title: Lung and other cancer site mortality in a cohort of Italian cotton mill workers.
abstract: BACKGROUND
  Several studies report a lower than expected mortality in lung cancer among workers exposed to organic dust. Recent studies also reported a decreased risk for cancer at other sites.
  
  
  OBJECTIVE
  To evaluate the mortality from lung and other cancer sites in cotton mill workers.
  
  
  METHODS
  A cohort of 3961 Italian cotton mill workers was divided into those working with carding (exposed to high levels of endotoxin-containing cotton dust) and other tasks, which generally have lower exposure. Standardised mortality ratios (SMRs), with 95% confidence intervals (CI), were calculated using death rates of the regional general population as a reference. Cancer mortality was analysed in relation to the length of employment in the two task groups. An internal analysis was also performed through Poisson regression.
  
  
  RESULTS
  Among workers in carding departments, lung cancer SMRs were 1.88 (CI: 0.69 to 4.08), 1.01 (CI: 0.20 to 2.94) and 0.22 (CI: 0.00 to 1.24), respectively, for <6, 6-12 and >12 years of employment (chi(2) for trend = 5.45; p<0.05). A significant (p = 0.04) trend was confirmed by Poisson regression. No reduced risks were found for other forms of cancer, nor for those working with other tasks.
  
  
  CONCLUSIONS
  The results support previous reports that a high and prolonged exposure to cotton dust and other endotoxin-containing organic dusts is related to a lower risk of lung cancer. There was no indication of a reduced risk for other forms of cancer.
authors.affiliation: Department of Environmental Medicine and Public Health, University of Padova, Via Giustinianai 2, 35128 Padova, Italy. giuseppe.mastrangelo@unipd.it
authors.forename: G
authors.initials: G
authors.lastname: Mastrangelo
authors.forename: E
authors.initials: E
authors.lastname: Fadda
authors.forename: R
authors.initials: R
authors.lastname: Rylander
authors.forename: G
authors.initials: G
authors.lastname: Milan
authors.forename: U
authors.initials: U
authors.lastname: Fedeli
authors.forename: M
authors.initials: M
authors.lastname: Rossi di Schio
authors.forename: J H
authors.initials: JH
authors.lastname: Lange
mesh_terms: D000328:Adult; D017677:Age Distribution; D000368:Aged; D002423:Cause of Death / Q000639:trends; D015331:Cohort Studies; D032561:Cotton Fiber; D004391:Dust; D004731:Endotoxins / Q000633:toxicity*; D006801:Humans; D007558:Italy / Q000453:epidemiology; D008175:Lung Neoplasms / Q000401:mortality; D008875:Middle Aged; D009369:Neoplasms / Q000401:mortality*; D012307:Risk Factors; D013783:Textile Industry / Q000706:statistics & numerical data*; D055815:Young Adult
chemical_list: D004391:Dust; D004731:Endotoxins