (22.3%). Overall, smoking cigarettes at any time was associated with a 5-fold increase in lung cancer risk (odds ratio 5.21, 95% confidence interval 4.49-6.04); corresponding figures for current smoking habits were 8.94, 7.54-10.6. The association showed a dose-response relationship with duration of the habit and daily and cumulative lifetime smoking. A significant excess risk of 70% was associated with every 10 pack-years smoked. After 10 years of smoking cessation, the relative risk decreased to 20% compared to current smokers. The following characteristics were associated with a higher relative risk: inhalation of smoke, smoking non-filter cigarettes, smoking dark-type cigarettes and starting at young age. The association was observed for all major histological types, being the strongest for small-cell type carcinoma, followed by squamous-cell type and the lowest for adenocarcinoma. The proportion of lung-cancer cases in the population attributable to cigarette smoking ranged from 14% to 85%. We concluded that women share most features of the association between cigarette smoking and lung cancer observed in men.

Adult↗

[Proportion of lung tumors attributable to occupation].

This paper reviews estimates of the proportion of lung cancer attributable to occupational exposures and presents estimates for the City of Turin where a population-based case-control study on lung cancer has been conducted in 1991-1992 among the residents. An analysis of six hundred and five cases (505 males and 100 females) and 859 controls (684 males and 175 females) with histological/cytological confirmed diagnosis of lung cancer and occupational and smoking complete histories has been performed to estimate the proportion of lung cancers attributable to occupation in the city of Turin. The occupational exposure has been assessed with two different classifications: a) classification of a checklist of occupations as obtained from the study questionnaire according to industries and occupations known (List A) and suspected (List B) to be associated with lung cancer; b) translation of ISCO-ISIC codes for industries and occupations according to the same List A and List B. The population attributable risks are comparable when estimated with the two different classifications. In the city of Turin, at the beginning of the Nineties, about 10%-15% of lung cancers in males and 2%-5% in females could be attributed to occupational exposure.

Adult↗

[Database of occupations and industrial activities that involve the risk of pulmonary tumors].

Lists of occupations and industries associated with lung cancer are a useful tool to estimate attributable risks for occupational exposures. They were first published in 1982, based on IARC Monographs. List A included industries, processes and occupations definitely entailing carcinogenic risk, list B those probably/possibly carcinogenic. In 1995 the lists had been updated. We carried out a further update, reviewing IARC Monographs Volumes 62-75, focusing on Group 1, 2 A, and 2 B agents, and coded the lists according to widely used classifications: ISIC Rev. 2, ISIC Rev. 3, NACE Rev. 1, and ISTAT ATECO 1991 (for economic activities); ILO-ISCO 1968 and ISTAT-Classificazione delle professioni 1991 (for occupations). In order to evaluate temporal and geographical variations in attributable risk, exposure assessment must be performed consistently across different studies and standard tools to identify exposures, such as the one we propose here, are needed. The lists can also help to develop maps of industrial activities entailing carcinogenic risk at local, regional, and national level, and to identify economic activities that deserve priority action to control occupational exposures to carcinogens. The classifications were originally developed for economic and demographic purposes, and some exposure circumstances cannot be coded with sufficient specificity. This applies to productions or processes (i.e.: PVC production) that could be classified only by codes corresponding to wide groups of economic activities and/or occupations: in these instances we associated no code, so as not to inflate the estimates of exposed workers. As a consequence, however, certain exposures are not represented in the coded version of the lists. Even keeping in mind such limitations, coding makes the lists easier to apply, and increases the comparability of studies on lung cancer and occupation, as well as of surveys on exposure prevalence.

Databases as Topic↗

[Health effects of passive smoking].

Exposure to environmental tobacco smoke (ETS) is an established cause of lung cancer, ischaemic heart disease and chronic respiratory disease in adults and of asthma in children. A meta-analysis of 48 risk estimates from 39 published studies in non smokers gave a relative risk of 1.24 (95% Confidence Interval: 1.15-1.34), 1.14 (95% CI: 0.98-1.33) and 1.15 (95% CI: 0.92-1.43) for spousal, working environment and childhood ETS exposures. Misclassification of active smokers, exposure to ETS in reference groups, dietary confounding and publication bias have little effect on the association with spousal exposure. Estimates of the number of lung cancer deaths attributable to ETS from spousal exposure gave 1146 and 200 yearly deaths in the European Union (EU) and Italy respectively. Review of the available evidence confirms that exposure to ETS increases the risk for lung cancer and other diseases and is an important public health problem in the EU and Italy.

Adult↗