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Biomedical subjects

C Zocchetti

Publications and source records attributed to C Zocchetti.

At least 37 records · Page 2Linked to original sources

Cancer incidence in a population accidentally exposed to 2,3,7,8-tetrachlorodibenzo-para-dioxin.

In 1976, an accident in a plant near Seveso, Italy, exposed the local population to 2,3,7,8-tetrachlorodibenzo-p-dioxin (TCDD). Persons residing in three zones of decreasing TCDD contamination (A, B, and R) and a reference population were followed up for cancer occurrence in 1977-1986. The most exposed subgroup (A) was small, and only 14 cancer cases were observed. In zone B, hepatobiliary cancer was elevated, especially for those living in the area for > 5 years [relative risk (RR) = 2.8; 95% confidence interval (CI) = 1.2-6.3]. Men exhibited an increase in hematologic neoplasms, most notably lymphoreticulosarcoma (RR = 5.7; 95% CI = 1.7-19.0). Women experienced an increased incidence of multiple myeloma (RR = 5.3; 95% CI = 1.2-22.6) and myeloid leukemia (RR = 3.7; 95% CI = 0.9-15.7). In zone R, the incidence of soft tissue tumors and non-Hodgkin's lymphomas was elevated, particularly among persons living in the area for > 5 years (RR = 3.5; 95% CI = 1.2-10.4 for sarcomas, and RR = 2.0; 95% CI = 1.2-3.6 for non-Hodgkin's lymphomas). Breast cancer among females was below expectations in the most contaminated zones, and a clear deficit for endometrial cancer was observed in zones B and R.

Adult↗

Neuropsychological performance in HIV-1-infected drug abusers.

Twenty-five HIV-seropositive drug abusers (DA+HIV+) (groups II-III and IV [A, C2 and E] of the CDC classification) were evaluated by use of the WAIS scale to determine any possible involvement of cognitive functions in the not yet overt phases of AIDS. The results were compared with those obtained in two control populations composed of 19 seronegative drug abusers (DA+HIV-) and 24 healthy subjects (DA-HIV-) to evaluate, in addition to the disease, the possible effect of the use of alcohol and toxic substances on cognitive performance. In spite of the small number of subjects, the study indicated that drug abuse is the main factor, among those analyzed, in determining a decline in cognitive functions.

Acquired Immunodeficiency Syndrome↗

Mortality of a young population after accidental exposure to 2,3,7,8-tetrachlorodibenzodioxin.

The mortality experience of 19,637 people aged 1-19 years living in an area around Seveso, Italy, contaminated by 2,3,7,8-tetrachlorodibenzo-p-dioxin (TCDD) after an accidental explosion in a chemical plant was examined for the period 1976-1986. For comparison, the mortality of the population of nearly 100,000 people living in the surrounding districts was examined. People who left the study area were followed up. Vital status ascertainment was successful in over 99% of the cases. A group of 186 children who contracted chloracne, a reversible marker of TCDD intoxication, shortly after the accident were in the study: none of them died during the observation period. Among the exposed, mortality owing to all causes, to all accidents and to all cancers failed to show major departure from expectations. Five leukaemia deaths were observed, four among males and one among females; the corresponding relative risks were 2.1 (95% confidence interval (CI): 0.7-6.9), and 2.5 (95% CI: 0.2-27.0), respectively. Two lymphatic leukaemias among males yielded a RR = 9.6 (95% CI: 0.9-106.0). Mortality owing to congenital anomalies showed a nearly twofold increase in the contaminated area; however, five out of seven observed cases were born before the accident. Interpretation is limited by the small number of deaths, short latency period and low validity of death certificate information for certain causes, and by the definition of exposure which was based merely on residence. The follow-up is continuing. A cancer morbidity study is in progress.

Adolescent↗

Mortality study of cancer risk among oil refinery workers.

The mortality experience of 1595 male workers employed in one of the largest Italian refineries in the period from 1949-1982 was examined. From the comparison with national and local death rates, increases in mortality owing to lung and kidney cancers, brain tumors, and leukemias emerged. No definite trends according to duration of exposure and years since first exposure were apparent. The increases regarding cancer of the lung, kidney and brain appeared to be associated with the early period of operations. Analysis by exposure category suggested an association of the increased mortality from leukemias with working in production (observed = 2; expected = 0.61). Kidney cancer mortality was elevated among maintenance workers (obs. = 2; exp. = 0.18). Small numbers prevented firmer conclusions. Workers in the moving department had a significantly increased mortality from all cancers (obs. = 22; exp. = 11.7), and lung cancer (obs. = 11; exp. = 3.6). Confounding by smoking could be excluded as sufficient explanation of the three-fold increase in lung cancer deaths. It was in moving that highest airborne levels of polynuclear aromatic hydrocarbons had been discovered in an independent environmental investigation.

Adolescent↗

Ten-year mortality study of the population involved in the Seveso incident in 1976.

In 1976, an accidental explosion in a plant near Seveso, Italy, caused the contamination of a populated area by 2,3,7,8-tetrachlorodibenzo-p-dioxin (TCDD). The area was subdivided into three zones (A, B, and R) having decreasing mean levels of TCDD soil contamination. This study examines the mortality between 1976 and 1986 among the subjects, aged 20-74 years, who were resident in the area since the accident (n = 556 in zone A, n = 3,920 in zone B, n = 26,227 in zone R). Subjects' exposure was classified by residence. A referent cohort of 167,391 subjects who lived in the immediate surroundings was concurrently examined. Vital status ascertainment was successful for over 99% of the subjects. Increased mortality from cardiovascular causes was found; incident-related stressors were considered more relevant to increased mortality than was TCDD exposure. Mortality from several cancers was elevated. The increases in biliary cancer (females), brain cancer, and lymphatic and hemopoietic neoplasms (particularly leukemia in males) did not appear to result from chance, confounding, or information/comparison bias. However, no definite patterns related to exposure classification were apparent. Merely suggestive increases in soft tissue tumors and melanoma were also noted. Liver and breast cancer mortality tended to be below expectations. Interpretation is hampered by the short observation period, small number of deaths from certain causes, and poor exposure definition. Further research is in progress.

Accidents, Occupational↗

Effects derived from long-term low-level chromium exposure in ferro-alloy metallurgy. Study of absorption and renal function in workers.

Ferro-chromium production is based on the use of chromium oxide (III) and it is generally accepted that chromium in this form is not able to cross biological barriers. However, the data on the toxic and carcinogenic effects of hexavalent chromium in man are now firmly established. Some studies have questioned these data, calling for a clarification as to whether exposure to trivalent chromium can also produce human effects, perhaps with different latency time. A study was carried out on the exposure conditions (type and degree) in a ferro-chromium foundry that had been in operation since 1972. The absorption levels in the working population of the foundry, and the possible toxic effects on the kidney have been investigated. A total of 236 workers (142 employed in production departments, 33 office workers and 61 sub-contractor employees) were examined with measurement of the indicators of dose (urinary-chromium) and of effect on the kidney (albumin, retinol binding protein, and renal tubular epithelium antigens in the urine). Environmental hygiene measurements showed relatively low values of total chromium in the air (always less than 0.160 mg/m3). Hexavalent chromium was absent or, if present, at levels below the sensitivity of the analytical method used (0.001 mg/m3). The values of urinary chromium measured at the beginning and at the end of the working day and at the end of the work shift were always less than 5 micrograms/g creatinine, which has been proposed as a biological limit in chromium exposure. However, differences were observed between groups of subjects employed on different jobs, which is indicative of an absorption process varying according to the degree of exposure. The indicators of effect did not reveal any renal impairment, even early, that could be attributed to the toxic action of chromium.

Adult↗

Cancer mortality of capacitor manufacturing workers.

Experimental studies have demonstrated that certain types of commercially produced polychlorinated biphenyls (PCBs) are carcinogenic. Data in humans are still controversial. This study was undertaken in order to determine possible long-term effects, particularly cancer, in workers engaged in the manufacture of capacitors impregnated with PCBs in a plant operating since 1946. All workers employed for at least 1 week between 1946 and 1978 were admitted to the study (544 males and 1,556 females), and their mortality was examined for the period 1946-1982. Data on environmental contamination, workers' PCBs intake, and health effects (chloracne) were available, which documented the general exposure conditions in the plant. Vital status was ascertained for over 99% of the subjects, and death certificates were obtained for all deceased persons. Expected deaths were calculated using two sets of mortality rates, national and local. Among male workers, cancer deaths (14 obs.) were significantly increased as were deaths owing to cancer of the gastrointestinal (GI) tract (6 obs.). Also, mortality from hematologic neoplasms (3 obs.) and lung cancer (3 obs.) was higher than expected; however, the excess was statistically not significant. Female workers exhibited an overall mortality that was significantly increased above expectations. Cancer deaths (12 obs.) and hematologic neoplasms (4 obs.) were significantly higher than expected when compared with the local population. Interpretation of the results is limited by the small number of deaths; however, the point of interest is the consistency of these results with previous experimental and epidemiologic studies, which indicated the GI tract and lymphatic and hemopoietic tissue as the most probable target sites of the PCBs carcinogenic activity.

Digestive System Neoplasms↗

Exposure to formaldehyde and cancer mortality in a cohort of workers producing resins.

The mortality of 1,332 male workers employed at least 30 days in 1959-1980 in a resins-manufacturing plant was examined. Ambient measurements taken in the plant between 1974 and 1979 documented a potential for exposure to levels of formaldehyde as high as greater than 3.0 mg/m3. Vital status was ascertained for 98.6% of the cohort members, and their mortality was compared with expected deaths drawn from the national and local population rates. A statistically significant increase in lung cancer was observed, based on 18 deaths, which was not fully accounted for by possible confounding factors linked to personal habits or sociocultural characteristics. This elevated risk, however, could not be attributed specifically to exposure to formaldehyde. Mortality from digestive cancer (14 deaths observed) and hematologic neoplasms (5 deaths observed) was not substantially higher than expected. The study was limited by information bias due to incomplete work histories, by the small number of deaths from some relevant causes, and by the possibly insufficient length of the observation period. Therefore these results do not provide sufficient grounds either to link formaldehyde exposure in the plant to the increased cancer risk noted or to exclude that formaldehyde might pose such a risk to humans under certain exposure circumstances.

Adolescent↗

Cancer mortality of an Italian cohort of workers in man-made glass-fiber production.

This study was undertaken in order to examine possible long-term effects, particularly cancer, associated with working in the man-made glass-fiber production industry in Italy (glass wool and continuous filament). All male production workers employed for a minimum of one year between 1944 and 1974 were admitted to the study (1,098 subjects), and their mortality was examined in the period 1944-1983 (21,325 person-years). The vital status ascertainment was successful for 98.9%, of the cohort members. An increased risk of cancer of the larynx was noted based, however, on only four deaths. When contrasted with the values of the local population, the increase proved to be statistically significant after 25 years since first exposure. The higher than expected larynx cancer mortality was confined to workers hired before the age of 25 years, exposed for at least 15 years, who started exposure before 1960 (main production: glass wool), and who belonged to the highest cumulative exposure categories. Known confounding factors could not completely account for the excess observed. Among the numerous studies carried out on man-made glass-fiber workers, only one incidence study in France support our findings. No other increased cancer risks have been suggested by the present study.

Adult↗

Behaviour of biological indicators of cadmium in relation to occupational exposure.

Cadmium in blood (CdB), cadmium in urine (CdU) and beta 2-microglobulins (beta 2MU) were determined in 83 male workers exposed to cadmium fumes. CdU was measured both on 24-h urine samples and on spot samples. The behaviour of the biological indicators of cadmium was assessed in relation to degree of current exposure, length of exposure and cumulative exposure (computed as concentration of cadmium at the workplace multiplied by duration of exposure). CdB values were significantly higher in the subgroups of subjects with higher current cadmium exposure and in the subgroups of subjects with greater cumulative exposure, but the test levels were not influenced by duration of exposure. CdU levels were significantly higher in the subgroup of subjects with greater cumulative exposure, but were less influenced by current exposure or duration of exposure. Considering the entire population, a rather close correlation (r = 0.69) was observed between CdB and CdU. When the population was divided according to level of current exposure, a close relationship was observed between the two indicators in all subgroups; nevertheless, for identical CdU values, the CdB values were higher in the subjects with heavier current exposure. Even if in all Cd workers the beta 2MU levels were in the range of reference values, the highest beta 2MU levels were found in the subjects with CdU greater than 10 micrograms/l. The data confirm that CdU is prevalently influenced by the body burden of metal, but they also suggest that the CdB levels are not influenced solely by the intensity of current exposure but also depend to a considerable degree on the body burden.

Adult↗

[Pyrosis in major diseases of the upper digestive tract. Computerized analysis of symptoms in 700 cases subjected to gastroduodenoscopy].

The prevalence of the symptom pyrosis was investigated in 700 cases subjected to gastroduodenoscopy. The incidence of pyrosis was considered in relation to sex, age, "vices" (consumption of coffee, alcohol, cigarettes), character traits, family and pathological medical histories and the diagnosis formed during endoscopy. The incidence of pyrosis proved to be identical for both sexes and slightly higher in the first decades of life. There was no correlation between familial gastroduodenal or intestinal diseases and pyrosis. There seems to be no connection between cigarette smoking and alcohol consumption (assessed quantitatively) and a higher incidence of pyrosis; the consumption of coffee, however, does appear to increase the incidence of pyrosis. When interpreting these data, it should be remembered that many subjects may have modified their habits as a result of pyrosis. The incidence of pyrosis was always found in cases of oesophagitis, current bulbar ulcers, the initial stage of gastric tumours (not advanced cases) and, although with less certainty, in pyloric stenosis and duodenitis. A low incidence was recorded for cases of hypotrophic gastropathies, and cicatricial gastric or duodenal ulcers, for males with oesophageal varices or with a history of chronic hepatopathies. To conclude, pyrosis does not seem to show any characteristics of specificity or sensitivity.

Adult↗

[Dyspepsia among the principal diseases of the upper tract of the digestive apparatus. Analysis of the symptom in 700 cases subjected to gastroduodenoscopy].

700 cases subjected to endoscopic examination were investigated to find the relationship between dyspepsia and personal characteristics, lifestyle, family and pathological history and formulated diagnosis. Dyspepsia is taken to represent: epigastric heaviness following meals, prolonged and difficult digestion accompanied by the sensation of slow gastric emptying and fullness. Dyspepsia occurs with equal frequency in both series and is more common during the first decades of life. Dyspepsia is not affected by whether or not the patient lives in the town or the country, smokes, drinks significant amounts of alcohol or coffee. Neither a family history of gastroduodenal or intestinal complaints or gall bladder stones or chronic liver diseases have many bearing on dyspepsia. An attempt to connect endoscopic diagnosis with dyspepsia had no positive result. Dyspepsia was observed with the same frequency in subjects free from upper digestive tract diseases, subjects with organic disease and subjects with functional diseases.

Adult↗

Influence of sex, age, and smoking habits on the urinary excretion of D-glucaric acid.

Reference values for urinary D-glucaric acid and the influence of sex, age and smoking habits were evaluated with a low-pH enzymatic method. D-Glucaric acid measured on spot urine samples from 573 healthy subjects gave mean concentrations (mumol/1) and D-glucaric acid/creatinine ratios (mmol/mol creatinine) of 56.1 (+/- 22.9) and 3.05 (+/- 0.99) for males and 53.3 (+/- 20.9) and 3.35 (+/- 0.95) for females. No difference between morning and evening was observed for urinary D-glucaric acid/1 values, but D-glucaric acid/creatinine was higher in the evening samples for both sexes. There was a negative correlation between D-glucaric acid/1 values and age in males but not in females: the decrease of D-glucaric acid concentration was, however, quantitatively very small. Smoking produced a significant increase in D-glucaric acid concentration and in the D-glucaric acid/creatinine ratio for males and also partially for females.

Adolescent↗

A mortality study of newspaper printing workers.

Following an inquiry from the workers of a large newspaper plant in Milan, Italy, a mortality study was undertaken to investigate the reportedly high occurrence of cancer. The study covered the period from 1956 to 1975. Among the 700 workers participating, for a total of 12,198 person-years, 199 deaths had occurred. Overall mortality was not lower than expected and a significant excess was found among the workers aged 25-54 years. Cancer mortality was higher than expected; the only significant excess, however, was found among packers and forwarders who had a greater incidence of all neoplasms, all respiratory cancers, and lung cancer. Some possible explanations concerning personal life-style and occupational exposure previously not considered are proposed. Mortality from circulatory diseases and ischemic heart disease was significantly in excess among the workers aged 25-54 years and was associated with length of employment, age at the time of hiring, and duration of follow-up; analysis by job category revealed a significant mortality excess from these causes among packers and forwarders. It is suggested that the mortality pattern observed for cardiovascular disease, as well as for all causes, could be interpreted in the light of the peculiar characteristics of newspaper production. The initial complaint, instigating the study, arose from the packers and forwarders department.

Adult↗