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Biomedical subjects

P Comba

Publications and source records attributed to P Comba.

At least 37 records · Page 2Linked to original sources
PubMed1997

Cohort mortality study of rubber and plastics product makers in Italy.

A retrospective cohort mortality study was carried out in 20 industrial factories in the Local Health Unit Bologna Sud (Emilia Romagna, Italy), where different rubber and plastics products were manufactured. The cohort consisted of 925 subjects (578 males and 347 females) employed for at least six months continuously; follow-up was between the beginning of operation of each factory, ranging between mid fifties and mid seventies, and 31 December 1989. For those exposed more than one year cause specific Standardized Mortality Ratios (SMRs) were computed using regional rates for comparison, 90% confidence intervals (CI) were calculated assuming the Poisson distribution. Among the 748 subjects employed for more than one year (457 males and 291 females) there were no lost to follow-up, 54 individuals were dead (41 males and 13 females) and for three subjects the cause of death was unknown. The results showed that all causes mortality was above expectancy in the total cohort (SMR = 123; 54 Obs; 90% CI = 97-154), among males (SMR = 117; 41 Obs; 90% CI = 89-152) and females (SMR = 143; 13 Obs; 90% CI = 85-228). Increased mortality for all malignant tumours was observed in the total cohort (SMR = 150; 25 Obs; 90% CI = 104-209) and for both genders. All nine lung cancer cases were observed among males, the SMR was equal to 218 and was statistically significant; seven cases occurred at duration of exposure less than 10 years and six at latency up to 20 years. The interpretation in terms of causality of the present investigation is limited by the small number of observations and by exposure definition solely in terms of employment in the study factories; nonetheless the results are indicating the existence, in this group of rubber and plastics product makers, of an adverse health effect which deserve further investigation.

Adult↗
PubMed1997

Mortality of plastic-ware workers exposed to radiofrequencies.

The mortality experience of a cohort of Italian plastic-ware workers exposed to radiofrequency (RF)-electromagnetic fields generated by dielectric heat sealers was investigated. Follow-up extended from 1962 to 1992. The standardised mortality ratio (SMR) analysis was restricted to 481 women workers, representing 78% of the total person-years at risk. Mortality from malignant neoplasms was slightly elevated, and increased risks of leukemia and accidents were detected. The all-cancer SMR was higher among women employed in the sealing department, where exposure to RF occurred, than in the whole cohort. This study raises interest in a possible association between exposure to RF radiation and cancer risk. However, the study power was very small, and the possible confounding effects of exposure to solvents and vinyl chloride monomer (VCM) could not be ruled out. The hypothesis of an increased risk of cancer after radiofrequency exposure should be further explored by means of analytical studies characterised by adequate power and more accurate exposure assessment.

Adolescent↗
PubMed1997

[The ethical problem of the health-environment relationship].

The need for a specific ethical evaluation in environmental health has been emphasized in recent years, with special reference to the conduction of research in environmental epidemiology, and to the subsequent implementation of public health action. Deontologic aspects that have been extensively debated include the duties of investigators towards study subjects, conflicts of interest, and rules to respect when dealing with institutions and with society at large. Epistemologic issues concern the explicitation of underlying values that influence choices in the stages of priority setting and study design. Finally, moral value is relevant whenever decision making takes place. In this frame it is recommended to refer to the core values of the public health movement, and to apply them to new, emerging problems.

Environmental Health↗
PubMed1996

Accuracy of death certification of pleural mesothelioma in Italy.

In order to provide estimates of the accuracy of death certification of malignant pleural mesothelioma in Italy, the causes of death of a series of ascertained cases were investigated. The study included 523 cases of pleural mesothelioma diagnosed in 1984-1988 by 88 hospital departments and clinics. Vital status at 7 May 1990 was ascertained for 92.7% of subjects. The overall concordance between pathological diagnosis and death certification was about 75%.

Adult↗
PubMed1996

Bladder cancer: a selected review of the epidemiological literature.

The present contribution reviews the epidemiological literature on the risk factors for bladder cancer in humans, pointing to the new leads from the available knowledge and to suggestions on prevention and research needs. Smoking accounts for about 50% of bladder cancer cases in western countries, occupational exposures are second in importance in bladder cancer development. Exposure to aromatic amines in dyestuff manufacture, in the rubber and textile industry, occupations entailing exposure to paints and solvents, leather dust, inks, some metals, PAH, combustion products and diesel exhausts have been identified as risk factors from epidemiological studies. Other investigations have detected increased risk for bladder cancer in association with dietary factors, specifically fats and cholesterol, and with contamination of drinking water by chlorination by-products.

Carcinogens↗
PubMed1995

Nasal cancer in leather workers: an occupational disease.

Nasal cancer has a number of causative agents; exposures to most of the established nasal carcinogens occur in the workplace. An increased risk of nasal cancer has been ascertained in shoe-making and shoe-repairing, but the results for leather goods manufacture and leather tanning don't provide adequate evidence of carcinogenicity. Findings from two epidemiological studies carried out in Italy (a case/control study and a case/series report) add further information on this issue. The case/control study was performed in the provinces of Siena (Tuscany), Verona and Vicenza (Venetia) including 96 cases and 378 controls. A significant increased risk (Odds Ratio: 6.8; 90% C.I. = 1.9-25) of sinonasal cancer was found for the employ in the whole leather industry; Odds Ratio of 8.3 (C.I. = 1.9-36) and 5.0 (C.I. = 0.92-28) were associated with shoe-making and leather tanning. The case/series report is based on 110 patients accepted in some Italian hospitals during last three years (1990-1993): 26 cases had worked in the leather industry; adenocarcinoma is the most frequent type observed. Chromium salts and natural tannins are indicated as possible aetiological agents.

Case-Control Studies↗
PubMed1994

Mortality study on a cohort of Italian licensed pesticide users.

This study describes the mortality experience in a cohort of 23,401 farmers, residing in southern Piedmont, Italy, and licensed to use pesticides. From 1970 to 1986 the cohort included 340,794 person-years and 2683 deaths were observed. A strong attenuation of the death risk was found due to the healthy worker effect (seen as an active role in the application for the license by the members of the cohort) and due to the limited comparability of the cohort with respect to the reference population. The standardized mortality ratios (SMRs) were remarkably < 100 for all causes (SMR = 59; 95% confidence interval = 57-61) and for all tumors (SMR = 60; 95% CI 55-64), but they increased with the increasing duration of the follow-up. A risk increase was observed with respect to melanomas and eye tumors in the entire cohort and lymphoma and tumors of the connective tissue in the subcohort of subjects living in villages with mainly arable land.

Adolescent↗
PubMed1994

Cohort mortality study of rock salt workers in Italy.

A cohort mortality study of rock salt workers was carried out in Volterra, Italy. The occupational risk factors identified during environmental hygiene surveys were high noise levels and exposure to dusts and to chrysotile asbestos. The cohort consists of 487 subjects (367 males and 120 females) employed in the mine between 1/1/1965 and 12/31/1989. At the end of follow-up, 387 individuals were alive (295 males and 92 females), and 100 were decreased (72 males and 28 females). For two decedents, the cause of death was unknown. Regional rates were used for the computation of standardized mortality ratios (SMRs). In the entire cohort, observed mortality for all causes was similar to expected (SMR = 98, 100 obs); SMR for all cancer was 127 (41 obs); for lung cancer, the SMR was 146 (10 obs). Two cases of pleural mesothelioma, both in males, resulted in a statistically significant elevation of this cause (SMR = 741, 90% confidence interval (CI) 131-2,332). Two malignant brain tumors were detected (SMR 328, 90% CI 58-1,032); one of these was identified as a secondary neoplasm with consideration of additional clinical information. Among males, mortality for all cancers was significantly increased (SMR = 140, 90% CI 106-192). The observed mortality for malignant tumors of the digestive and the respiratory systems was higher than expected. In women, two cases of malignant ovarian cancer were observed vs. 0.42 expected on the basis of the regional rates. Increased mortality from lung and pleural tumors was consistent with the exposure to asbestos, which has also been shown to play a role in the development of ovarian tumors. The main limitations of this study were the small number of subjects and the definition of exposure solely in terms of duration of employment. Further studies of rock salt workers are needed to elucidate our findings.

Adult↗
PubMed1994

[Integration of geographic and analytical approach in environmental epidemiology].

Some developments of research in environmental epidemiology are reviewed, with special emphasis on the limitations of currently adopted methods. At the light of causal criteria commonly used in the evaluation of epidemiologic studies, an approach based on the integration of geographic and analytic studies is suggested, in order to obtain results relevant in terms of public health.

Environmental Health↗
PubMed1992

Environmental household exposures to asbestos and occurrence of pleural mesothelioma.

We reviewed the certificates of 39,650 deaths which occurred in the period 1975-1988 in Leghorn and of 45,900 in La Spezia (Italy) in the period 1958-1988. In total 262 cases have been recorded as pleural mesothelioma. The main occupational exposures occurred in the shipbuilding industry. Regarding non-occupational exposures to asbestos, 13 cases of mesothelioma were found in women who had washed the work clothes of their relatives at home; we also found other domestic uses of asbestos which were rarely or never discussed previously in the literature: six cases might be explained by the installation of fireproof or non-conductive materials in the domestic environment. These exposures probably are more frequent than realized until now.

Asbestos↗
PubMed1992

A mortality cohort study of seamen in Italy.

A total of 2,208 male subjects, enrolled as merchant marine seamen at the Civitavecchia (Italy) harbor from 1936 to 1975 were followed up through 1989 in order to evaluate their mortality experience. Available information about the number of sailings made it possible to divide subjects into two subgroups: 948 workers with at least one sailing (cohort A) and 1,260 with no reported sailing (cohort B). Fewer than expected overall deaths were observed in both cohorts (cohort A: SMR = 0.83; cohort B: SMR = 0.81), mainly due to a lower mortality from circulatory, respiratory, and digestive diseases. Lung cancer deaths were significantly increased in cohort A (O = 30, SMR = 1.71, 95% CI = 1.15-2.44), whereas no excess was observed in cohort B (O = 6, SMR = 0.57, 95% CI = 0.21-1.26). Among subjects employed aboard ship, a trend in SMRs for lung cancer increasing with duration of employment was observed. Furthermore, three neoplasms of other parts of the respiratory system (including one mesothelioma) were detected in cohort A (SMR = 5.87), and one in cohort B. The study substantiates an increased risk of respiratory cancer among subjects with an occupational history of sailing; past exposure to asbestos and to other environmental carcinogens aboard could be implicated.

Adolescent↗
PubMed1992

A case-control study of cancer of the nose and paranasal sinuses and occupational exposures.

The association between nasal cancer and various occupations was investigated in a case-control study in the provinces of Verona and Vicenza (northeastern Italy) and Siena (central Italy). Cases of malignant epithelial neoplasm of the nasal cavities and paranasal sinuses diagnosed in the years 1982-1987 in the hospitals of Verona, Legnago, Bussolengo, Vicenza, and Siena comprised the study. Controls were patients admitted to the same hospitals as the cases, with any diagnosis except chronic rhino-sinusal disease and nasal bleeding. Age, gender, residency, and date of admission were taken into account by matching. Cases and controls, or their next of kin, were interviewed or required to fill in a mailed questionnaire; the overall response rate was 70%. Altogether, 78 cases and 254 controls provided information on occupational history. Significantly increased risks were associated (in males) with work in the wood industry (odds ratio [O.R.]: 5.8; 90% confidence interval [C.I.]: (2.2-16) and in the leather industry (6.8; 1.9-25). Textile workers, furnacemen, construction workers, and workers with possible exposure to organic dusts showed increased risks even if statistical significance was not reached.

Adenocarcinoma↗
PubMed1992

Cancer of the nose and paranasal sinuses in the metal industry: a case-control study.

The association between nasal cancer and work in the metal industry was investigated in a case-control study located in the province of Brescia, north eastern Italy. Thirty five cases of malignant epithelial neoplasms of the nasal cavity and paranasal sinuses who were resident in the province of Brescia and diagnosed or treated by the ear, nose, and throat department and the radiotherapy unit (Centro Alte Energie) of the Brescia Hospital in the years 1980-9 were included in the study. Controls (102) were patients affected by benign and malignant neoplasms of the head and neck who were resident in the Brescia Province and matched the cases by age and sex. All the subjects were interviewed by telephone. Metal workers showed an increased risk of nasal cancer (odds ratio (OR) 3.1; 90% confidence interval (90% CI) 0.48-20); a higher risk was associated with work in foundries (OR 5.9; 90 CI 0.77-46). Work in wood, leather, and textile industries was also associated with increased risk of nasal cancer.

Aged↗
PubMed1992

Mortality study of workers employed by the Italian National Institute of Health, 1960-1989.

A cohort mortality study was conducted to evaluate the cancer risk of workers employed by the National Institute of Health in Rome, Italy. Cancer mortality was evaluated for research staff. A deficit of overall cancer mortality was found for the men, but not for the women. Elevated (albeit statistically nonsignificant) standardized mortality ratios were found for cancer of the pancreas (men 155, women 236), cancer of the brain (men 159), lympho- and reticulosarcomas (men 233, women 512), and lymphatic and hematopoietic tumors (women 623). In addition the women had a statistically significantly elevated risk of breast cancer (288). Although most of these results, with the exception of breast cancer among the women, were not statistically significant, due to the limited study size, they point to the existence of excess risks for some tumors. The possibility that these increases are related to exposures occurring in the laboratory setting deserves further consideration.

Adult↗
PubMed1992

[Territorial distribution of mortality from malignant tumors of the pleura in Italy].

Mortality from malignant pleural neoplasms in Italy, 1980-87, was studied in order to detect areas at risk. The number of observed deaths occurring in each of the 8000 Italian municipalities was contrasted to the expected figure obtained from regional and/or national rates; whenever a significant increase, based on at least three observed cases, was detected, the municipality was included in the study. The main findings in Piedmont concern the city of Casale Monferrato, where an important asbestos cement factory is located, and some areas characterized by the presence of the textile industry. Genoa and other harbours of the northwestern coast, where important shipyards are located, were detected. In Lombardy an increased in risk concerning women was observed in several municipalities. Major increases in risk were seen in Venice. Trieste and Monfalcone, where important shipyards are located. In Tuscany, the highest risk was reported in Leghorn and surrounding areas; naval industry and chemical industries should be considered. In southern Italy, several cities with industrial harbours were shown to be at risk.

Cause of Death↗
PubMed1992

[Etiological epidemiology of tumors of the nasal cavities and the paranasal sinuses].

Etiologically-oriented epidemiologic studies on cancer of the nasal cavities and paranasal sinuses have been carried out since the beginning of the century. These studies showed that several chemical agents (chromates, nickel compounds, isopropylic alcohol, and mustard gas), and two occupational exposures (wood dust in the furniture industry and exposure to leather in shoe factories) were causally associated with nasal cancer. An increased risk has also been associated with several occupations (i.e. metalworker, textile worker, construction worker, and farmer) even in the apparent absence of causal agents. The first reports of an increased risk of nasal cancer in woodworkers and leather workers in Italy date back to 1980. Subsequent studies have provided estimates of the relative risk, ranging from 3.0 to 11.0 among woodworkers and from 8.1 to 47.1 among leatherworkers. Increased risks have been associated to the metal industry (relative risk ranging from 3.1 to 5.9), the textile industry (ranging from 2.9 to 17.0), the mining and construction industry (ranging from 2.3 to 5.3), and the agricultural industry (ranging from 1.9 to 3.3); all of these estimates are time- and place-specific. Moreover, the estimates are not reliable because of the small sample size, resulting from the low occurrence of the disease. The etiologic fraction for the population, taking into account both verified and suspected carcinogenic exposures, ranges between 50% and 65% in males. Relatively few cases of nasal cancer (all of them occurring in woodworkers) have been notified for workman's compensation; woodworkers with nasal cancer have received monetary compensation in Italy since 1988. Nasal cancer is an often fatal but largely preventable disease. Several verified and suspected occupational exposures are associated with this neoplasm. The reduction of dust and fumes in the air of the above mentioned work environments is recommended for reducing the occurrence of this disease.

Air Pollution↗
PubMed1991

A collaborative study of cancer incidence and mortality among vinyl chloride workers.

A large European multicentric cohort study has been coordinated by the International Agency for Research on Cancer with the objectives of investigating the dose-response relationship between liver cancer and exposure to vinyl chloride and assessing cancer risk for sites other than the liver. A nearly threefold increase in liver cancer was detected on the basis of 24 observed deaths and 8.4 expected (standardized mortality ratio 286, 95% confidence interval 186-425). The excess from liver cancer was clearly related to time since first exposure, duration of employment, and estimated ranked and quantitative exposures. Other cancer sites investigated on the basis of a priori hypotheses were either not in excess (lung) or apparently unrelated to the exposure variables (brain and lymphoma).

Adult↗