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Pietro Comba

Publications and source records attributed to Pietro Comba.

34 records · Page 2Linked to original sources
PubMedDate not supplied

[Mortality from malignant pleural neoplasms in Broni (Pavia), 1980-1997].

Mortality for malignant pleural neoplasms (1980-97) was studied in Broni (Pavia) and in the surrounding area in order to update previous studies indicating a high incidence of pleural mesothelioma, due to the presence of an asbestos-cement factory. Observed mortality for pleural neoplasms was compared to expected figures derived from mortality rates of the population resident in Province of Pavia. A significant increase was found in Broni (SMR 825, CI 95%: 604-1, 100, 46 observed). An increased risk of death from malignant pleural neoplasms was evident in both genders, especially in the most recent years, and in younger age groups; this increase in pleural neoplasm mortality also involves some neighbouring municipalities.

Adolescent↗
PubMedDate not supplied

[Epidemiologic study of workers exposed to vinyl chloride in Porto Marghera: mortality update].

The investigation describes mortality of vinyl chloride exposed workers in the Montedison-Enichem plant located in Porto Marghera, near Venice, Italy. A total of 1658 workers employed from start of production (1950), present in 1956 or successively hired until 1985, were followed up between 01.01.1973 and 31.07.1999, for a total of 41.037 person years at risk: 248 deaths were observed. Mortality from all causes compared with regional population was lower than expected, (SMR 0.75; 90% CI 0.68-0.83) and from all malignant neoplasms similar to expected (SMR 0.94; 90% CI 0.81-1.09). SMR for primary liver cancer was significantly increased (SMR 2.78 90% CI 1.86-4.14). In the first year since leaving employment observed mortality was significantly above the null value for all causes (SMR 2.76; 90% CI 1.94-3.91), all malignant neoplasms (SMR 1.89; 90% CI 0.97-3.92) and cardiovascular diseases (SMR 2.37; 90% CI 1.13-4.95). Mortality rates for liver angiosarcoma (6 cases) increased with latency (trend test x 2 (1df) = 25.20 p < 0.001) and cumulative exposure (trend test x 2 (1df) = 61.00 p < 0.001), there were no cases with duration of employment less than 12 years, latency less than 10 years and for cumulative exposure less than 2.379 ppm-years. Mortality rates for hepatocellular carcinoma (12 cases) and liver cirrhosis (20 cases) showed a similar pattern for cumulative exposure. Observed mortality from lung cancer was higher than expected among those workers whose only job title was bagger. In the analysis accounting for latency, age and calendar period the RR for only bagger was 2.31 (90% CI 1.15-4.61). Mortality pattern for all causes, all malignancies and cardiovascular disease increased by time since employment, as expected in presence of a particularly strong Healthy Worker Effect (HWE). These results and the increased SMR values during the first year since leaving employment indicate that workers were selected into employment on the basis of good health conditions and early selective removal of weaker ones followed. The study results confirm the causal relationship between VCM exposure and liver angiosarcoma, and add supplementary evidence in favour of a causal explanation of the excess risk for hepatocellular carcinoma and liver cirrhosis as well as lung cancer among only baggers.

Cause of Death↗
PubMedDate not supplied

[The precautionary principle: scientific evidence and decision processes].

We analyse conceptual and procedural approaches to the precautionary principle. Moreover, we describe the implications of its use in evaluation of scientific evidence and in decision making. In many cases evaluation of possible risks is influenced by individuals or groups with personal interests different from those of public health. Their actions discredit positive studies, giving rise to forced controversies and discouraging new studies. The result is to hinder checking of causal patterns. We report examples of historical cases and of issues rising from electromagnetic fields. The use of the precautionary principle is desirable both in issues related to global change and in possible risks associated with specific biological, chemical and physical agents. The precautionary principle should be included between values of public health evaluations and its use requires institutional subjects to take high responsibility for it. Both time and quality of analysis of causal patterns are linked to the sincere desire to solve doubts and defend public health interests for those who are active in public health.

Electromagnetic Fields↗
PubMedDate not supplied

[Malignant pleural mesothelioma in housewives in the province of Catania].

Our study reports pleural malignant mesothelioma (PMM) in seven female patients. All patients were resident in Catania area (Sicily), the median age was 69.2 years and ranged from 59 to 81 years. They were housewife. Their anamnesis was negative for both direct and indirect previous exposure to asbestos; the partners of all patients were also not exposed to asbestos. The exposure to X-rays was also excluded for these patients. Different pathogenetic mechanisms for the appearance of PMM in these patients can be hypothesized, for example, SV40 infection and genetic susceptibility; a minimal domestic exposure to asbestos can be not excluded. Therefore, further studies in a more large number of subjects are necessary to determine whether one or all of these hypothetic pathogenetic mechanisms are more significant for the develop of PMM.

Aged↗
PubMedDate not supplied

[Geographical distribution of mortality from malignant pleural neoplasms and of former asbestos-exposed workers in the Campania Region].

AIM: The purpose of the present paper is to describe the geographical distribution at municipality level of mortality from malignant pleural neoplasms in the Campania Region, along with the distribution of former asbestos-exposed workers. A GIS (Geographical Information System) application has been developed to integrate exposure and mortality data. STUDY DESIGN: The number of asbestos workers by municipality has been estimated by merging data provided by the National Institute for Insurance against Occupational Accidents (INAIL), the Ministry of Labour and an association of formerly exposed workers (AUSER Flegrea). The number of deaths from malignant pleural neoplasms by municipality has been derived from published studies regarding two consecutive periods: 1988-1994 and 1995-1997. RESULTS: In the first period most deaths occurred in areas with a high number of formerly exposed asbestos workers, whilst in the second period mesothelioma mortality increased extending to other areas without registered exposed workers. CONCLUSION: This finding may be attributable to the presence of atypical occupational exposures, not reported by the current information systems, or to environmental, non occupational exposure patterns.

Asbestos↗
PubMedDate not supplied

[Mortality study of asbestos cement workers in Emilia-Romagna].

OBJECTIVE: The present study updates to 06/30/1998 the cohort mortality study of 3358 workers employed in 10 asbestos cement production plants in the Italian region Emilia-Romagna. PARTICIPANTS: The cohort includes 2712 males and 646 females. RESULTS: Overall mortality was significantly increased (SMR=131, IC95%:108-127). Excess mortality has been observed for all malignant neoplasms (SMR=131, IC95%: 115-149, 250 observed) and for respiratory diseases (SMR=153, IC: 105-216, 32 observed), 3 deaths due to asbestosis. Mortality for all respiratory tract neoplasms (SMR=179, IC: 148-215, 114 observed), pulmonary cancer (SMR=157, IC: 126-192, 90 observed) and pleural cancer (SMR=1922, IC: 1139-3038, 18 observed) are significantly increased. DISCUSSION: This study confirms the previous cohort study observation of increased mortality for all causes, all neoplasm and cancer affecting lungs and pleura.

Asbestos↗
PubMedDate not supplied

[Soft tissue sarcomas in Mantua: epidemiological evidence and perspectives for environmental remediation].

Subsequently to the report by a general practitioner of an apparent cluster of soft tissue sarcomas (STS) in thepopulation resident in the neighbourhood of Mantua chemical industries, two independent epidemiological studies (an incidence study and a case-control study) confirmed the original observation and extended the findings in a wider time-span. The two studies are reviewed in the present paper in order to analyze concordant and diverging findings. In the light of the available evidence, recommendations for further studies are presented and perspectives of environmental remediation are discussed.

Benzofurans↗
PubMedDate not supplied

[Cause-specific mortality in an area of Campania with numerous waste disposal sites].

OBJECTIVE: To investigate cause-specific mortality in an area of Campania region, in the surroundings of Naples, characterized by many toxic waste dumping grounds sites and by widespread burning of urban wastes. DESIGN: The study area was characterized by examining the spatial distribution of waste disposal sites and toxic waste dumping grounds, using a geographic information system (GIS). Mortality (1986-2000) was studied in the three municipalities of Giugliano in Campania, Qualiano and Villaricca, encompassing a population of about 150,000 inhabitants. Mortality rates of the population resident in the Campania region were used in order to generate expected figures. OUTCOMES: Causes of death of a priori interest where those previously associated to residence in the neighbourhood of (toxic) waste sites, including lung cancer, bladder cancer, leukemia and liver cancer. RESULTS: Overall 39 waste sites, 27 of which characterized by the likely presence of toxic wastes, were identified in the area of interest. A good agreement was found between two independent surveys of the Regional Environmental Protection Agency and of the environmentalist association Legambiente. Cancer mortality was significantly increased, with special reference to malignant neoplasm of lung, pleura, larynx, bladder, liver and brain. Circulatory diseases were also significantly in excess and diabetes showed some increases. CONCLUSIONS: Mortality statistics provide preliminary evidence of the disease load in the area. Mapping waste dumping grounds provides information for defining high risk areas. Improvements in exposure assessment together with the use of a range of health data (hospital discharge cards, malformation notifications, observations of general practitioners) will contribute to second generation studies aimed at inferring causal relationships.

Cause of Death↗
PubMedDate not supplied

[Epidemiological study of populations exposed to high levels of 50 Hz magnetic fields].

The purpose of the present paper is to provide guidelines about the implementation of epidemiological studies on populations exposed to particularly high levels of 50 Hz magnetic fields, indicatively units of microT. The available evidence, in fact, points to a consistent increase of the occurrence of neoplastic and neurodegenerative disease and adverse reproductive outcomes associated to these levels of exposure. An approach based on the detection of high risk groups is proposed. In this frame contrastability between study subjects and suitable reference populations is the core issue. Some procedures aimed at selecting individuals and populations to be studied are discussed, in order to support local environmental and health authorities in setting priorities for studies and interventions. Finally, the implications of these studies in terms of scientific knowledge and environmental reclamation are examined.

Electromagnetic Fields↗
PubMedDate not supplied

[Pleural cancer mortality and compensated cases of asbestosis in Sardinia Region municipalities (1980-2000)].

OBJECTIVE: To his study describes the geographical distribution of pleural cancer deaths and asbestosis cases from 1980 to 2000 in Sardinia Region (Italy). For both conditions regionwide registration systems have been available for a relatively long time and allow the identification of statistically significant clusters. DESIGN: For each town we have estimated Standardized Mortality Ratios (SMRs) for pleural cancer and Standardized Incidence Ratios (SIRs) for asbestosis. Expected cases were estimated from age- and gender specific rates in Sardinia. SatScan software was used to identify clusters and to verify their statistical significance. SETTING: Sardinia Region (Italy). MAIN OUTCOME MEASURES: Standardized mortality and incidence rates respectively for pleural cancers and asbestosis cases and territorial clusters. RESULTS: The most important cluster of pleural cancer was identified in the area defined by Carloforte, Calasetta, Portoscuso and Sant'Antioco municipalities (Southwestern Sardinia) with 15 observed cases (p value= 0.003). Other clusters were detected in the municipality of La Maddalena (11 observed cases against 1.91, expected p value= 0.008) and in Southern Sardinia between Cagliari and Sarroch (p value= 0.018). The town of Marrubiu is clearly the most important cluster (p value= 0. 001) with 6 asbestosis cases in the period. CONCLUSIONS: These results indicate the urgency of the epidemiological surveillance of asbestos related diseases in Sardinia. The active search for incident cases of malignant mesothelioma in the whole Region and the analysis of modalities of asbestos exposure (according to national guidelines) is an indispensable tool for the primary prevention of occupational, environmental and domestic exposures from unknown asbestos sources of contamination.

Asbestosis↗
PubMedDate not supplied

[Preliminary study of cause-specific mortality of a population exposed to 50 Hz magnetic fields, in a district of Rome municipality].

OBJECTIVE: To investigate cause-specific mortality in a population exposed to high levels of 50 Hz magnetic fields, in a district of Rome. DESIGN: A cohort of 357 subjects that are resident in an area of about 100 meters on the two sides of a 60 kV power line was studied. Exposure to 50 Hz magnetic fields was evaluated by spot and long-term measurements and by adopting a model based on current load, characteristics of the line and distance of dwellings from conductors. The mortality experience of the cohort was observed from January 1st, 1980 through December 31st, 2003. Analysis took into account duration of residence and latency. Separate analyses were performed for three subcohorts characterized by different distances from the line and different estimated and measured field levels. MAIN OUTCOMES: Cause-specific standardized mortality ratios (SMRs) were computed comparing the observed number of deaths with the corresponding expected figures derived from the Latium Region mortality rates. This was done both in the overall cohort and in the subcohorts. RESULTS: All-causes mortality of the cohort did not differ from expected values (SMR 0.99; 95% CI 0.73-1.35; 40 observed). All cancers mortality showed a non-significant increase (SMR 1.34; 95% CI 0.82-2.18; 16 observed), that reached statistical significance in the analyses limited to subjects with more than 30 years of residence (SMR 2.09; 95% CI 1.05-4.19; 8 observed). Mortality from lymphohaematopoietic malignancies was increased, based on two cases of leukemia. All cancers mortality was highest in the subcohort closest to the power line and exposed to highest levels of magnetic fields. An increased risk for digestive tract neoplasms (SMR 3.57; 95% CI 1.49-8.58; 5 observed) was observed, which was mainly caused by pancreatic cancer. DISCUSSION AND CONCLUSION: Some increase in mortality of the overall cohort and especially of the highly exposed sub cohort was detected, notwithstanding the low power of the study. Other studies are currently on-going in the same area: a cross-sectional investigation on health status, an analysis of hospital discharge cards, a project for estimating individual exposure levels and a research in veterinary epidemiology. It is recommended to replicate the present study in areas presenting similar exposure patterns, in order to be able to pool data with the aim of estimating risk associated with the exposure levels of interest.

Cause of Death↗
PubMedDate not supplied

[Increase in mortality for motor neuron disease in Italy, 1980-1999].

OBJECTIVE: To describe the mortality rates for motor neuron disease (MND) in Italy both at national level and at three large geographical sub-areas (Northern, Central, Southern Italy). DESIGN: Deaths for MND are coded accordingly to ICD (IX revision) with 335.2 code. Mortality for MND is analysed for the period 1980-99. Mortality rates are age-standardized on the structure of the 1991 Italian population. Mortality data are derived from the National Institute for Statistics (ISTAT) and are made available by the Epidemiological Database of the Italian National Agency for New Technologies, Energy and the Environment (ENEA). MAIN OUTCOME MEASURES: Age adjusted mortality rates for MND are calculated for 5-year periods (1980-84, 1985-89, 1990-94, 1995-99) at both national level and three geographical sub-areas (north, center and south); sex and age specific mortality rates are also reported for two decades (1980-89 and 1990-99). RESULTS: During 1980-99 the annual age-standardized mortality rate in Italy was 1.35 x 100000 in males and 1.10 (x 100000) in females. In the period 1995-99 the mortality rates increased by 39.3% in males and 78.2% in females at national level when compared to 1980-84 rates (1.56 vs 1.12 deaths per 100000 for males and 1.39 vs 0.78 per 100000 for females in 1980-84 and 1995-99, respectively). In the three large geographical sub-areas such increases were 37.6%, 29.7% and 57% in males and 73%, 63.1% and 114.3% in females, respectively. CONCLUSION: The increase reported in this study is probably due to a mix of different factors as population ageing (age-specific rates reach a peak in the age class 70-74 years), better accuracy of death certificates, adoption of new clinical criteria and at last a wide spread of environmental risk factors (metals, solvents, pesticides, electromagnetic fields) and modification of life style (smoking, diet, professional sport).

Adult↗
PubMedDate not supplied

[Mortality and hospital discharges in the population of Biancavilla (Sicily) contaminated by natural fibres].

OBJECTIVE: The volcanic area of Biancavilla (Sicily Italy) has been included by the Italian national law among the areas of "environmental reclamation" due to the presence of amphibole fluoro-edenitic fibres in the environment. The aim of the study was to evaluate the health of residents in the area, through the analysis of the mortality registry and the hospital discharge records. DESIGN: Age, cause and gender specific indirect standardized mortality ratios SMR (1995-2000) and morbidity ratios SHR (2001-2003) were computed with 95% confidence intervals, using the population of surrounding municipalities as reference. RESULTS: statistically significant increases in mortality and morbidity were observed, both in men and women, for malignant pleural neoplasms (mortality: men SMR= 700, 6 observed; women SMR= 840, 3 observed; hospital admissions: women SHR= 1210, 5 observed), cardiovascular diseases (mortality: men SMR= 115, 267 observed, women SMR= 115, 278 observed; hospital admissions: men SHR= 109, 631 observed; women SHR= 114, 528 observed) and respiratory diseases (mortality: men SMR= 164, 68 observed; women: SMR= 215, 44 observed; hospital admissions: men SHR= 139, 558 observed, women SHR= 125, 374 observed). CONCLUSIONS: the excesses observed in this study are consistent with previous findings and suggest the need for further investigations aimed at improving the knowledge of the mineralogical aspects of the fibres, the assessment of human exposure and at estimating the prevalence of pleural plaques and lung fibrosis.

Asbestos, Amphibole↗