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P Boffetta

Publications and source records attributed to P Boffetta.

At least 199 records · Page 11Linked to original sources
PubMed1997

Non-smoker lung cancer deaths attributable to exposure to spouse's environmental tobacco smoke.

BACKGROUND: The causal relationship between environmental tobacco smoke (ETS) and lung cancer is established; however, the magnitude of the risk is not known. Therefore, it is conceivable that ETS is responsible for a number of lung cancer deaths because of the large number of smokers and the widespread presence of ETS. We estimated the number of lung cancer deaths occurring in 1990 in the European Union (EU), attributable to ETS generated by a spouse. METHODS: In each country and for each sex, we used the proportion of smokers and of married people in 1970 to estimate the number of lung cancer deaths not attributable to tobacco smoking occurring in married people, assuming a relative risk (RR) for active smoking equal to 10. We then assumed a prevalence of smoking among these deaths equal to the population at large, and estimated the number of deaths attributable to ETS based on an RR for ETS of 1.3. Additional analyses were carried out assuming different values of RR for smoking and exposure to spouse's ETS. RESULTS: Based on our best assumptions, we calculated that 1146 (839 females, 307 males) lung cancer deaths were attributable to exposure to spouse's ETS in the EU in 1990. All the hypotheses tested resulted in not less than several hundred deaths. CONCLUSION: Regardless of the limitations of this exercise, our results suggest that exposure to spouse's ETS represents a relatively important public health problem in the EU.

Adult↗
PubMed1997

Cancer mortality among man-made vitreous fiber production workers.

We have updated the follow-up of cancer mortality for a cohort study of man-made vitreous fiber production workers from Denmark, Finland, Norway, Sweden, United Kingdom, Germany, and Italy, from 1982 to 1990. In the mortality analysis, 22,002 production workers contributed 489,551 person-years, during which there were 4,521 deaths. Workers with less than 1 year of employment had an increased mortality [standardized mortality ratio (SMR) = 1.45; 95% confidence interval (CI) = 1.37-1.53]. Workers with 1 year or more of employment, contributing 65% of person-years, had an SMR of 1.05 (95% CI = 1.02-1.09). The SMR for lung cancer was 1.34 (95% CI = 1.08-1.63, 97 deaths) among rock/slag wool workers and 1.27 (95% CI = 1.07-1.50, 140 deaths) among glass wool workers. In the latter group, no increase was present when local mortality rates were used. Among rock/slag wool workers, the risk of lung cancer increased with time-since-first-employment and duration of employment. The trend in lung cancer mortality according to technologic phase at first employment was less marked than in the previous follow-up. We obtained similar results from a Poisson regression analysis limited to rock/slag wool workers. Five deaths from pleural mesothelioma were reported, which may not represent an excess. There was no apparent excess for other categories of neoplasm. Tobacco smoking and other factors linked to social class, as well as exposures in other industries, appear unlikely to explain the whole increase in lung cancer mortality among rock/slag wool workers. Limited data on other agents do not indicate an important role of asbestos, slag, or bitumen. These results are not sufficient to conclude that the increased lung cancer risk is the result of exposure to rock/slag wool; however, insofar as respirable fibers were an important component of the ambient pollution of the working environment, they may have contributed to the increased risk.

Aged↗
PubMed1997

Mortality of Italian lead smelter workers.

OBJECTIVES: The purpose of this study was to evaluate the health consequences of employment in the lead-smelting industry. METHODS: A mortality study of 1388 workers and laborers in production and maintenance departments was conducted in an Italian lead-smelting plant. The vital status of cohort members was determined from 1950 to 1992. Standardized mortality ratios were calculated for specific causes of death on the basis of national and regional reference rates. The relative risk for selected causes of death was also modeled as a function of age, calendar period, latency, and duration of employment with Poisson regression analysis. RESULTS: A significant 4.5-fold excess mortality from pneumoconiosis and other diseases of the respiratory system was observed, but the risk of pneumoconiosis did not show a significant trend by duration of employment. Mortality from all cancers, stomach cancer, and lung cancer was lower than expected. The standardized mortality ratios for genitourinary diseases and kidney cancer were not significantly elevated, but the Poisson regression analysis showed that both risks increased significantly by duration of employment. CONCLUSIONS: These findings provide limited evidence that long-term employment in lead-smelting plants increases the risk of genitourinary diseases and kidney cancer. The observed increase in mortality from pneumoconiosis and other diseases of the respiratory system was more likely related to silica exposure in other workplaces.

Adult↗
PubMed1997

Cancer mortality among pulp and paper workers in Poland. A cohort study.

Mortality among workers in the Polish pulp and paper industry was evaluated in a cohort study of 10,460 workers who had been employed continuously for at least one year, between 1968 and 1990 in the factory producing sulphate pulp, paper, board and paper products. Three subcohorts were formed according to the work areas. A standardized mortality ratio (SMR) analysis was used to compare death rates for each group exposed with Polish national rates. Mortality from all causes and from all malignant neoplasms, both in the female and in male cohorts was lower than that observed in the general population. In the pulp male subcohort a significantly elevated risk of death from peritoneum cancer (2 obs, SMR = 2,530) and prostate cancer (4 obs, SMR = 854) was recorded, although overall mortality from all causes and from all malignant neoplasms was lower than expected. The excess of deaths from neoplasms in other sites was statistically nonsignificant in all subcohorts. This study did not confirm the excess mortality from lung, stomach and lymphatic cancers found by other authors. The "young" cohort and a relatively short follow-up period (23 years) might have affected the results.

Adult↗
PubMed1997

Socioeconomic differences in cancer incidence and mortality.

This chapter summarizes accumulated data on the presence, magnitude and consistency of socioeconomic differentials in mortality and incidence of all malignant neoplasms and 24 individual types of neoplasms in 37 populations in 21 countries. More or less consistent excess risks in men in lower social strata were observed for all respiratory cancers (nose, larynx and lung) and cancers of the oral cavity and pharynx, oesophagus, stomach, and, with a number of exceptions, liver, as well as for all malignancies taken together. For women, low-class excesses were consistently encountered for cancers of the oesophagus, stomach, cervix uteri and, less consistently, liver. Men in higher social strata displayed excesses of colon and brain cancers and skin melanoma. In the two Latin American populations for which data were available, lung cancer was more frequent in higher social strata. Excesses in high female socioeconomic strata were seen in most populations for cancers of the colon, breast and ovary and for skin melanoma. Longitudinal data from England and Wales suggested widening over time of social class differences in men for all cancers combined and for cancers of the lung, larynx and stomach, and in women for all cancers combined and for cervical cancer.

Adolescent↗
PubMed1997

Infection with Helicobacter pylori and parasites, social class and cancer.

Three genera of parasites are known or suspected risk factors for cancer in humans: Schistosoma, Opisthorchis and Clonorchis. No adequate information is available on the determinants of infections related to social class. Infection with the bacterium Helicobacter pylori is an important cause of stomach cancer. Studies, in particular from the United Kingdom and the United States of America, strongly suggest that social class factors, especially those acting during childhood, are determinants of the infection, with odds ratios of seroprevalence of the order of 1.5-5 for lower social class as compared with higher social class. A conservative estimate of the contribution of social class, acting through an increased prevalence of H. pylori infection, to the burden of stomach cancer gives a figure of over 50,000 stomach cancers per year worldwide, or 8% of all stomach cancers. In countries with both high and low prevalence of infection with H. pylori, it is likely that a sizeable proportion of this difference is due to social-class-related risk factors of infection.

Child↗
PubMed1997

Exposure to occupational carcinogens and social class differences in cancer occurrence.

It has been estimated that occupational exposures are responsible for about 4% of all human cancers in industrialized countries. These cancers are concentrated among manual workers and in the lower social classes, thus contributing to the social class gradient in cancer incidence and mortality. On the basis of the 1971 cancer mortality data from England and Wales, it was estimated that occupational cancer is responsible for about a third of the total cancer difference between high (I, II and III-NM) and low (III-M, IV and V) social classes, and for about half of the difference for lung and bladder cancer. However, direct evidence on the extent of the contribution of occupational exposure to carcinogens to social class differences is lacking, and several problems, such as the possible interaction between carcinogens and the effect of extraoccupational confounding factors, add further elements of uncertainty.

Carcinogens↗
PubMed1997

Environmental exposure, social class, and cancer risk.

Exposure to a variety of environmental factors associated with cancer occurrence varies by social class. These factors include air pollutants (SO2, NO2, total suspended particulates, etc.), toxic waste hazards, and ionizing and other radiation. Heavy environmental pollution has been associated with an increased risk of some cancers and in particular lung cancer. There is limited evidence suggesting that individuals from lower social classes are exposed to higher levels of environmental pollutants than are individuals from higher social classes. This may be due to the placement of new sources of pollution or of toxic processes in disadvantaged areas, or to the selective migration of the poorer sectors of society to these areas. The available data do not allow any conclusion on the possible contribution of exposure to environmental pollution to social class differences in cancer occurrence. Exposure to ultraviolet (UV) radiation, principally from sunlight, is modified strongly by personal behaviours such as choice of recreation and use of protective clothing. Those in outdoor occupations are likely to receive the highest cumulative exposure to UV radiation. There is no clear evidence from recent survey research in Australia and North America that socioeconomic factors are strongly related to non-occupational exposure to UV radiation. Information is lacking on the influence of socioeconomic status on sun exposure in other parts of the world. There is little information on the social distribution of exposure to ionizing radiation.

Adolescent↗
PubMed1996

Exposure to styrene and mortality from nervous system diseases and mental disorders.

Chronic low-dose exposure to solvents has been associated in epidemiologic studies with chronic neurotoxicity, but the evidence is not consistent. Styrene causes acute disturbances in the central and peripheral nervous systems. To determine if exposure to styrene may contribute to chronic diseases of the central nervous system, the authors examined mortality from nervous system diseases, mental disorders, and suicide in relation to styrene exposure in an international historical cohort study. The cohort involved 35,443 workers employed during 1945-1991 in the reinforced plastics industry, where high exposures to styrene occur. Indicators of exposure were reconstructed through job histories and environmental and biologic monitoring data. Poisson regression was used for internal comparisons. Mortality from diseases of the central nervous system (27 deaths) increased with time since first exposure, duration of exposure, average level of exposure, and cumulative exposure to styrene. A quadratic model described best the dose-response shape for cumulative exposure and duration of exposure with the highest risks at around 300 ppm-years and 5 years, respectively, and a subsequent decrease in risk in the highest exposure categories. Mortality from epilepsy increased monotonically with all styrene exposure indicators, while associations for degenerative diseases of the central nervous system were generally weaker. Mortality from mental disorders and suicide decreased with increasing duration of exposure and cumulative exposure, while there was no trend with time since first exposure and average exposure to styrene. These findings suggest that, in addition to the known acute effects, exposure to styrene may contribute to chronic diseases of the central nervous system.

Cause of Death↗
PubMed1996

Bladder cancer and occupation: a case-control study in northern Italy.

OBJECTIVES: A hospital based case-control study was conducted between 1992 and 1993 in the province of Brescia, a highly industrialised area in northern Italy, to evaluate occupational risk factors of bladder cancer. METHODS: The study evaluated 355 histologically confirmed cases of bladder cancer (275 men, 80 women) and 579 controls affected by urological non-neoplastic diseases (397 men, 182 women). Lifetime occupational history, smoking and drinking habits, and sociodemographic characteristics were recorded by means of a structured questionnaire. Odds ratios (ORs) were computed with adjustment for age, smoking, alcohol and coffee consumption, education, and place of residence. RESULTS: A significant (P < 0.05) increase of risk of bladder cancer were found in men for labourers in the construction industry (OR 2.1, 95% confidence interval (95% CI) 1.1-3.9) and for recreational and cultural services (OR 5.0, 95% CI 1.3-18.9). Increased risks, although not significant, were found for various other occupations and industries such as machinery mechanics, metal processers and polishers, blacksmiths, gunsmiths, painters; for transport workers, an increased risk with increasing duration of employment was found. CONCLUSIONS: Occupational exposures seem to contribute to bladder cancer risk in the area under study.

Adult↗
PubMed1996

Cancer mortality among shoe manufacturing workers: an analysis of two cohorts.

OBJECTIVES: To examine the cancer risk of shoe manufacturing workers and evaluate whether the risk was associated with exposure to leather dust and solvents. METHODS: Data from two historical cohort studies of shoe workers were expanded and analysed in parallel. A total of 4215 shoemakers from England contributing 103 726 person-years at risk and 2008 shoemakers from Florence, Italy, contributing 54,395 person-years at risk were included in the analysis. Exposure to leather dusts and solvents from glues was evaluated on the basis of job title information. Standardised mortality ratios (SMR) were calculated as ratios of observed deaths (Obs) over expected derived from national mortalities. RESULTS: Overall mortality was lower than expected in both cohorts (English cohort: Obs 3314, SMR 81, 95% confidence interval (95% CI) 78-84; Florence cohort: Obs 333, SMR 87, 95% CI 78-97). An increased risk of nasal cancer was found (English cohort: Obs 12, SMR 741; Florence cohort: Obs 1, SMR 909). 10 of the 13 cases occurred among English workers employed in the manufacture of welted boots (SMR 926, 95% CI 444-1703), a sector of the industry thought to have had the highest exposure to leather dust. Mortality from leukaemia was not increased in the English cohort (Obs 16, SMR 89), but was increased in the Florence cohort (Obs 8, SMR 214, 95% CI 92-421); and the highest risk was found among shoe workers in Florence who were first exposed between 1950 and 1959 when exposure to benzene was substantial (Obs 3, SMR 536, 95% CI 111-1566). Some evidence for an excess risk of stomach, bladder, and kidney cancer, as well as multiple myeloma and non-Hodgkin's lymphoma was also found in the Florence cohort only among workers employed in jobs with the highest exposure to solvents. CONCLUSIONS: These findings confirm the associations between exposure to leather dust and nasal cancer and between exposure to benzene and leukaemia in the shoe manufacturing industry and suggest that the risk of other cancers may be increased among workers exposed to solvents or glues.

Adult↗
PubMed1996

Exposure to styrene and mortality from nonmalignant respiratory diseases.

A cohort of 34,560 men and 6128 women employed in 660 European factories manufacturing reinforced plastic products, followed up originally to assess the risk of cancer, was used to assess the risk of non-malignant respiratory diseases associated with exposure to styrene. Mortality from pneumonia was associated with intensity of exposure to styrene, but this may have been due to chance. Mortality from bronchitis, emphysema, and asthma was not associated with styrene exposure.

Cohort Studies↗
PubMed1996

Mortality in a cohort of Russian fertilizer workers.

OBJECTIVES: The study evaluated the mortality of workers exposed to precursors of N-nitroso compounds in a Russian fertilizer plant. METHODS: Workers employed at least two years between 1945 and 1985 in production departments or other services were included in the cohort, which comprised 2039 men and 2957 women followed from 1965 to 1990. The standardized mortality ratios (SMR) were calculated using cause-specific death rates for the Moscow region as reference. An internal comparison was carried out using Poisson regression modeling. Exposure to arsenic, nitrogen oxides, and sulfur dioxide was estimated from an industrial hygiene survey. RESULTS: The production and other workers had no excess of mortality from all causes or all neoplasms. However the male production workers had excess mortality from all cancers combined (SMR 143) and lung cancer (SMR 186) after a latency period of > or = 20 years. Men with the highest exposure to nitrogen oxides had a twofold increase in mortality from stomach cancer, with a marginally significant increasing trend between stomach cancer and cumulative exposure to nitrogen oxides for both genders. Excess mortality from all cancers and stomach cancer was found for the worker with the highest average exposure to arsenic, and excess lung cancer mortality could be attributed to exposure to arsenic. CONCLUSIONS: The investigation showed a weak association between employment in a fertilizer production plant and increased mortality from cancer. The results somewhat support the hypothesis that occupational exposure to precursors of N-nitroso compounds increases the risk of stomach cancer mortality, as does exposure to arsenic.

Arsenic↗
PubMed1996

Exposure to styrene and mortality from nonmalignant diseases of the genitourinary system.

OBJECTIVES: A historical cohort study was carried out to investigate mortality from nonmalignant diseases of the genitourinary system among workers in the reinforced plastics industry, where high workroom concentrations of styrene are encountered. METHODS: The external comparisons in this report were based on an average of 12.6 years of retrospective follow-up of 35 443 workers who were first employed in the reinforced plastics industry during 1945-1991 and were known to have been exposed to styrene in their work. For the internal comparisons, 2641 subjects with incomplete occupational histories were excluded, leaving 32 802 subjects. Previous individual exposure histories to styrene were reconstructed through job histories and environmental and biological monitoring data. RESULTS: Mortality from nonmalignant diseases of the genitourinary system (N = 20) was associated with average exposure to styrene (P for trend 0.05). Weaker increasing trends in risk were seen for time since first exposure and cumulative exposure, while no increase was identified for duration of exposure. There was a significant increasing trend in mortality from nephritis and nephrosis (N = 5), associated with an increasing average level of exposure to styrene (P for trend 0.03). No clear trend was observed for time since first exposure, duration of exposure, or cumulative exposure. CONCLUSIONS: In this large cohort study of workers exposed to styrene, mortality from nonmalignant diseases of the genitourinary system increased as the average intensity of exposure increased. This finding indicates that other data should be scrutinized.

Air Pollutants, Occupational↗
PubMed1996

Occupation and the risk of lung cancer in Uruguay.

OBJECTIVES: The purpose of this study was to provide more information regarding the risk of lung cancer associated with asbestos, and other exposures in the Uruguayan work force. METHODS: This multisite case-referent study was part of a large project designed for evaluating the role of occupational exposures in cancer risk in Uruguay. According to the design employed, cases were a subset of the data base corresponding to a particular site (in this instance lung cancer), and they were compared with all other sites combined (referents). RESULTS: Significant increases in risk associated with workers in the construction industry were mainly observed for squamous-cell carcinoma. Asbestos, silica dust, and DDT (dichlorodiphenyltrichloroethane) exposure were also associated with increases in the risk of lung cancer. Pipefitters, bakers, and textile workers were also at increased risk of developing lung cancer. CONCLUSIONS: Workers employed in the construction industry, as well as those exposed to DDT may have an excess risk of lung cancer. These findings are particularly important in showing that developing countries like Uruguay display risk patterns of similar magnitude as those observed in developed communities.

Adult↗