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Renier M, Hippert J, Louis-Bastien W, Tual S, Meryet-Figuiere M, Vigneron N, Marcotullio E, Baldi I, Lebailly P. Agricultural exposure and risk of ovarian cancer in the AGRIculture and CANcer (AGRICAN) cohort. Occup Environ Med 2024; 81:75-83. [PMID: 38199811 DOI: 10.1136/oemed-2023-109089] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2023] [Accepted: 12/17/2023] [Indexed: 01/12/2024]
Abstract
BACKGROUND Ovarian cancer is rare with a poor prognosis and few established risk factors. Hormones and reproductive factors significantly impact its development, suggesting a potential link with endocrine disrupters. METHODS In the AGRICAN cohort, 59 391 female farmers completed data on lifelong agricultural exposures and reproductive life. Cox models with attained age as timescale (HR and 95% CI) were used. The role of hormonal factors as potential confounders was considered along with specific time windows for exposure (childhood, puberty and menopause). Female farmers were the reference group (for the principal analyses). RESULTS Between enrolment (2005-2007) and the end of follow-up (31 December 2017), 262 incident ovarian cancers were identified. An increased risk was observed for females involved in pigs (HR=2.12 (95% CI 1.27 to 3.52)) including during puberty (HR=1.83 (95% CI 1.13 to 2.94)), fruit-growing (HR=2.17 (95% CI 1.09 to 4.30)) and potato seed treatment (HR=2.81 (95% CI 1.29 to 6.09)). Conversely, females born on farms growing grain cereals (HR=0.64 (95% CI 0.46 to 0.90)) or pig-breeding (HR=0.78 (95% CI 0.55 to 1.12)) presented a reduced risk of ovarian cancer. Triazine herbicide exposure was not associated with ovarian cancer. The effect of agricultural exposures remained unchanged in multivariate models considering contraception, parity, puberty age, menopause age and body mass index. CONCLUSION This study is the first to assess the association between specific agricultural exposures and ovarian cancer comprehensively. Some of the positive associations observed suggest that some pesticide exposure (especially during puberty) could play a role in the development of ovarian cancer. On the other hand, agricultural exposure during early life could have a protective effect, as observed for lung cancer among farmers. Finally, we did not confirm the previous putative effect of exposure to triazine herbicides.
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Affiliation(s)
- Marine Renier
- Institut National de la Santé et de la Recherche Médicale (INSERM), Unité mixte de Recherche (UMR) 1086 ANTICIPE, Caen, France
- Centre François Baclesse Centre de Lutte Contre le Cancer, Caen, France
- Université de Caen Normandie, Caen, France
| | - Juliette Hippert
- Institut National de la Santé et de la Recherche Médicale (INSERM), Unité mixte de Recherche (UMR) 1086 ANTICIPE, Caen, France
- Centre François Baclesse Centre de Lutte Contre le Cancer, Caen, France
- Université de Caen Normandie, Caen, France
| | - Weiswald Louis-Bastien
- Institut National de la Santé et de la Recherche Médicale (INSERM), Unité mixte de Recherche (UMR) 1086 ANTICIPE, Caen, France
- Centre François Baclesse Centre de Lutte Contre le Cancer, Caen, France
- Université de Caen Normandie, Caen, France
| | - Séverine Tual
- Institut National de la Santé et de la Recherche Médicale (INSERM), Unité mixte de Recherche (UMR) 1086 ANTICIPE, Caen, France
- Centre François Baclesse Centre de Lutte Contre le Cancer, Caen, France
- Université de Caen Normandie, Caen, France
| | - Matthieu Meryet-Figuiere
- Institut National de la Santé et de la Recherche Médicale (INSERM), Unité mixte de Recherche (UMR) 1086 ANTICIPE, Caen, France
- Centre François Baclesse Centre de Lutte Contre le Cancer, Caen, France
- Université de Caen Normandie, Caen, France
| | - Nicolas Vigneron
- Institut National de la Santé et de la Recherche Médicale (INSERM), Unité mixte de Recherche (UMR) 1086 ANTICIPE, Caen, France
- Centre François Baclesse Centre de Lutte Contre le Cancer, Caen, France
- Registre général des tumeurs du Calvados, Caen, France
| | | | - Isabelle Baldi
- INSERM, Bordeaux Population Health Research Center, Team EPICENE, UMR 1219, Université de Bordeaux, Bordeaux, France
- CHU de Bordeaux, Pôle de Santé Publique, Service de Médecine du Travail et Pathologies Professionnelles, Bordeaux, France
| | - Pierre Lebailly
- Institut National de la Santé et de la Recherche Médicale (INSERM), Unité mixte de Recherche (UMR) 1086 ANTICIPE, Caen, France
- Centre François Baclesse Centre de Lutte Contre le Cancer, Caen, France
- Université de Caen Normandie, Caen, France
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Fazzo L, Minelli G, De Santis M, Ceccarelli E, Iavarone I, Zona A. The Epidemiological Surveillance of Mesothelioma Mortality in Italy as a Tool for the Prevention of Asbestos Exposure. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:5957. [PMID: 37297561 PMCID: PMC10252364 DOI: 10.3390/ijerph20115957] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/23/2023] [Revised: 05/17/2023] [Accepted: 05/19/2023] [Indexed: 06/12/2023]
Abstract
As part of a surveillance plan active since the early 1990s, this study evaluates malignant mesothelioma (MM) mortality for the time-window 2010-2019 in Italy, a country that banned asbestos in 1992. National and regional mortality rates for MM, and municipal standardized mortality ratios (all mesotheliomas, pleural (MPM) and peritoneal (MPeM)), by gender and age group were calculated. A municipal clustering analysis was also performed. There were 15,446 deaths from MM (11,161 males, 3.8 × 100,000; 4285 females, 1.1 × 100,000), of which 12,496 were MPM and 661 were MPeM. In the study period, 266 people ≤50 years died from MM. A slightly decreasing rate among males since 2014 was observed. The areas at major risk hosted asbestos-cement plants, asbestos mines (chrysotile in Balangero), shipyards, petrochemical and chemical plants, and refineries. Female mortality excesses particularly were found in municipalities with a fluoro-edenite-contaminated mine (Biancavilla) and textile facilities. Excesses were also found in a region with the presence of natural asbestos fibres and in males living in two small islands. The Italian National Prevention Plan stated recommendations to eliminate asbestos exposures and to implement health surveillance and healthcare for people exposed to asbestos.
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Affiliation(s)
- Lucia Fazzo
- Department of Environment and Health, Istituto Superiore di Sanità, 00161 Rome, Italy; (M.D.S.); (I.I.); (A.Z.)
| | - Giada Minelli
- Statistical Service, Istituto Superiore di Sanità, 00161 Rome, Italy; (G.M.); (E.C.)
| | - Marco De Santis
- Department of Environment and Health, Istituto Superiore di Sanità, 00161 Rome, Italy; (M.D.S.); (I.I.); (A.Z.)
| | - Emiliano Ceccarelli
- Statistical Service, Istituto Superiore di Sanità, 00161 Rome, Italy; (G.M.); (E.C.)
| | - Ivano Iavarone
- Department of Environment and Health, Istituto Superiore di Sanità, 00161 Rome, Italy; (M.D.S.); (I.I.); (A.Z.)
| | - Amerigo Zona
- Department of Environment and Health, Istituto Superiore di Sanità, 00161 Rome, Italy; (M.D.S.); (I.I.); (A.Z.)
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Slavik CE, Demers PA, Tamburic L, Warden H, McLeod C. Do patterns of past asbestos use and production reflect current geographic variations of cancer risk?: mesothelioma in Ontario and British Columbia, Canada. Cancer Causes Control 2023; 34:349-360. [PMID: 36729166 PMCID: PMC9971118 DOI: 10.1007/s10552-023-01672-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2022] [Accepted: 01/20/2023] [Indexed: 02/03/2023]
Abstract
PURPOSE Canada was a major global asbestos producer and consumer. Geographic patterns of Canadian asbestos use and mesothelioma, a highly fatal cancer linked to asbestos exposure, have not been previously reported. This study summarized key trends in mesothelioma incidence by geography and time in two Canadian provinces, Ontario and British Columbia (BC), and explored how past workforce characteristics and geographic trends in asbestos production and use may shape variations in regional rates of mesothelioma. METHODS We report trends in mesothelioma incidence (1993-2016) for Ontario and British Columbia using population-based incidence data that were age-standardized to the 2011 Canadian population. Historical records of asbestos production and use were analyzed to geo-locate industrial point sources of asbestos in Ontario and BC. The prevalence of occupations in regions with the highest and lowest rates of mesothelioma in Ontario and BC were calculated using labor force statistics from the 1981 Canadian Census. RESULTS Regional mesothelioma rates varied in both provinces over time; more census divisions in both Ontario and BC registered mesothelioma rates in the highest quintile of incidences during the period 2009 to 2016 than in any prior period examined. Certain occupations such as construction trades workers were more likely to be overrepresented in regions with high mesothelioma rates. CONCLUSION This work explored how studying asbestos exposure and mesothelioma incidence at small-scale geographies could direct cancer surveillance and research to more targeted areas. Findings indicated that regional variations in mesothelioma could signal important differences in past occupational and potentially environmental exposures.
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Affiliation(s)
- Catherine E. Slavik
- grid.419887.b0000 0001 0747 0732Occupational Cancer Research Centre, Ontario Health (Cancer Care Ontario), Toronto, ON M5G 1X3 Canada
| | - Paul A. Demers
- grid.419887.b0000 0001 0747 0732Occupational Cancer Research Centre, Ontario Health (Cancer Care Ontario), Toronto, ON M5G 1X3 Canada ,grid.17063.330000 0001 2157 2938Dalla Lana School of Public Health, University of Toronto, Toronto, ON M5T 3M7 Canada
| | - Lillian Tamburic
- grid.17091.3e0000 0001 2288 9830Partnership for Work, Health and Safety, School of Population and Public Health, University of British Columbia, Vancouver, BC V6T 1Z3 Canada
| | - Hunter Warden
- grid.419887.b0000 0001 0747 0732Occupational Cancer Research Centre, Ontario Health (Cancer Care Ontario), Toronto, ON M5G 1X3 Canada ,grid.17063.330000 0001 2157 2938Faculty of Medicine, University of Toronto, Toronto, ON M5S 1A8 Canada
| | - Christopher McLeod
- grid.17091.3e0000 0001 2288 9830Partnership for Work, Health and Safety, School of Population and Public Health, University of British Columbia, Vancouver, BC V6T 1Z3 Canada
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Spinazzè A, Consonni D, Borghi F, Rovelli S, Cattaneo A, Zellino C, Dallari B, Pesatori AC, Kromhout H, Peters S, Riboldi L, Cavallo DM, Mensi C. Asbestos Exposure in Patients with Malignant Pleural Mesothelioma included in the PRIMATE Study, Lombardy, Italy. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19063390. [PMID: 35329075 PMCID: PMC8949216 DOI: 10.3390/ijerph19063390] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/24/2022] [Revised: 03/04/2022] [Accepted: 03/11/2022] [Indexed: 12/04/2022]
Abstract
The PRIMATE study is an Italian translational research project, which aims to identify personalized biomarkers associated with clinical characteristics of malignant pleural mesothelioma (MPM). For this purpose, characteristics of MPM patients with different degrees of asbestos exposure will be compared to identify somatic mutations, germline polymorphism, and blood inflammatory biomarkers. In this framework, we assessed exposure to asbestos for 562 cases of MPM extracted from the Lombardy region Mesothelioma Registry (RML), for which a complete interview based on a standardized national questionnaire and histopathological specimens were available. Exposure assessment was performed: (1) through experts' evaluation (considered as the gold standard for the purpose of this study), according to the guidelines of the Italian National Mesothelioma Registry (ReNaM) and (2) using a job-exposure matrix (SYN-JEM) to obtain qualitative (ever/never) and quantitative estimates of occupational asbestos exposure (cumulative exposure expressed in fibers per mL (f/mL)). The performance of SYN-JEM was evaluated against the experts' evaluation. According to experts' evaluation, occupational asbestos exposure was recognized in 73.6% of men and 23.6% of women; furthermore, 29 men (7.8%) and 70 women (36.9%) had non-occupational exposure to asbestos. When applying SYN-JEM, 225 men (60.5%) and 25 women (13.2%) were classified as occupationally exposed, with a median cumulative exposure higher for men (1.7 f/mL-years) than for women (1.2 f/mL-years). The concordance between the two methods (Cohen’s kappa) for occupational exposure assessment was 0.46 overall (0.41 in men, and 0.07 in women). Sensitivity was higher in men (0.73) than in women (0.18), while specificity was higher in women (0.88) than in men (0.74). Overall, both methods can be used to reconstruct past occupational exposure to asbestos, each with its own advantages and limitations.
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Affiliation(s)
- Andrea Spinazzè
- Department of Science and High Technology, University of Insubria, 22100 Como, Italy; (F.B.); (S.R.); (A.C.); (D.M.C.)
- Correspondence:
| | - Dario Consonni
- Occupational Health Unit, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy; (D.C.); (C.Z.); (B.D.); (A.C.P.); (L.R.); (C.M.)
| | - Francesca Borghi
- Department of Science and High Technology, University of Insubria, 22100 Como, Italy; (F.B.); (S.R.); (A.C.); (D.M.C.)
| | - Sabrina Rovelli
- Department of Science and High Technology, University of Insubria, 22100 Como, Italy; (F.B.); (S.R.); (A.C.); (D.M.C.)
| | - Andrea Cattaneo
- Department of Science and High Technology, University of Insubria, 22100 Como, Italy; (F.B.); (S.R.); (A.C.); (D.M.C.)
| | - Carolina Zellino
- Occupational Health Unit, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy; (D.C.); (C.Z.); (B.D.); (A.C.P.); (L.R.); (C.M.)
| | - Barbara Dallari
- Occupational Health Unit, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy; (D.C.); (C.Z.); (B.D.); (A.C.P.); (L.R.); (C.M.)
| | - Angela Cecilia Pesatori
- Occupational Health Unit, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy; (D.C.); (C.Z.); (B.D.); (A.C.P.); (L.R.); (C.M.)
- Department of Clinical Sciences and Community Health, University of Milan, 20122 Milan, Italy
| | - Hans Kromhout
- Institute for Risk Assessment Sciences, Utrecht University, 3584 CM Utrecht, The Netherlands; (H.K.); (S.P.)
| | - Susan Peters
- Institute for Risk Assessment Sciences, Utrecht University, 3584 CM Utrecht, The Netherlands; (H.K.); (S.P.)
| | - Luciano Riboldi
- Occupational Health Unit, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy; (D.C.); (C.Z.); (B.D.); (A.C.P.); (L.R.); (C.M.)
| | - Domenico Maria Cavallo
- Department of Science and High Technology, University of Insubria, 22100 Como, Italy; (F.B.); (S.R.); (A.C.); (D.M.C.)
| | - Carolina Mensi
- Occupational Health Unit, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy; (D.C.); (C.Z.); (B.D.); (A.C.P.); (L.R.); (C.M.)
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Mensi C, Zellino C, Polonioli M, Dallari B, Pesatori AC, Riboldi L, Consonni D. Pleural mesothelioma in a circus worker. J Occup Health 2021; 63:e12250. [PMID: 34350658 PMCID: PMC8344853 DOI: 10.1002/1348-9585.12250] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2021] [Revised: 05/17/2021] [Accepted: 06/16/2021] [Indexed: 11/07/2022] Open
Abstract
OBJECTIVES To describe an unusual occupational asbestos exposure in a patient with mesothelioma. METHODS Since 2000, the Lombardy Mesothelioma Registry (LMR) collects cases of malignant mesothelioma (MM) occurring among people residing in the Lombardy Region, North-West Italy, with a population of 10 million inhabitants. For each case, clinical records and asbestos exposure are collected. Each case is then classified in agreement with the guidelines of the National Mesothelioma Registry. RESULTS We identified a male (86 years old), former smoker, who had been working for 53 years as a circus truck driver and tamer of lions and tigers. The first circumstance of exposure was the use of an asbestos tape that wrapped around the hoop in the feline jumping show with a flaming hoop. The second one was the presence of insulating panels protecting the engine placed inside the trucks. CONCLUSION A new MM case with an occupational etiology has been found in the public entertainment, an occupational sector not usually considered at risk for the presence of asbestos.
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Affiliation(s)
- Carolina Mensi
- Occupational Health UnitFondazione IRCCS Ca’ Granda Ospedale Maggiore PoliclinicoMilanItaly
| | - Carolina Zellino
- Occupational Health UnitFondazione IRCCS Ca’ Granda Ospedale Maggiore PoliclinicoMilanItaly
| | - Marco Polonioli
- Post Graduation School of Occupational MedicineUniversità degli Studi di MilanoMilanItaly
| | - Barbara Dallari
- Occupational Health UnitFondazione IRCCS Ca’ Granda Ospedale Maggiore PoliclinicoMilanItaly
| | - Angela Cecilia Pesatori
- Occupational Health UnitFondazione IRCCS Ca’ Granda Ospedale Maggiore PoliclinicoMilanItaly
- Department of Clinical Sciences and Community HealthUniversità degli Studi di MilanoMilanItaly
| | - Luciano Riboldi
- Occupational Health UnitFondazione IRCCS Ca’ Granda Ospedale Maggiore PoliclinicoMilanItaly
| | - Dario Consonni
- Occupational Health UnitFondazione IRCCS Ca’ Granda Ospedale Maggiore PoliclinicoMilanItaly
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