Merler E, Ercolanelli M, de Klerk N
Unità operativa di epidemiologia, Centro per lo studio e la prevenzione oncologica, Azienda ospedaliera di Careggi, Firenze, Italia.
Epidemiol Prev. 2000 Nov-Dec;24(6):255-61.
The crocidolite mine at Wittenoom Gorge, Western Australia, has been active from 1943 to 1966, and managed by Australian Blue Asbestos Ltd (ABA). Migrants constituted the large majority of workers. The list of workers is composed of 6,911 subjects (6,501 males). In it we identified 1,102 Italians (1,069 males) and completed the follow up for those previously lost, remained in Australia or returned to Italy. Up to 1997, 302 subjects (301 males) definitively resettled in Italy, almost always returning to their community of origin. The median length of work at Wittenoom for those resettled was 17.8 months. The resettled subjects are spread around Italy, and 112 subjects (37%) already died. We compared the mortality rates of those returned to Italy to the rates of the male Italian population. Migrants were subjected to a strong selection before departure and were the target of a surveillance program during work at Wittenoom: however, for those resettled, instead of a healthy migrant effect, we observed an overmortality, mainly due to deaths from penumoconiosis (10 deaths vs 0.38 expected), from respiratory tumours (3 deaths from pleural mesothelioma and 4 from primary peritoneal tumours; an excess of lung cancers, SMR 1.28, 95% CI 0.72-2.11, and an excess of undefined caused of deaths (SMR 6.29, 95% CI 2.52-12.96). The study suggests that asbestos-related diseases and deaths have been observed among those resettled to Italy. In order to increase the precision of the follow up of the Wittenoom cohort, a search outside Australia should be carried out in some European countries for workers whose vital status was unconfirmed. Survivors in Italy are suffering from asbestosis, jeopardizing their life, and are at risk of cancer, but few have received information, actions aimed at reducing the accumulated risk, or compensation. Italy had a multi-million number of migrants for work, and an important percentage of migrants is returned to Italy: the effects of occupational exposures to adverse agents should be expected, but this topic has received up to now little attention.
西澳大利亚州维特努姆峡谷的青石棉矿于1943年至1966年期间运营,由澳大利亚蓝石棉有限公司(ABA)管理。移民构成了工人的绝大多数。工人名单包括6911名受试者(6501名男性)。我们从中识别出1102名意大利人(1069名男性),并对那些之前失去联系、仍留在澳大利亚或返回意大利的人进行了随访。截至1997年,302名受试者(301名男性)最终定居在意大利,几乎都回到了他们的原籍社区。定居者在维特努姆工作的中位时长为17.8个月。定居者分布在意大利各地,112名受试者(37%)已经死亡。我们将返回意大利的人的死亡率与意大利男性人口的死亡率进行了比较。移民在出发前经过了严格筛选,在维特努姆工作期间是监测项目的对象:然而,对于那些定居者,我们没有观察到健康移民效应,反而观察到了过高死亡率,主要原因是肺尘埃沉着病导致的死亡(10例死亡,预期0.38例)、呼吸道肿瘤导致的死亡(3例胸膜间皮瘤死亡和4例原发性腹膜肿瘤死亡;肺癌超额,标准化死亡比1.28,95%置信区间0.72 - 2.11)以及不明原因导致的死亡超额(标准化死亡比6.29,95%置信区间2.52 - 12.96)。该研究表明,在定居到意大利的人群中观察到了与石棉相关的疾病和死亡。为了提高维特努姆队列随访的精确度,应该在一些欧洲国家对生命状态未确认的工人进行澳大利亚境外的搜索。意大利有数百万人移民工作,且有相当比例的移民返回意大利:职业接触有害因素的影响是可以预期的,但到目前为止这个话题很少受到关注。