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Italië: onderzoek naar latentietijd asbestziektes

21-11-2007 00:00

Onderzoek onder 3434 ex-werknemers van een Italiaanse Eternitfabriek laat zien dat zij een verhoogd risico hebben op pleuramesothelioom (longvlieskanker), peritoneaal mesothelioom (buikvlieskanker), longkanker en bij vrouwen baarmoederhals- en eierstokkanker. Het risico neemt bij longkanker vanaf 15 jaar en bij pleuramesothelioom vanaf 30 jaar na het laatste moment van asbestblootstelling af. De piek in de latentietijd, de periode tussen het eerste moment van blootstelling en de ontdekking van de ziekte, ligt bij longkanker tussen de 30 en 40 jaar en bij pleura mesothelioom tussen de 30 en 50 jaar. Bij peritoneaal mesothelioom vertoont deze een continue stijgende lijn tot meer dan 50 jaar na het eerste moment van asbestblootstelling. De voormalige asbestfabriek was tussen 1907 en 1986 in werking in de plaats Casale Monferrate (Piedmont, Italië). Bron: Magnani, C. et al., (2007). Cancer risk after cessation of asbestos exposure. A cohort study of Italian asbestos cement workers. OEM online, 17 aug., doi:10.1136/oem.2007.032847.

Magnani, C. et al., (2007). Cancer risk after cessation of asbestos exposure. A cohort study of Italian asbestos cement workers. OEM online, 17 aug., doi:10.1136/oem.2007.032847.
Abstract

Objectives: We aimed at studying mortality for asbestos related diseases and incidence of mesothelioma in a cohort of Italian asbestos cement workers after cessation of asbestos exposure.
Methods: The Eternit factory operated from 1907 to 1986. The cohort included 3434 subjects active in 1950 or hired in 1950-86, recorded from company books, without selections. Local reference
rates were used for both mortality and mesothelioma incidence.
Results: Mortality was increased in both sexes for all causes (overall 1809 obs vs 1312.3 exp. p<.0.01), pleural (135 obs vs. 3.6 exp. p<.0.01) and peritoneal (52 vs 1.9. p<.0.01) malignancies and
lung cancer (249 vs. 103.1. p<.0.01). In women, ovarian (9 vs 4.0. p<.0.05) and uterine (15 vs 5.8. p<.0.01) malignancies were also in excess. No statistically significant increase was found for
laryngeal cancer (16 obs vs. 12.2 exp). In Poisson regression analyses the RR of death from pleural neoplasm linearly increased with duration of exposure while it showed a curvilinear increase with latency and time since cessation of exposure. RR for peritoneal neoplasm continued to increase by latency, duration and time since cessation of exposure. RR for lung cancer showed a reduction after 15 years since cessation of exposure and leveled off after 40 years of latency.
Conclusion: this study of a cohort of asbestos exposed workers with very long follow-up confirmed the reduction of risk of death from lung cancer after the end of exposure. It also suggested a
reduction of risk for pleural mesothelioma with over 40 years of latency while risk for peritoneal mesothelioma showed a continuing increase.