A Case–Control Study of Lung Cancer Nested in a Cohort of European Asphalt Workers

BACKGROUND: We conducted a nested case-control study in a cohort of European asphalt workers in which an increase in lung cancer risk has been reported among workers exposed to airborne bitumen fume, although potential bias and confounding were not fully addressed. OBJECTIVE: We investigated the contribution of exposure to bitumen, other occupational agents, and tobacco smoking to the risk of lung cancer among asphalt workers. METHODS: Cases were cohort members in Denmark, Finland, France, Germany, the Netherlands, Norway, and Israel who had died of lung cancer between 1980 and the end of follow-up (2002-2005). Controls were individually matched in a 3:1 ratio to cases on year of birth and country. We derived exposure estimates for bitumen fume and condensate, organic vapor, and polycyclic aromatic hydrocarbons, as well as for asbestos, crystalline silica, diesel motor exhaust, and coal tar. Odds ratios (ORs) were calculated for ever-exposure, duration, average exposure, and cumulative exposure after adjusting for tobacco smoking and exposure to coal tar. RESULTS: A total of 433 cases and 1,253 controls were included in the analysis. The OR was 1.12 [95% confidence interval (CI), 0.84-1.49] for inhalation exposure to bitumen fume and 1.17 (95% CI, 0.88-1.56) for dermal exposure to bitumen condensate. No significant trend was observed between lung cancer risk and duration, average exposure, or cumulative exposure to bitumen fume or condensate. CONCLUSIONS: We found no consistent evidence of an association between indicators of either inhalation or dermal exposure to bitumen and lung cancer risk. A sizable proportion of the excess mortality from lung cancer relative to the general population observed in the earlier cohort phase is likely attributable to high tobacco consumption and possibly to coal tar exposure, whereas other occupational agents do not appear to play an important role

"Che tempo fa?" Indagine sul grado di Soddisfazione dei servizi offerti dal Centro Basaglia: l'opinione dei pazienti.

Studio costituito da una prima parte nella quale viene presentata l’evoluzione storica del Sistema Sanitario Nazionale italiano presentando successivamente i piani sanitari odierni in materia di salute mentale; l’importanza della valutazione della soddisfazione del servizio in salute mentale per migliorare la qualità di vita degli utenti apprendendo l’evoluzione dello stesso concetto e della sua importanza. Nella seconda parte della tesi verrà descritto nello specifico la rete dei servizi nel settore della salute mentale svolte sul territorio pisano con un attenzione particolare al Centro Basaglia, luogo in cui è stato possibile raccogliere i dati a testimonianza di tale ricerca

American College of Rheumatology Provisional Criteria for Clinically Relevant Improvement in Children and Adolescents With Childhood-Onset Systemic Lupus Erythematosus

10.1002/acr.23834ARTHRITIS CARE & RESEARCH715579-59