title: A historical mortality study among bus drivers and bus maintenance workers exposed to urban air pollutants in the city of Genoa, Italy.
abstract: OBJECTIVE
  A historical mortality cohort study was conducted in Genoa, Italy among public transport workers ever employed between 1949 and 1980, to estimate overall and cause-specific mortality from January 1970 to December 2005 and to examine associations between exposure to urban air pollutants and overall and cause-specific mortality.
  
  
  METHODS
  Causes of death for 9267 males (6510 bus drivers, 2073 maintenance workers and 601 white collar workers) were coded according to ICD-9. Standardised mortality ratios (SMRs) and 95% CIs were computed by applying Italian and regional male death rates to person-years of observation for the entire cohort and following stratification by longest held job title and length of and time since first employment using the Poisson regression model.
  
  
  RESULTS
  There were 2916 deaths and 230,009 person-years of observation; 17 subjects were lost to follow-up. SMRs for all causes, diseases of the circulatory, respiratory, digestive and genitourinary systems, and for accidents were lower than expected. SMRs (95% CI) were increased for lung cancer (1.16, 1.05 to 1.28), non-Hodgkin's lymphoma (1.23, 0.85 to 1.78), Hodgkin's lymphoma (2.14, 1.19 to 3.87) and diabetes mellitus (1.16, 1.05 to 1.28). The SMR for leukaemia was 0.77 (0.51 to 1.16). Hodgkin's lymphoma mortality was significantly increased among bus drivers (1.62, 1.37 to 5.04). Lung cancer risk was significantly increased among all workers after 30 years' employment and among maintenance workers.
  
  
  CONCLUSIONS
  The study failed to show any increased risk for leukaemias. The increased mortality from Hodgkin's lymphoma and lung cancer may be associated with long-term exposure to urban air pollution.
authors.affiliation: Unit of Epidemiology, Biostatistics and Clinical Trials, Department of Epidemiology and Prevention, National Cancer Research Institute, Largo Rosanna Benzi 10, Genoa 16132, Italy.
authors.forename: Domenico Franco
authors.initials: DF
authors.lastname: Merlo
authors.forename: Elena
authors.initials: E
authors.lastname: Stagi
authors.forename: Vincenzo
authors.initials: V
authors.lastname: Fontana
authors.forename: Dario
authors.initials: D
authors.lastname: Consonni
authors.forename: Claudia
authors.initials: C
authors.lastname: Gozza
authors.forename: Elsa
authors.initials: E
authors.lastname: Garrone
authors.forename: Pier Alberto
authors.initials: PA
authors.lastname: Bertazzi
authors.forename: Angela Cecilia
authors.initials: AC
authors.lastname: Pesatori
mesh_terms: D000393:Air Pollutants / Q000633:toxicity*; D000397:Air Pollution / Q000706:statistics & numerical data; D001334:Automobile Driving; D001554:Benzene / Q000032:analysis / Q000633:toxicity; D004781:Environmental Exposure / Q000009:adverse effects / Q000032:analysis; D004784:Environmental Monitoring / Q000379:methods; D004812:Epidemiologic Methods; D062665:Epidemiological Monitoring; D005260:Female; D006801:Humans; D007558:Italy / Q000453:epidemiology; D008297:Male; D018986:Motor Vehicles / Q000706:statistics & numerical data; D009369:Neoplasms / Q000209:etiology / Q000401:mortality; D009784:Occupational Diseases / Q000209:etiology / Q000401:mortality*; D052638:Particulate Matter / Q000032:analysis / Q000633:toxicity; D012140:Respiratory Tract Diseases / Q000209:etiology / Q000401:mortality; D014504:Urban Health / Q000706:statistics & numerical data
chemical_list: D000393:Air Pollutants; D052638:Particulate Matter; D001554:Benzene