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P Comba

Publications and source records attributed to P Comba.

At least 73 records · Page 4Linked to original sources
PubMedDate not supplied

Cancer risk associated with residential proximity to industrial sites: a review.

In this study, the authors sought to review available epidemiologic studies of cancer risk and its association with residence in a neighborhood characterized by industrial sites and to discuss options for future study design. The authors attempted to identify all case-control studies published from January 1980 through July 1997 in which investigators examined exposure resulting from residential proximity to an industrial site neighborhood relative to an increased risk of lung, urinary tract, and lymphohematopoietic malignancies. During these years, some authors reported significant associations between lung cancer risk and residential proximity to (a) smelters, (b) complex industrial areas, and (c) other localized emission sources. There was some evidence that leukemia and lymphomas occurred in the neighborhoods that contained industrial sites.

Bias↗
PubMedDate not supplied

A case-control study of carcinomas of the nose and paranasal sinuses in the woolen textile manufacturing industry.

A population-based case-control study was conducted in Biella, which is located in northwestern Italy, to investigate the reported association between sinonasal carcinomas and woolen fabrics production. The study included 33 cases diagnosed during 1976-1988 (14 adenocarcinomas, 11 epidermoid carcinomas, 3 other specified carcinomas, 1 unspecified carcinoma, and 4 cases without histologic confirmation) and 131 controls. No association was found with smoking. As reported previously, excess risks were observed in wood and furniture workers (odds ratio [OR] = 4.4, 95% confidence interval [95% CI] = 1.41-13.4) and in the leather industry (OR = 3.5, 95% CI = 0.6-20.3). Odds ratios in the wood and furniture industry were 22.0 (95% CI = 4.4-124.0) for adenocarcinomas and 0.9 (95% CI = 0.4-8.3) for epidermoid carcinomas. No association was found with the woolen textile or garment industries (OR = 0.8, 95% CI = 0.2-2.8), nor with farming, construction, metal works, and transport. Odds ratios for the textile industry did not vary with length of exposure or histologic type. Power for detecting an odds ratio of 3.0 at the 95% level of significance was 40%.

Aged↗
PubMedDate not supplied

Malignant mesothelioma in Rome, Italy 1980-1995. A retrospective study of 79 patients.

AIM AND BACKGROUND: To evaluate the characteristics of a case-series of 79 malignant mesothelioma patients collected from the main teaching hospital of Rome, Italy, and other local clinics of Latium Region and to assess the role of asbestos exposure, since previous studies on the occurrence of the disease in this area were lacking. METHODS: The study included cytohistologically diagnosed malignant mesothelioma (71 pleural, 7 peritoneal, and 1 testicular tunica vaginalis) detected or referred for consultation during the period 1980-1995. Information regarding occupational and/or nonoccupational exposures was derived from clinical records and interviews, when available. RESULTS: Patients were resident in Rome and other towns of Latium; a few were from other parts of central and southern Italy. Exposure to asbestos was assessed for 45.5% of patients, another 45.5% had unknown exposure, and for the remaining 9% such information was lacking. Occupational exposure occurred in 53% of men for whom information was available and nonoccupational exposure occurred in 20% of women. The study identified two clusters of cases from an asbestos-cement plant and a facility where asbestos was ubiquitous. Furthermore, most exposed subjects reported occupations in the construction industry, which is particularly active in the Latium Region; others were railroad workers, naval mechanics and navy personnel, bakers, explosive workers and car mechanics. A few patients reported indoor exposure to asbestos at home and/or in the workplace. CONCLUSIONS: The study confirmed that mesothelioma risk is present in several job titles of the construction industry, and it is no longer confined to workers employed in the manufacture or application of asbestos products. The occurrence of malignant mesothelioma in patients with unexpected occupational and nonoccupational exposures indicates the need for further investigation on previously underestimated exposures.

Adult↗
PubMedDate not supplied

[An epidemiological study of workers exposed to vinyl chloride in the plants of Ferrara, Rosignano and Ravenna].

The aim of the present study is to investigate cause-specific mortality among male workers employed in vinyl chloride manufacture and polymerization in three Italian plants located in Ferrara, Rosignano and Ravenna. The cohorts include all workers hired between start of operation and, respectively 1985, 1978 and 1985, amounting to 418, 206 and 635 subjects followed up for mortality until 1996 (Ferrara and Rosignano) and 1997 (Ravenna). Cause specific SMRs (Standardized mortality ratios) were computed. Expected figures were obtained from mortality rates for the population resident in the region where the plant was located, for each SMR value a 90% confidence interval (CI) was calculated on the assumption of a Poisson distribution. The study detected an increased mortality for primary liver cancer in all three plants; SMR values were 444 in Ferrara (4 Obs. 90% CI 160-1069), 200 in Rosignano (1 Obs. 90% CI 10-869) and 375 in Ravenna (3 Obs. 90% CI 110-1038). In the pooled cohort liver cancer SMR was equal to 364 (8 Obs. 90% CI 108-390). In one plant, Ferrara, observed mortality was above the expected for lung cancer, SMR = 146 (14 Obs. 90% CI 89-229) and for larynx cancer, SMR = 500 (4 Obs. 90% CI 174-1167). One death from pleural cancer was observed in Rosignano (SMR = 1000 90% CI 47-4331). A non significant increase was detected for liver cirrhosis, in Ferrara (SMR 108, 6 Obs. 90% CI 73-332) and Rosignano (SMR 129, 3 Obs. 90% CI 35-332). The study results are confirming the carcinogenic action of vinyl chloride on the liver, they are pointing to its possible role in lung cancer development, as already shown for workers employed in Porto Marghera; an increased risk for larynx cancer is also shown.

Adult↗
PubMedDate not supplied

[Causality in epidemiology: populations, individuals, and alternative explanations].

The purpose of the present paper is to review issues concerning causal reasoning in epidemiology, with special emphasis on the relationship between observation at the individual and population level. The sequence of the three sections of the paper, causality in epidemiology, individual and population, alternative explanations, reflects the need to deal with issues of research methodology mainly derived from discussions in the frame of risk assessment, decision making, regulation and legal setting. In discussing the aforementioned topics, special attention is given to the attribution of causality to a single exposure in the presence of a plurality of potential causes. As a case study, data concerning the occurrence of hepatic and pulmonary tumors among subjects exposed to vinyl chloride are considered making reference to hearings on this topic which took place in Court.

Causality↗
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[Setting priorities for environmental protection from asbestos: ethical aspects].

The allocation of resources destined for environmental rehabilitation of areas contaminated by asbestos requires scientific, political, economical and ethical evaluation. Ethically relevant issues reviewed in this paper include: identification of the populations most expected to benefit from the intervention, risk assessment, effectiveness of different technical approaches, as well as a comparison between populations of current socio-economic standards, level of legal assistance and access to both information and participation in the decision making process. A relevant ethical criterion is minimizing inequalities within and between communities.

Asbestosis↗
PubMedDate not supplied

[A cluster of doubts].

Explore the source record for details and available documents.

Anemia, Aplastic↗
PubMedDate not supplied

[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.

Humans↗
PubMedDate not supplied

[Malignant mesothelioma in the industrial area of Colleferro].

The study describes the occurrence of pleural and peritoneal malignant mesothelioma in the Colleferro industrial area (Province of Rome, 9 municipalities, population 63,000, period 1993-98) which is the site of a large chemical plant (BPD) producing organic chemicals, acid mixtures, insecticides, explosives and dynamite, and was involved in manufacturing/maintenance of railroad rolling stock. Asbestos was extensively used in these plants in the past. Mesothelioma cases were actively searched from data in files of pathology archives, hospital admission and discharge (records), and death certificates recorded at local health authority register. 23 potential cases were identified for whom clinical charts and pathological slides were reviewed. A multidisciplinary evaluation of all collected information confirmed 18 cases of cyto-histologically proven malignant mesothelioma (pleural/peritoneal ratio of 2.75:1) among residents and/or workers at BPD. The remaining 5 cases were defined as not mesothelioma; however, two were cases of lung cancer (both occupationally exposed to asbestos). All subjects with malignant mesothelioma had been occupationally exposed to asbestos (14 males and 3 females), except one (1 female with domestic exposure). No mesothelioma case was attributable to environmental exposure. Of the 17 cases with occupational asbestos exposure, 15 occurred in BPD workers employed in manufacturing/maintenance of railroad rolling stock (3 cases), general maintenance services (5 cases), or in the armaments sector (7 cases) and 2 in residents but not BPD workers (1 baker, 1 pipefitter). The incidence rate in residents of the 9 municipalities was 5.5 in males and 1.3 in females (standardized on the Italian population x100,000, census 1981). For Colleferro municipality only, the incidence was 10.1 in males and 4.1 in females, which are the highest rates reported so far in Italy. Besides confirming the risk of mesothelioma risk in railroad rolling stock manufacturing and asbestos-insulated pipe maintenance workers, this study identifies a cluster of malignant mesothelioma in explosives production workers.

Aged↗
PubMedDate not supplied

[Communicating with health authorities and the public about asbestos risk in Biancavilla (CT)].

The high incidence of pleural mesothelioma observed in Biancavilla (Catania) is causally associated to the presence of amphybolic fibres in the volcanic rock used by the local construction industry. This paper examines risk communication in this setting, with respect to presentation of the epidemiologic findings and decision making in the field of environmental clean up. The central issues in communicating with health authorities have been evaluation of the causal link and connections between available knowledge and subsequent action. The public has been rapidly informed, through press and local broadcasting stations. It has been made clear that recommended interventions were of preventive nature, namely paving with asphalt roads that were previously paved with the local quarry's byproducts. It has been stated that expected benefits would be delayed in time. Compliance of the local community may be jeopardized by further delay in the implementation of this intervention.

Asbestosis↗
PubMedDate not supplied

[The epidemiologist in the court: requirements, professional standards, and deontologic considerations].

This paper examines two issues associated with the activity of epidemiologists who act as expert witness in courts: professional standards and deontologic codes. These issues are to be viewed in the light of the various roles the epidemiologist is called to play in court, as consultant for the prosecutor, the defendant and the plaintiffs. The criteria adopted in court should not differ from the ones usually followed in good epidemiologic practice. Potential conflict of interest that may occur when the personal interest of a researcher leads to introduce bias in his/her/witnes is another relevant issue. Another relevant point is how an epidemiologist deals with his/her colleagues in the courts: diversity in opinions and rigorous critics are acceptable but they must be adequately documented.

Epidemiology↗
PubMedDate not supplied

[Cohort study of mortality among leather tanners in the Lower Valdarno area].

BACKGROUND: Epidemiological studies of tanners have shown increased risk for a number of cancer sites, namely: lung, bladder, kidney and urinary organs as well as stomach, intestine, pancreas, nose and nasal cavities, together with leukemias and soft tissue sarcomas. OBJECTIVE: To study cause specific mortality of leather tanners in Tuscany (Valdarno Inferiore area). METHODS: The cohort included 4874 workers (4150 males and 724 females) employed in 92 tanneries operating in 1996 (Valdarno Inferiore Tanneries Census) which were also operating on 31-12-1970. Ascertainment of vital status was completed for all individuals on 31-12-1998 (end of follow-up), and the cause of death was known for all deceased subjects. Demographic and work history data were obtained from factory payrolls. Regional mortality rates were used for comparison to calculate SMR (Standardised Mortality Ratio) and 90% Confidence Intervals (CI). In addition to the overall cohort analysis, for men only separate analyses were completed for finishers, chrome tanners and vegetable tanners. RESULTS: The study showed an increased mortality from lung cancer among finishers, Standardised Mortality Ratio (SMR) 145, 19 observed (obs) (90% Confidence Intervals, 90% CI 95-212), from bladder cancer in the overall cohort (SMR 134, 9 obs, 90% CI 70-233) and among finishers (SMR 125, 2 obs, 90% CI 22-393) and from pancreatic cancer among finishers (SMR 120, 2 obs, 90% CI 21-379). Mortality from lymphoemopoietic cancer is above expected, and the increase is mainly due to myeloid leukaemia, both in males (SMR 208, 5 obs, 90% CI 82-437) and females (SMR 599, 2 obs, 90% CI 106-1887). No deaths from soft tissue sarcoma were observed. A new finding of the study was the increased mortality from cancer of the endocrine glands (SMR 566, 4 obs, 90% CI 194-1297), psychiatric disorders (SMR 195, 6 obs, 90% CI 85-385) and blood diseases (SMR 329, 4 obs, IC 90% 112-752). CONCLUSIONS: The observations of increased lung cancer mortality among finishers, of bladder cancer in the overall cohort and among finishers, as well as an increase in pancreatic cancer among the latter, confirm previous epidemiological findings among tanners. The increase in myeloid leukemia mortality for both males and females, and the absence of deaths from cancer of the connective tissue, which includes soft tissue sarcomas, are worthy of note. The results should be valued with caution, given the small number of cases and the novelty of some observations.

Adult↗
PubMedDate not supplied

[Indications of public health in areas naturally polluted with asbestiform fibers].

Adverse health effects of naturally occurring asbestiform fibres have been reported since the Seventies in various countries. The present paper describes the case of Biancavilla, a municipality located in Eastern Sicily, where the occurrence of the amphibolic fibre fluoro-edenite has been associated to a cluster of pleural mesotheliomas. The public health recommendations aimed at reducing exposure to fluoroedenite are described. This case study shows the importance of public-driven remedial action, including interruption of activities of previously operating quarries and asphalt paving of roads, in influencing population's compliance to recommendations aimed at modifying individual behaviours. In order to pursue the goal of fostering community's autonomy in decision making, the optimal approach is ensuring timely and transparent information dissemination.

Asbestos, Amphibole↗
PubMedDate not supplied

Mesothelioma associated with environmental exposures.

BACKGROUND: The main sources of environmental, non-occupational exposure to asbestos or asbestiform fibres are: a) industrial plants in which asbestos was used in the production process; b) asbestos "in place" (mainly in buildings); c) contaminated soils. The association of these exposures with increasing risk of mesothelioma has been documented since 1960 in many places. OBJECTIVES AND METHODS: The present paper is aimed at describing the main results of studies performed in the locations with soils naturally contaminated with asbestos or asbestiform fibres. Environmental exposure data and asbestos-related health outcomes, mainly mesothelioma, are analyzed through a review of the literature. RESULTS: The sites with asbestos or other mesotheliomatogenous fibres in soils are characterized by low concentration levels of airborne fibres. Furthermore, exposure levels may increase when specific activities are carried out (mainly related to building construction), involving mechanical disturbance of fibre-containing materials. The type of fibres found are mainly amphiboles (tremolite). The population at risk of exposure is the general population, which can be exposed from birth. In these sites, the sex ratio of mesothelioma cases is close to 1.0 and the average age of cases ranges from 50 to 60 years. CONCLUSIONS: Both "natural"and industrial environmental asbestos or asbestiform fibre exposures increase potential risk for mesothelioma. Strategies of environmental reclamation and risk communication should be implemented in these areas.

Asbestos↗