Cohort study of mortality among farmers and agricultural workers.

A cohort study was made of the mortality experience of 1701 male and 426 female farm workers (Aprilia, Italy) during the period 1972-1988. A low overall mortality was found due mainly to a decreased risk of circulatory diseases and respiratory conditions. Also, the overall cancer mortality was reduced (SMR = 0.88 for males and 0.58 for females). No statistically significant excesses were observed in cancer mortality, but there was an evident tendency towards an increased risk of gastric cancer (0 = 23, SMR = 1.24), renal cancer (0 = 5, SMR = 2.12), skin cancer (0 = 2, SMR = 1.67) and leukemia (0 = 6, SMR = 1.54), mainly of the myeloid type. Finally, 41 lung cancer cases were observed against 40.12 expected. Under 65 years excess deaths were found for all cancer sites investigated except cancer of the lymphatic and hemopoietic tissues. Since farmers usually have a low lung cancer rate, the increased mortality in the young age group (0 = 24, SMR = 1.28) and also the excess of kidney cancer (0 = 4, SMR = 3.67), although not statistically significant, deserve consideration in relation to past exposure to pesticides, especially DDT, in this population.

[Avoidable deaths in the evaluation of the performance of health services. II. European Atlas of avoidable deaths: initial data and several reflections]. / Le morti evitabili nella valutazione dell' attività del servizio sanitario. II. Atlante Europeo sulle morti evitabili: primi dati ed alcune riflessioni.

The second European Atlas of Avoidable deaths, which will be shortly issued, concerns the period 1979-83 for Italy. The causes of deaths included were: tuberculosis, neoplasms of the cervix uteri and those of the uterus with no specified site, Hodgkin's disease, chronic rheumatic heart disease, hypertensive and cerebrovascular disease, childhood respiratory infections, asthma, appendicitis, abdominal hernia, cholecystitis and cholelithiasis, maternal and perinatal deaths. In Italy marked excesses for cholecystitis-cholelithiasis, Hodgkin's disease, hypertensive and cerebrovascular disease and perinatal mortality were observed. A remarkable decrease was observed in comparison with the first Atlas (1974-78); but the European countries generally maintained the differences amongst them and their rank. Proposals to assess the causes of the observed differences are suggested (death certificate quality evaluation studies, case-reference studies, cohort studies) and the role of confidential enquiries is discussed.

Respiratory cancer mortality among workers employed in thermoelectric power plants.

A historical cohort study of 406 workers was undertaken to evaluate the possible health hazards of employment in traditional electric power plants with particular regard to cancer mortality. The total mortality was below that expected [observed 40, standardized mortality ratio (SMR) 87] on the basis of national rates. Cancer mortality was slightly increased (SMR 112), mainly because of an excess of respiratory cancer (observed 9, SMR 171, 90% CI 89-299). Lung cancer deaths were higher than expected among those less than 60 years of age and among those with a duration of exposure and a latency period since first employment of over 10 years (observed 7, SMR 184). Furthermore, the increase was more pronounced among maintenance workers and workers in general services. Previous data indicated that there had been past exposure to some known respiratory carcinogens (ie, asbestos, polycyclic aromatic hydrocarbons). This study suggests that a possible lung cancer risk from traditional electricity generating plants should be considered and further studied.