title: Exposure to carcinogens and mortality in a cohort of restoration workers of water-damaged library materials following the River Arno flooding in Florence, 4 November 1966.
abstract: BACKGROUND
  In Florence, Italy, the Arno River overflowed on 4 November 1966 and the rare library collections of the National Central Library in Florence (FNCL) were flooded. A Restoration Centre was immediately set up. For book restoration many toxic chemicals were used, such as chlorinated solvents, ethylene oxide (EtO), formaldehyde, petroleum distillates, and pesticides. The study's aims were: (I) to document the restoration process, (II) to identify the potential chemical exposures, (III) to evaluate the mortality experience of restorers.
  
  
  METHODS
  A small cohort of 168 workers was identified. The restorers were employed in the FNCL's Restoration Centre during the years 1967-1976. We excluded 9 subjects from the analysis because no working period data were available. Mortality from all causes, from all cancers, and from cancers of specific sites was compared with that of the Italian general population. Standardized Mortality Rates (SMRs) and their 95% confidence intervals were estimated.
  
  
  RESULTS
  Restorers were exposed to relatively low levels of several carcinogens. A non-significant excess of cancer mortality was found. Significant increases in brain neoplasm among men and in uterine cancer among women were found,
  
  
  CONCLUSIONS
  The small cohort size hampers interpretation of the results. Larger epidemiology studies on library material restorers are needed in order to evaluate risks in this activity. Recommendations to improve future studies are given.
authors: Occupational and Environmental Epidemiology Unit, Centre for Study and Prevention of Cancer, Scientific Institute of Tuscany Region, Florence, Italy mc.fondelli@cspo.it
authors: M Cristina
authors: MC
authors: Fondelli
authors: Adele Seniori
authors: AS
authors: Costantini
authors: M
authors: M
authors: Ercolanelli
authors: Anna Maria
authors: AM
authors: Pizzo
authors: Simona Alberghini
authors: SA
authors: Maltoni
authors: Margaret M
authors: MM
authors: Quinn
mesh_terms: D002273:Carcinogens; D015331:Cohort Studies; D016001:Confidence Intervals; D003627:Data Interpretation, Statistical; D004190:Disasters / Q000266:history; D004202:Disinfectants / Q000009:adverse effects; D052918:Environmental Restoration and Remediation; D005027:Ethylene Oxide / Q000009:adverse effects; D005260:Female; D005500:Follow-Up Studies; D005557:Formaldehyde / Q000009:adverse effects; D049673:History, 20th Century; D006801:Humans; D007558:Italy; D007990:Libraries / Q000266:history*; D008297:Male; D009369:Neoplasms / Q000139:chemically induced* / Q000401:mortality; D009784:Occupational Diseases / Q000139:chemically induced* / Q000401:mortality; D016273:Occupational Exposure; D010575:Pesticides / Q000009:adverse effects; D010578:Petroleum / Q000009:adverse effects; D011904:Rare Books / Q000266:history*; D012984:Software; D012997:Solvents / Q000009:adverse effects; D013997:Time Factors
chemical_list: D002273:Carcinogens; D004202:Disinfectants; D010575:Pesticides; D010578:Petroleum; D012997:Solvents; D005557:Formaldehyde; D005027:Ethylene Oxide