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DOSE-RESPONSE RELATIONSHIPS IN HUMAN EXPERIMENTAL EXPOSURE TO SOLVENTS
Previous studies carried out in the field of experimental toxicology have shown evidence of biphasic dose-response relationships for different experimental models, endpoints and chemicals tested. As these studies excluded humans as the experimental model, we have examined the literature of the last three decades in order to verify data concerning human experimental exposure with the aim of highlighting possible biphasic dose-response relationships. The substances used for experimental exposures included hydrocarbons, esters, alcohols, ketones, ethers, glycoethers, halogenated hydrocarbons, and carbon sulphide; the absorption route was inhalation. We did not detect any biphasic dose-response relationship and, in the studies reviewed, our examination revealed major methodological limitations that prevented us making a more detailed examination of experimental data. We concluded that the experimental data available did not allow us to support evidence of biphasic dose-response relationships in human experimental exposure to the above-mentioned chemical substances
Predictors of Lung Cancer Risk: An Ecological Study Using Mortality and Environmental Data by Municipalities in Italy
Lung cancer (LC) mortality remains a consistent part of the total deaths occurring world-wide. Its etiology is complex as it involves multifactorial components. This work aims in providing an epidemiological assessment on occupational and environmental factors associated to LC risk by means of an ecological study involving the 8092 Italian municipalities for the period 2006–2015. We consider mortality data from mesothelioma as proxy of asbestos exposure, as well as PM2.5 and radon levels as a proxy of environmental origin. The compensated cases for occupational respiratory diseases, urbanization and deprivation were included as predictors. We used a negative binomial distribution for the response, with analysis stratified by gender. We estimated that asbestos is responsible for about 1.1% (95% CI: 0.8, 1.4) and 0.5% (95% CI: 0.2, 0.8) of LC mortality in males and females, respectively. The corresponding figures are 14.0% (95% CI: 12.5, 15.7) and 16.3% (95% CI: 16.2, 16.3) for PM2.5 exposure, and 3.9% (95% CI: 3.5, 4.2) and 1.6% (95% CI: 1.4, 1.7) for radon expo-sure. The assessment of determinants contribution to observed LC deaths is crucial for improving awareness of its origin, leading to increase the equity of the welfare system
Arretium or Arezzo? A Neural Approach to the Identification of Place Names in Historical Texts
This paper presents the application of a neural architecture to the identification of place names in English historical texts. We test the impact of different word embeddings and we compare the results to
the ones obtained with the Stanford NER module of CoreNLP before and after the retraining using a novel corpus of manually annotated historical travel writings
Mesothelioma incidence surveillance systems and claims for workers’ compensation. Epidemiological evidence and prospects for an integrated framework
<p>Abstract</p> <p>Background</p> <p>Malignant mesothelioma is an aggressive and lethal tumour strongly associated with exposure to asbestos (mainly occupational). In Italy a large proportion of workers are protected from occupational diseases by public insurance and an epidemiological surveillance system for incident mesothelioma cases.</p> <p>Methods</p> <p>We set up an individual linkage between the Italian national mesothelioma register (ReNaM) and the Italian workers’ compensation authority (INAIL) archives. Logistic regression models were used to identify and test explanatory variables.</p> <p>Results</p> <p>We extracted 3270 mesothelioma cases with occupational origins from the ReNaM, matching them with 1625 subjects in INAIL (49.7%); 91.2% (1,482) of the claims received compensation. The risk of not seeking compensation is significantly higher for women and the elderly. Claims have increased significantly in recent years and there is a clear geographical gradient (northern and more developed regions having higher claims rates). The highest rates of compensation claims were after work known to involve asbestos.</p> <p>Conclusions</p> <p>Our data illustrate the importance of documentation and dissemination of all asbestos exposure modalities. Strategies focused on structural and systematic interaction between epidemiological surveillance and insurance systems are needed.</p
The epidemiology of malignant mesothelioma in women: gender differences and modalities of asbestos exposure
INTRODUCTION: The epidemiology of gender differences for mesothelioma incidence has been rarely discussed in national case lists. In Italy an epidemiological surveillance system (ReNaM) is working by the means of a national register. METHODS: Incident malignant mesothelioma (MM) cases in the period 1993 to 2012 were retrieved from ReNaM. Gender ratio by age class, period of diagnosis, diagnostic certainty, morphology and modalities of asbestos exposure has been analysed using exact tests for proportion. Economic activity sectors, jobs and territorial distribution of mesothelioma cases in women have been described and discussed. To perform international comparative analyses, the gender ratio of mesothelioma deaths was calculated by country from the WHO database and the correlation with the mortality rates estimated. RESULTS: In the period of study a case list of 21 463 MMs has been registered and the modalities of asbestos exposure have been investigated for 16 458 (76.7%) of them. The gender ratio (F/M) was 0.38 and 0.70 (0.14 and 0.30 for occupationally exposed subjects only) for pleural and peritoneal cases respectively. Occupational exposures for female MM cases occurred in the chemical and plastic industry, and mainly in the non-asbestos textile sector. Gender ratio proved to be inversely correlated with mortality rate among countries. CONCLUSIONS: The consistent proportion of mesothelioma cases in women in Italy is mainly due to the relevant role of non-occupational asbestos exposures and the historical presence of the female workforce in several industrial settings. Enhancing the awareness of mesothelioma aetiology in women could support the effectiveness of welfare system and prevention policies
The epidemiology of malignant mesothelioma in women: gender differences and modalities of asbestos exposure
ntroduction The epidemiology of gender differences
for mesothelioma incidence has been rarely discussed in
national case lists. In Italy an epidemiological surveillance
system (ReNaM) is working by the means of a national
register.
Methods Incident malignant mesothelioma (MM)
cases in the period 1993 to 2012 were retrieved from
ReNaM. Gender ratio by age class, period of diagnosis,
diagnostic certainty, morphology and modalities of
asbestos exposure has been analysed using exact
tests for proportion. Economic activity sectors, jobs
and territorial distribution of mesothelioma cases in
women have been described and discussed. To perform
international comparative analyses, the gender ratio of
mesothelioma deaths was calculated by country from the
WHO database and the correlation with the mortality
rates estimated.
Results In the period of study a case list of 21 463
MMs has been registered and the modalities of asbestos
exposure have been investigated for 16 458 (76.7%) of
them. The gender ratio (F/M) was 0.38 and 0.70 (0.14
and 0.30 for occupationally exposed subjects only) for
pleural and peritoneal cases respectively. Occupational
exposures for female MM cases occurred in the chemical
and plastic industry, and mainly in the non-asbestos
textile sector. Gender ratio proved to be inversely
correlated with mortality rate among countries.
Conclusions The consistent proportion of
mesothelioma cases in women in Italy is mainly due to
the relevant role of non-occupational asbestos exposures
and the historical presence of the female workforce in
several industrial settings. Enhancing the awareness of
mesothelioma aetiology in women could support the
effectiveness of welfare system and prevention policie
Letter concerning:‘Response to:‘The epidemiology of malignant mesothelioma in women: gender differences and modalities of asbestos exposure’by Marinaccio et al’
Finkelstein1 invited physicians and researchers interested in mesothelioma to investigate on past usage of talcum powders by affected people. In Italy, asbestos contamination in talc for industrial use has been documented,2 and, as he underlines tremolite contamination at low levels of cosmetic and pharmaceutical talc has been reported in USA by Blount3 and Gordon and colleagues.4
In the Italian National Mesothelioma Register (ReNaM), the analysis of intensive exposure to talc has been evaluated with respect to occupational and environmental history. The catalogue of possible asbestos exposure circumstances (a tool for the interviewers) reports the potential presence of industrial talcs in quarries or mines working activities, in leather tanning and in rubber industries. The use of intensive cosmetic talc for personal use is evaluated by means of a structured questionnaire,5 as reported in the ReNaM guidelines (see https://www.inail.it/cs/internet/docs/all-linee-guida-renam.pdf?section=attivita, p82, p98, in Italian).
In our paper regarding gender differences in mesothelioma epidemiology,6 we have presented figures referring to 21 463 MM cases detected by ReNaM with a diagnosis between 1993 and 2012. Among female case list (6087 cases), 4374 cases (71.9%) have been interviewed for defining exposure. During the interview, 30 MM female cases referred an intensive use of talc in the context of occupational or life habits. For five of them, the regional centre has identified an exposure to asbestos due to intensive talc use, classifying such modality of exposure as ‘leisure activities’ (see ReNaM guidelines5). For the remaining 25 cases, an occupational exposure to asbestos in other working (or familiar or environmental) circumstances has been identified and coded.
Registry data such as those provided by ReNaM cannot provide estimates of the mesothelioma risk associated with any particular exposure circumstance. We plan to include talc exposure at work and cosmetic talc usage in the analyses of a case–control study on pleural mesothelioma currently under way. A specific survey to compare and discuss how the modalities of exposure to talc have been evaluated in patients with mesothelioma in countries where epidemiological surveillance systems are active could improve knowledge and support prevention policies
La prevención de las patologÃas del asbesto: perspectivas operativas de la cooperación italiana con los paÃses de américa latina
El propósito del presente artÃculo es valorar la tesis de que el impacto en la salud de la exposición a fibras de asbesto presentes en los lugares de trabajo y en el ambiente, requiere contramedidas basadas en la evidencia cientÃfica y la cooperación internacional. La evidencia cientÃfica adquirida en el ámbito internacional sobre el asbesto, la experiencia pluridecenal madurada en Italia sobre este tema, asà como la conciencia de que la adopción de medidas para combatir los efectos en la salud causados por la exposición a asbesto, deben ser verificadas considerando la especificidad de los diversos contextos nacionales y locales en América Latina. Constituyen la base para la identificación de las cuatro principales directrices de intervención (Promoción del acceso a la documentación sobre el asbesto; Realización de intervenciones para reducir la exposición al asbesto; Vigilancia sanitaria de los sujetos expuestos; Detección del mesotelioma) que pueden ser desarrolladas en el ámbito de la cooperación técnico-cientÃfica entre Italia y los paÃses de América Latina. La integración de las capacidades de los investigadores colombianos e italianos permitirá obtener estos resultados, contribuyendo al proceso de eliminación del asbesto, ya en curso en América Latin
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