title: Mortality and morbidity study of petrochemical employees in a polluted site.
abstract: BACKGROUND
  The area of Gela was included among the 57 Italian polluted sites of national interest for environmental remediation because of its widespread contamination from a petrochemical complex. The present study investigates mortality and morbidity of the cohort of Gela petrochemical workers with the aim of disentangling occupational from residential risk.
  
  
  METHODS
  Mortality was assessed for 5,627 men hired from 1960, year of the plant start-up, to 1993; it was followed up for vital status in the period 1960-2002. Morbidity was analysed for 5,431 workers neither dead nor lost to follow-up from 1960 to 2001 and was based on Hospital Discharge Records in the period 2001-2006. The work experience was classified in terms of job categories such as blue collars, white collars, and both--workers who shifted from blue to white collar (95%) or vice versa. An ad hoc mobility model was applied to define qualitative categories of residence in Gela, as residents and commuters. Standardized Mortality Ratios (SMRs) and Mortality Rate Ratios (MRRs) were computed, the latter by using a Poisson regression model. Morbidity was analyzed in terms of Hospital Discharge Odds Ratios (HDORs) through a logistic regression model. While performing the internal comparisons, white collars was the reference category for the job analysis, and commuters was the reference category for the residential analysis.
  
  
  RESULTS
  In the light of epidemiological evidence about health risk from petrochemical industries in both occupational and environmental settings, and/or on the basis of information about occupational and residential contamination and health risk in the area of Gela, noteworthy results are shown for lung cancer [MRR: 2.11 (CI 90%; 0.96-4.63) in blue collars; 1.71 (1.09-2.69) in residents], respiratory diseases [HDOR: 2.0 (1.0-3.0) in blue collars; 1.4 (0.96-2.06) in residents] and genitourinary diseases [HDOR: 1.34 (1.06-1.68) in blue collars; 1.23 (1.04-1.45) in residents].
  
  
  CONCLUSIONS
  The results support a role of the exposures in the occupational and residential settings, the latter due to the local ascertained contamination, in affecting the workers' health. These results underline the urgent need of water, soil, air and food-chain monitoring programs, to discover active sources of exposure and consequently define public health interventions.
authors.affiliation: Department of Environment and Primary Prevention, Istituto Superiore di Sanità, Viale Regina Elena 299, Rome 00161, Italy. roberto.pasetto@iss.it
authors.forename: Roberto
authors.initials: R
authors.lastname: Pasetto
authors.forename: Amerigo
authors.initials: A
authors.lastname: Zona
authors.forename: Roberta
authors.initials: R
authors.lastname: Pirastu
authors.forename: Achille
authors.initials: A
authors.lastname: Cernigliaro
authors.forename: Gabriella
authors.initials: G
authors.lastname: Dardanoni
authors.forename: Sebastiano Pollina
authors.initials: SP
authors.lastname: Addario
authors.forename: Salvatore
authors.initials: S
authors.lastname: Scondotto
authors.forename: Pietro
authors.initials: P
authors.lastname: Comba
mesh_terms: D002617:Chemical Industry; D015331:Cohort Studies; D004787:Environmental Pollution / Q000009:adverse effects*; D005260:Female; D005500:Follow-Up Studies; D015386:Hazardous Substances / Q000633:toxicity*; D006798:Housing; D006801:Humans; D007558:Italy / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D009784:Occupational Diseases / Q000139:chemically induced / Q000453:epidemiology* / Q000401:mortality*; D016273:Occupational Exposure
chemical_list: D015386:Hazardous Substances