Fazzo Lucia, Nicita Carmela, Cernigliaro Achille, Zona Amerigo, Bruno Caterina, Fiumanò Giovanna, Villari Caterina, Puglisi Giovanni, Marinaccio Alessandro, Comba Pietro, Tumino Rosario
Dipartimento di ambiente e connessa prevenzione primaria, Istituto superiore di sanità, Viale Regina Elena 299, 00161, Roma.
Epidemiol Prev. 2010 May-Jun;34(3):87-92.
The present paper estimates the burden of asbestos-related disease among asbestos-cement production workers of the Sacelit plant that operated in San Filippo del Mela (Province of Messina) from 1958 through 1993.
The cohort was enumerated by the local committee of formerly exposed workers, with whom a collaboration was set up. The cohort includes 198 subjects with complete individual anagraphic information, out of 231 previous workers identified by the committee. A record-linkage with the Sicilian centre of the National mesothelioma registry enabled estimation of mesothelioma incidence for the years 1998-2008. Standardised proportionate mortality (SPMR) for asbestos-related causes was computed for the years 1986-2009. Sicilian Region constituted the reference population. The rationale for using SPMR rather than standardized mortality ratio (SMR) was a consequence for the lack of company files from which to obtain dates of start and termination of employment, and thus to compute person-years of observation, following the guidelines of the international scientific literature.
Standardised incidence ratio (SIR) for mesothelioma in the overall cohort was 251 (4 observed, 0.02 expected). Proportionate mortality analysis among male subjects showed significant increases for pneumoconiosis (SPMR 80.1, 5 observed), lung cancer (SPMR 2.81, 10 observed) and pleural neoplasms (SPMR 19.4, 2 observed).
Notwithstanding limitations in cohort reconstruction, for which the proportion of eligible subjects was 87.5% of those detected by the local committee, and the lack of information on duration of employment, it was possible to estimate a significant increase of the incidence of pleural mesothelioma with respect to Sicilian population. Also mortality from asbestos-related causes was in excess with respect to the regional reference population.
本文估算了1958年至1993年在墨西拿省圣菲利波-德尔梅拉运营的萨塞利特工厂的石棉水泥生产工人中与石棉相关疾病的负担。
该队列由当地曾接触石棉的工人委员会进行统计,委员会与这些工人建立了合作关系。在委员会确定的231名前工人中,该队列包括198名具有完整个人户籍信息的受试者。与西西里岛国家间皮瘤登记中心的记录链接,使得能够估算1998 - 2008年期间间皮瘤的发病率。计算了1986 - 2009年期间与石棉相关病因的标准化比例死亡率(SPMR)。西西里岛地区作为参考人群。使用SPMR而非标准化死亡率(SMR)的理由是,按照国际科学文献的指导方针,缺乏公司档案来获取就业开始和终止日期,从而无法计算观察人年数。
整个队列中间皮瘤的标准化发病率(SIR)为251(观察到4例,预期0.02例)。男性受试者的比例死亡率分析显示,尘肺病(SPMR 80.1,观察到5例)、肺癌(SPMR 2.81,观察到10例)和胸膜肿瘤(SPMR 19.4,观察到2例)显著增加。
尽管在队列重建方面存在局限性(符合条件的受试者比例为当地委员会检测到的受试者的87.5%),且缺乏就业时长信息,但仍有可能估算出相对于西西里岛人群,胸膜间皮瘤发病率有显著增加。与石棉相关病因的死亡率相对于地区参考人群也有所增加。