Aims
To analyze the relationship between asbestos exposure and malignant lymphoma in a multicenter case–control study conducted in Germany and Italy according to a common core protocol.
Methods
Male ...and female patients with malignant lymphoma (
n
= 1,034) between 18 and 80 years of age were prospectively recruited in six study areas in Germany (Ludwigshafen/Upper Palatinate, Heidelberg/Rhine-Neckar-County, Würzburg/Lower Frankonia, Hamburg, Bielefeld/East Westphalia, and Munich) and in two study areas in Sardinia, Italy (Cagliari and Nuoro provinces). A total of 1,173 population control subjects were drawn from population registers. In a structured personal interview, we elicited a complete occupational history, including every occupational period that lasted at least 1 year. On the basis of job task-specific supplementary questionnaires, trained experts assessed the exposure to asbestos. As a measure of cumulative asbestos exposure on a time by intensity scale, fiber-years were calculated. 12 cases (1.2%) and 12 control subjects (1.0%) had a cumulative asbestos exposure of more than 2.6 fiber-years (highest exposure category according to the 90th percentile of exposed control subjects). Odds ratios (OR) and 95% confidence intervals (CI) were calculated using unconditional logistic regression analysis adjusted for age, sex and study region. Patients with specific lymphoma sub-entities were additionally compared with the entire control group.
Results
We observed no statistically significant association between cumulative asbestos exposure and the risk of any lymphoma subtype. An elevated risk was found for the association between exposure to more than 2.6 fiber-years and multiple myeloma (OR = 6.0; 95% CI 1.4–25.1); however, numbers were small (
n
= 3 cases, all of them from Italy;
n
= 12 control subjects).
Conclusions
Our study does not support an association between asbestos exposure and risk of malignant lymphoma.
IntroductionCurrently, the health surveillance of past exposure to asbestos conveys scarce hope of improving life expectancy and quality. To uplift the screening capability, we validated our ...retrospective exposure assessment techniques and explored the feasibility of using the miRNA profile in the exhaled breath condensate (EBC) as a biomarker.Material and MethodsWe first classified lung fibrosis in the chest HRCT scans of 115 workers formerly exposed to asbestos and retrospectively estimated their exposure. We also assessed past exposure to asbestos and its correlation with the fibre count in the autoptic lung of 24 subjects who died from asbestos-related diseases. Finally, we used an NGS platform to detect miRNAs previously linked to lung cancer and pleural mesothelioma in the EBC of six subjects with no history of past exposure to respiratory hazards.ResultsThe risk of lung fibrosis increased linearly with time-weighted average (TWA, p = 0.0045) and cumulative exposure to asbestos (p = 0.009). An estimated cumulative exposure ≥ 10 fibre/ml-year conveyed an almost 11-fold (95% CI 1.54–75.7) excess risk of lung fibrosis. Cumulative exposure to asbestos correlated well with the fibre count in the autoptic lung (p = <0.0001).There was a good agreement between the miRNA detection rate in the EBC and plasma samples. The Spearman’s correlation between EBC and plasma miRNA counts was significant in 5/6 subjects (p = 0.001 – <0.001). The miRNA profile was consistent among the six participants.ConclusionsRetrospective exposure estimates can reliably reflect past exposure to asbestos. Parenchymal lung alterations show up in relation to estimates of past asbestos exposure much lower than previously thought. EBC sampling is a non-invasive, easily repeatable method to monitor the miRNA profile. It might be profitably used to detect early treatable effects even in subjects with low-level exposure to asbestos.
Purpose Potential sources of exposure to polycyclic aromatic hydrocarbons (PAHs) and genetic polymorphisms were investigated in relation to their contribution to interindividual variation in baseline ...levels of urinary 1-hydroxypyrene (1-OHP) excretion in subjects without occupational exposure to PAHs. Methods Urinary excretion of 1-OHP was measured in 114 subjects, including 48 women and 66 men. Questionnaire information was collected on possible environmental and individual sources of PAH exposure. A subset of 70 individuals also was evaluated for a single-nucleotide polymorphism (Ex7+295C→T) in the cytochrome P-450 1A2 (CYP1A2) gene, and 61 of these also were evaluated for the glutathione transferase T1 (GSTT1) gene polymorphism. Results 1-OHP values did not show a significant seasonal variability and were unaffected by age; education; body mass index; smoking status, including passive smoking; or the C→T base substitution in position 295 of exon 7 of the CYP1A2 gene. After reciprocal adjustment with logistic regression, living in a heavily trafficked urban area (odds ratio, 4.9; 95% confidence interval, 1.0–24.9), and frequent intake of grilled meat (odds ratio, 6.9; 95% confidence interval, 1.1–43.5) were significant predictors of background urinary 1-OHP levels of 0.50 μg/g creatinine or greater. Elevated risks also were associated with daily alcohol intake greater than 65 g and the nonnull GSTT1 genotype. Conclusion Our study shows that exposure to urban traffic, dietary habits, and the nonnull GSTT1 genotype may contribute to interindividual variation in background levels of 1-OHP urinary excretion in subjects without occupational exposure to PAHs.
In these days of 2020, tests for the diagnosis of SARS-CoV-2, and their use in the context of health surveillance of workers, are becoming popular. Nevertheless, their sensitivity and specificity ...could vary on the basis of the type of test used and on the moment of infection of the subject tested. The aim of this viewpoint paper is to make employers, workers, occupational physicians, and public health specialists think about the limits of diagnostic tests currently available, and the possible implication related to the erroneous and incautious assignment of "immunity passports" or "risk-free certificates" to workers during screening campaigns in workplaces.
Using a database of 1974-2003 incident cases of haematological malignancies, we explored the time trend, geographic spread and socio-economic and environmental correlates of ALL incidence in ...Sardinia, Italy, by sex and age. The age- and sex-standardized (World population) ALL incidence rate was 2.0 per 100,000 (95% CI 1.8 – 2.1) and showed variable trend patterns by sex and age. In the total population, ALL incidence showed an annual per cent change of -1.4% (95% CI 0.59 - 3.34) over the study period, with a knot separating a downward slope in 1974-1996 from an increase in 1996-2003. ALL incidence replicated such pattern in women but not men, whose incidence did not vary over the study period (APC = -2.57%, 95% CI -5.45 - 0.26). Among women, the spatial analysis suggested a clustering of ALL in the southwestern part of the region, whilst only a commune had a high posterior probability of a high ALL incidence among men. Three unrelated communes showed a high posterior probability of ALL at age ≤ 24; only the most populated urban centre showed excess cases at age ≥ 25 years. There was no correlation between the geographic spread of ALL at ages ≤ 24 and ≥ 25 years (p = 0.082). Urban residence was a risk factor for the younger age group. Residences near industrial settlements and in the most populated urban centre were risk factors for subjects aged ≥ 25 years. Our findings suggest age-related differences in ALL aetiology.
•In Sardinia, Italy, time trends in ALL incidence differed by age and sex.•The ALL risk at age ≤ 24 was elevated in 3 sparse communes.•At age ≥ 25 years, only the major urban area showed a high risk of ALL.•The geographic spread of ALL at age ≤ 24 and ≥ 25 years were unrelated.•ALL risk at age ≥ 25 increased in proximity of industrial settlements.
Since January 2011, media reports have been reviving claims about a presumed excess of haemolymphopoietic cancer in south-eastern Sardinia, Italy, that started 10 years before.The almost daily ...sequence of articles created alarm in the local population, and a judicial investigation was initiated. The present commentary discusses possible reasons for the perception of an excess of haemolymphopoietic cancer, which was not confirmed by four independent epidemiological investigations. The update 2003 of the spatial analysis of haemolymphopoietic cancer incidence in southern Sardinia, on the other hand, commissioned by the local health authorities, has suggested an elevated risk of leukaemia among males residing in areas far from those reported at risk.No action followed. It is unclear why the regional authorities do not use the epidemiological investigations commissioned by themselves, whatever the results are either negative or positive for possible environmental health problems.
Work-related stress is a known occupational hazard, with a putative role on the development of cardiovascular diseases (CVD). Although several investigations have explored the association in various ...workplace scenarios, none have focused on the airport flight logistic support personnel, a transportation business of crucial importance, potentially exposed to job stress and consequently to an increase in CVD risk. We explored the relationship between work-related stress and cardiovascular risk in 568 healthy workers of a flight logistic support company using the Health and Safety Executive questionnaire, the Framingham Heart Study General Cardiovascular Disease (CVD) Risk Prediction Score, and the WHO general well-being index (WHO-5). We used univariate and multivariate statistical methods to take account of possible confounders. Our results show that a low job support significantly increases the CVD risk score and decreases the WHO well-being index with reference to subjects reporting high support on the job. In addition, the well-being index of workers with high strain jobs appears lower in respect to workers employed in low strain job. The multivariate analysis confirms a protective effect of job support, and shows a detrimental influence on CVD risk by physical inactivity, regular intake of alcohol, and a low educational level. In addition, job control, job support, low strain, and high demand coupled with high control (active job) showed a beneficial effect on psychological well-being. Our results suggest that a combination of general risk factors and organizational factors contributes to increase CVD risk and well-being, representing a crucial target for intervention strategies to promote health in the workplace.
Nightshift work can cause daytime somnolence and decreased alertness, and can increase risk of medical errors, occupational injuries and car accidents. We used a structured questionnaire, including ...the Epworth Sleepiness Scale (ESS), to assess the prevalence and the determinants of sleep disruption in 268 Italian University hospital physicians from Cagliari (N = 57), Milan (N = 180) and Pisa (N = 31), who participated in the multicentre study on the prevalence of sleep disturbance among hospital physicians (PRESOMO); 198 of them (74%) were engaged in nightshift work. We explored the association between history of nightshift work and poor sleep quality and daytime somnolence with multivariate logistic regression, adjusting by personal and lifestyle covariates. Age, female gender, taking medication interfering with sleep and an elevated ESS score were significant predictors of poor sleep quality and daytime somnolence. Nightshift work was associated with a higher prevalence of unrestful sleep (84% versus 70%; odds ratio OR = 2.4, 95% confidence interval CI 1.18–5.05) and daytime dozing (57% versus 35%; OR = 1.9, 95% CI 1.03–3.64), with an upward trend by years of engagement in nightshift work for both conditions (p = .043 and 0.017, respectively), and by number of nightshifts/year for unrestful sleep (p = .024). Such an association was not detected with the ESS scale. Our results suggest that nightshift work significantly affects sleep quality and daytime somnolence in hospital physicians, who might underestimate their daytime dozing problem, when asked to subjectively scale it.
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