title: [Mortality from asbestos-related causes and incidence of pleural mesothelioma among former asbestos cement workers in San Filippo del Mela (Sicily)].
abstract: OBJECTIVE
  The present paper estimates the burden of asbestos-related disease among asbestos-cement production workers of the Sacelit plant that operated in San Filippo del Mela (Province of Messina) from 1958 through 1993.
  
  
  METHODS
  The cohort was enumerated by the local committee of formerly exposed workers, with whom a collaboration was set up. The cohort includes 198 subjects with complete individual anagraphic information, out of 231 previous workers identified by the committee. A record-linkage with the Sicilian centre of the National mesothelioma registry enabled estimation of mesothelioma incidence for the years 1998-2008. Standardised proportionate mortality (SPMR) for asbestos-related causes was computed for the years 1986-2009. Sicilian Region constituted the reference population. The rationale for using SPMR rather than standardized mortality ratio (SMR) was a consequence for the lack of company files from which to obtain dates of start and termination of employment, and thus to compute person-years of observation, following the guidelines of the international scientific literature.
  
  
  RESULTS
  Standardised incidence ratio (SIR) for mesothelioma in the overall cohort was 251 (4 observed, 0.02 expected). Proportionate mortality analysis among male subjects showed significant increases for pneumoconiosis (SPMR 80.1, 5 observed), lung cancer (SPMR 2.81, 10 observed) and pleural neoplasms (SPMR 19.4, 2 observed).
  
  
  CONCLUSIONS
  Notwithstanding limitations in cohort reconstruction, for which the proportion of eligible subjects was 87.5% of those detected by the local committee, and the lack of information on duration of employment, it was possible to estimate a significant increase of the incidence of pleural mesothelioma with respect to Sicilian population. Also mortality from asbestos-related causes was in excess with respect to the regional reference population.
authors.affiliation: Dipartimento di ambiente e connessa prevenzione primaria, Istituto superiore di sanità, Viale Regina Elena 299, 00161, Roma. lucia.fazzo@iss.it
authors.forename: Lucia
authors.initials: L
authors.lastname: Fazzo
authors.forename: Carmela
authors.initials: C
authors.lastname: Nicita
authors.forename: Achille
authors.initials: A
authors.lastname: Cernigliaro
authors.forename: Amerigo
authors.initials: A
authors.lastname: Zona
authors.forename: Caterina
authors.initials: C
authors.lastname: Bruno
authors.forename: Giovanna
authors.initials: G
authors.lastname: Fiumanò
authors.forename: Caterina
authors.initials: C
authors.lastname: Villari
authors.forename: Giovanni
authors.initials: G
authors.lastname: Puglisi
authors.forename: Alessandro
authors.initials: A
authors.lastname: Marinaccio
authors.forename: Pietro
authors.initials: P
authors.lastname: Comba
authors.forename: Rosario
authors.initials: R
authors.lastname: Tumino
mesh_terms: D001194:Asbestos / Q000009:adverse effects* / Q000032:analysis; D001195:Asbestosis / Q000453:epidemiology* / Q000209:etiology / Q000401:mortality; D005260:Female; D006801:Humans; D015994:Incidence; D008175:Lung Neoplasms / Q000453:epidemiology / Q000209:etiology / Q000401:mortality; D008297:Male; D008654:Mesothelioma / Q000453:epidemiology* / Q000209:etiology / Q000401:mortality; D016273:Occupational Exposure / Q000009:adverse effects* / Q000032:analysis; D010997:Pleural Neoplasms / Q000453:epidemiology* / Q000209:etiology / Q000401:mortality; D012802:Sicily / Q000453:epidemiology
chemical_list: D001194:Asbestos