Biomedical subjects
Publications and source records attributed to C Magnani.
We present the results of current epidemiological research on the association between ELF magnetic fields and neoplasm. ELF magnetic fields were considered as 'possibly carcinogenic to humans (Group 2B)' by IARC. The evidence was limited to childhood acute leukemia and to chronic leukemia (associated to occupational exposure) in adults.
In this short review we present the evidence of association of Malignant Mesothelioma and asbestos exposure in Italy, with focus on environmental exposure. After almost 10 years from the cessation of industrial use of asbestos, areas of high incidence attributable to environmental exposure are still observed.
(Epidemiological study on childhood tumors and leukaemia) study is an epidemiological case-control study, conducted in 15 Italian regions, including Apulia, to assess the possible risk of childhood cancer (leukaemia, LNH, and Neuroblastomes) resulting from exposures to electromagnetic fields (EMFs).
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BACKGROUND: Asbestos exposure is the only cause of epidemiological relevance for pleural malignant mesothelioma (MM), but the mechanism of action is not entirely understood. A causal role was suggested for SV40 since viral DNA and proteins were detected in pleural MM and SV40 caused MM in hamsters. SV40 proteins (Tag) interact with oncogenes P53 and Rb. OBJECTIVES: To review evidence on the association of SV40 with MM, bearing in mind laboratory and epidemiological studies. METHODS: The review on SV40 was based on scientific papers published since 1990 on association of SV40 with human cancer. RESULTS: Studies researching SV40 DNA in MM tissue observed a wide range of prevalences (0% to 70%); causes of variability were not convincingly identified. An association of MM with SV40 was suggested but confounding factors and biases were not considered. Cohort studies on humans inoculated with contaminated vaccines did not show an increased incidence but their statistical power was limited. Diffusion of SV40 in humans is linked to polio vaccines produced in 1955-63 from SV40-infected monkeys. A 11-12% prevalence of SV40 in adults were reported in the USA, 2-6% in Europe and Africa. The age pattern of MM does not suggest a cohort effect related to contaminated vaccines. DISCUSSION: Association of SV40 with human MM is suggested from laboratory observations but still lacks confirmation in well designed epidemiological studies. Other putative co-factors in MM occurrence are mutations in genes involved in repair of damage caused by asbestos, notably DNA-repair genes. Preliminary observations are available but epidemiological studies are needed to test this hypothesis.
The district of Biella in Piedmont (NW Italy) has one of the largest concentrations of the textile industry in Italy, traditionally manufacturing high quality wools. The present paper describes a survey of primitive cancers of the nasal fossae and paranasal sinuses diagnosed among residents of this area from 1970 to 1986. This study is a preliminary step in a case-control study aimed at investigating the association with occupational exposure in the textile industry. Seven cases were diagnosed in the 1970-75 period and 25 in the following ten years 1976-1986. The cut-off point corresponds to the year when the Hospital Admission and Discharge Registry became operative in Piedmont and Lombardy. The 1970-75 annual incidence rates (X 100,000, world standardized) were 0.5 both among males and females. Corresponding figures in 1976-86 were 1.2 and 0.2. Out of 32 cases, 16 were adenocarcinomas or adenoid-cystic carcinomas. Eleven cases are reported in the clinical record as wood or leather workers and seven as textile workers. Occupation was not reported for six cases. A case-control study is in progress.
In connection with the surveillance programme of congenital malformations in Emilia Romagna led by I.M.E.R. Group since 1978 a crosswise survey has been performed on selected malformations: Down's syndrome, cardiac defects, unilateral or bilateral cleft lip and/or palate, unilateral or bilateral club foot. This survey has been useful as a pilot-study for another longitudinal survey which had a place in the programmes of the C.N.R. (National Research Council). By means of a multi-discipline approach we have collected information both of pediatric and of psycho-social character. A total of 187 children with the above named malformations were recorded at birth, 106 boys and 81 girls, aged from 9 months to 4 years. The neonatal diagnosis was confirmed in 84 out 86 cases under study. The rate of infant mortality was particularly high among children with heart defects (39.1%) and Down children (27.4%). The surgical centres where these children were operated upon, through with large variations in connection with the type of malformation, were in Emilia Romagna (49%), outside it (40%), and abroad (10.9%). As for the parental reaction to the birth of babies with congenital malformations, it was of initial rejection 5 cases of Down children, 3 cases of cardiopathy and 1 case of cleft lip and palate. Later the refusal was permanently confirmed only in 2 cases of Down children (who were subsequently adopted). The birth of a malformed baby has affected the relationship between husband and wife contributing to the separation in 3 cases of Down's syndrome and in 1 case of cardiopathy.
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In a multicentric survey carried out in Emilia Romagna area on congenital malformations 1914 babies out of 103484 babies born from 1978-1984 were discovered to have malformations. Out of these malformations cases 17% were found to be affected by genitourinary tract anomalies (GU) divided as follows: 235 genital malformations and 91 urinary tract anomalies. All these GU patients were diagnosed within the first week of life. Genital malformations: Genital malformations are mainly constituted by hypospadias, found in 214 out of 235 babies. Among these babies, 72% have first degree hypospadias, 22.4% have second degree, and only ten babies were found with third degree hypospadias. In this study 4.1 out of 1000 male newborns have been found affected by hypospadias, in agreement with the results of other researches whose values were between 2% and 4.4%. Many different variables (such as parental age, exposure to smoke, alcohol, RX-ray before pregnancy, low birth weight, early age at menarche, exposure to progestins for threatened abortion, shorter gestation) have been considered in order to verify their correlation with the hypospadias, comparing with control group. Among these the most statistically significant are the exposure to progestins for threatened abortion (p less than 0.05), early age at menarche (p less than 0.001) and the intrauterine growth retardation (p less than 0.001). Also these results agree with the previous studies. Urinary tract anomalies: the 93 babies with kidney and-or urinary tract malformations out of 103484 newborns represent the 8.9%. The diagnoses were made or suspected (and later confirmed) during the first week of life.(ABSTRACT TRUNCATED AT 250 WORDS)
Systems for monitoring Congenital Malformations (C.M.) have been taken up by most Countries, even though there is great diversity in the methods of data collection. In Italy nothing existed until 1977. In 1978 in the Emilia-Romagna Region an epidemiological Program began for the surveillance and monitoring of all C.M. diagnosed in the first 7 days of life in the newborn babies and in the stillbirths of over 28 weeks of gestational age. After three years of monitoring-1978 to 1980-we have reached the baseline data which is the fundamental prerequisite to ensure comparability of data from different centers and within our region in different periods too. The incidence of all C.M. was 1.9% in the first three years of monitoring with no statistical difference from year to year or between the Districts of the Region. For six selected C.M. we studied the incidence in the Region and also in the four Districts starting from 1978. Our data is comparable to that reported in the other Countries but we observed high incidence of Down Syndrome (17.2 per 10,000 births that is one of the highest values detected = 1 case every 582 newborn babies). For hypospadias we observed, starting from the second quarter of 1980, a progressive increase that dropped however in the first quarter of 1981. No etiologic clues have yet been revealed.
We present six cases of V.A.C.T.E.R.L. association diagnosed by the Study Group of Congenital Malformations in Emilia Romagna (I.M.E.R.) from january 1978 to december 1981. With regard to the etiology, the pregnancy history of these six cases does not support the hypotesis of the progestin-estrogen compounds as possible teratogenic factors of the V.A.C.T.E.R.L. association. Furthermore the familial recurrence hypotesis of this complex needs further detailed studies. At last we attempt to specify the nosological limits of the V.A.C.T.E.R.L. association respect to other similar malformative complexes as the Caudal Regression Syndrome, Rokitansky Syndrome, Holt-Oram Syndrome and Potter Syndrome.
A spatial cluster of pleural mesothelioma cases was detected in Broni, in the Province of Pavia (northwestern Italy). Eighteen deaths due to malignant pleural neoplasms were observed in the years 1980-87 (SMR: 556; 95% confidence interval: 329-878) and the incidence of pleural mesothelioma in 1980-89 was 9.1 cases per 100,000 person-years among men and 4.3 cases among women. These findings are discussed with reference to the presence in Broni of a plant manufacturing asbestos cement products.
The paper presents the European multicentric case-control study on risk for mesothelioma after non-occupational (domestic and environmental) exposure to asbestos. The study includes eight centres in seven European countries (Belgium, Denmark, Greece, Italy, Spain, Sweden and Switzerland). It is focused on the measurement of mesothelioma risk in relation to low intensity exposure to asbestos and to exposure to MMMF and other agents. It includes incident cases of pleural malignant mesothelioma (histologically diagnosed and verified) and a random sample of the population.
The present report updates a mortality cohort study of workers in the largest Italian asbestos cement plant. The plant had been active in Casale Monferrato in 1907-1986 and produced boards, corrugated sheets, tubes and high-pressure pipes. Raw material included both chrysotile and crocidolite but not amosite. Airborne asbestos concentrations were measured for the first time in 1971 (over 20 ff/cc in most areas). Regular monitoring started in 1978, when the concentration measured in most samples was below 1 ff/cc. The cohort included 3367 blue-collar workers (2605 men and 762 women) employed at the plant at any time between 1950 and 1980. At the end of the follow-up in 1993, 57% were alive, 41% were dead and 2% were either lost or had moved abroad. Mortality in the cohort was compared to mortality rates in Piedmont; local rates have been available only since 1969 and mortality analyses were limited to the period since 1965. Both sexes showed a statistically significant increase in mortality for all causes: lung cancer (males: 162 obs. vs. 65.4 exp.; females 9 vs. 3.2), malignant neoplasm (MN) of the pleura (males 53 vs. 1.7; females 21 vs. 0.4), MN of the peritoneum (males 23 vs. 1.2; females 8 vs. 0.5) and asbestosis (males 118 vs. 0.2; females 14 vs. 0.1). No excesses were observed for MN of the larynx or of the digestive tract. Women show a statistically significant increase in MN of the ovary (7 vs. 2.7) and of the uterus (14 vs. 4.3). Mortality from MN of the lung increased with latency but, in men, showed a curvilinear trend with the highest SMR for those with between 10 and 19 years of employment. The curve could be related to workers with the highest seniority employed in better jobs. The study includes a review of epidemiological studies on mortality among asbestos cement workers.
A case-control study on pleural malignant mesothelioma (MM) was conducted in Casale Monferrato, where the largest Italian asbestos cement (AC) factory had been operating from 1907 to 1985. In a previous study we observed a five to seven-fold increase in the incidence of MM among people living in that city and never employed in the factory mentioned. The present study includes cases of MM with histological diagnosis over the period 1.1.1987-30.6.1993 among residents in the Local Health Unit (LHU) of Casale Monferrato. Population controls were randomly extracted from the list of the residents in the LHU, matched to cases on sex, date of birth, vital status and date of death. Cases and controls (or their closest relative) were interviewed with a standardised questionnaire focusing on asbestos exposure in the (life-long) residential and occupational histories and in leisure time activities as well as on occupational asbestos exposure of relatives and cohabitants, smoking and chest or occupational diseases. The interview was blind in respect to case or control status. For the analyses the addresses were coded on map grids with a 500 m. mesh size. Statistical analyses were conducted with conditional logistic regression in order to keep the matching between cases and controls. Eighty-eight cases and 244 controls were interviewed (95.6% of cases and 80.1% of controls): 26 and 11 respectively reported an activity in the AC industry. Seven cases and 7 controls were also exposed because of parental occupation. The main analyses are based on the conditional regression model including both occupational and residential exposure. The different modes of exposure are included on an ordinal scale: each subject is classified according to their highest level. Domestic exposure is included as an independent factor. Odds Ratios (OR) are estimated with reference to subjects without either occupational or residential exposure. The OR is 39.3 among subjects reporting occupational exposure, 11.9 among those never engaged in the AC industry but living within 1000 m. of the factory. A statistically significant risk is also observed for persons at some time living in the other areas of Casale Monferrato.
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