Objective To investigate the long-term mortality of a cohort of Italian asbestos miners.
Methods The cohort included 1056 men employed in a chrysotile mine between 1930 and 1990, who were followed up during 1946–2014, for a total of 37 471 person-years of observation. Expected deaths and SMRs were computed using national and local (after 1980, when available) reference.
Results A total of 294 (27.8%) subjects were alive and at the end of follow-up, 722 (68.4%) were dead and 40 (3.8%) were lost to follow-up. The SMR for overall mortality was 1.35 (95%CI 1.25 to 1.45). The SMR for pleural cancer, based on seven observed deaths, was 5.54 (95% CI 2.22 to 11.4) and related to time since first exposure, but not to duration of employment, cumulative exposure or time since last exposure. The SMR for lung cancer was 1.16 (95% CI 0.87 to 1.52; 53 observed deaths), with no excess among workers with cumulative exposure below 100 fibre/mL-years (SMR 0.82; 95% CI 0.44 to 1.40).
Conclusions The update of the follow-up of this cohort confirmed an increased mortality from pleural cancer mortality in miners exposed to chrysotile and a lack of significant increase in lung cancer mortality.
- pleural cancer
- lung cancer
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Contributors EP, CR, CLV and PB designed the study. EP and CR established the cohorts. EP, CR and CLV were involved in previous analyses of this cohort. FD acquired the additional mortality data. CP contributed to the statistical analysis. PB and EP drafted the manuscript. All authors reviewed and approved the manuscript.
Competing interests EP and CR reported personal fees for the defence from several law firms, outside the submitted work. CLV reported personal fees from expert opinion for the court and the defence in asbestos litigation, excluding mining and manufacturing, outside the submitted work. PB reported personal fees from expert witness for the defence in asbestos-related litigation, outside the submitted work.
Provenance and peer review Not commissioned; externally peer reviewed.