Late industrial development and occupational health in southern Italy

Our plain-English summary of Late industrial development and occupational health in southern Italy, by G. Assennato, L. Bisceglia, G. De Nichilo, et al (International Journal of Occupational and Environmental Health, 2005).

The study

• Authors: G. Assennato, L. Bisceglia, G. De Nichilo, M.E. Grassi, A. Lo Izzo
• Journal: International Journal of Occupational and Environmental Health
• Published: 2005;11(1):82-7
• Type of article: Historical article
• Read it: PubMed · Publisher

Abstract

The authors report the occupational medicine problems in the Apulia region, which are representative of those in Southern Italy. Late industrialization was associated with an early peak in injuries that was not associated with an increased workforce. Examples of operations adversely affecting worker and population health are presented.

In plain English

This article was an overview of earlier work, not a single new study. The authors described occupational health problems in the Apulia region of southern Italy, which they linked to late, state-funded industrialization. They summarized injury trends, an exposure survey of coke-oven workers at the Taranto steel plant, a 1976 arsenic release at the Manfredonia petrochemical plant, and a cancer study of residents near the Brindisi petrochemical plant. On asbestos, they summarized a published mortality study of 417 male workers at the Fibronit asbestos-cement plant in Bari. By 1995, 105 workers had died, and 40 more had died by 2000. Deaths were higher than expected for pleural mesothelioma, peritoneal mesothelioma, lung cancer and pneumoconiosis. A separate cited study of 64 mesothelioma deaths among Bari residents between 1980 and 2001 estimated a risk 2.38 times the reference level within 1 km of the plant. The authors wrote that the worker findings were consistent with other studies of asbestos-cement workers and that the increases could not be entirely explained by smoking. The article did not name the asbestos fiber type.

We wrote this plain-English summary from the full article with the help of AI, and a second AI model checked each sentence against the article. It is not the authors' wording; the abstract and the article are their own account.

What the study did and found

• Design: Narrative overview of occupational and environmental health problems in Apulia, summarizing earlier studies (several by the authors' group). The asbestos results come from a cited cohort mortality study (Coviello et al. 2002) and a cited geographic study of residents (ref. 22).
• Who was studied: Asbestos section: 417 male workers of the Fibronit asbestos-cement plant in Bari, Italy, followed to December 31, 1995 and December 31, 2000. A separate group: 64 malignant mesothelioma deaths among Bari residents, 1980 to 2001, taken from the national mesothelioma registry.
• Exposure: Work at the Fibronit asbestos-cement factory in Bari, built in the late 1930s, and residence near it. No fiber type is stated. The article also covers non-asbestos exposures: polycyclic aromatic hydrocarbons in coke-oven work and arsenic trioxide released in the Manfredonia accident.
• Main results:
  • In the Fibronit worker cohort, 105 deaths had occurred by the end of 1995, and 40 more by December 31, 2000.
  • First follow-up (to 1995) of Fibronit workers: standardized mortality ratios (SMR; 100 means as expected) were 14,810 for pneumoconiosis, 190.7 for lung cancer, 1,578.9 for pleural and 1,666.7 for peritoneal malignant neoplasms. The table lists 3 pleural mesothelioma deaths (95% CI 325.7 to 4613.3) and 2 peritoneal mesothelioma deaths (95% CI 222.3 to 6018.1), and gives lung cancer SMR as 192 (95% CI 116.5 to 294.4).
  • Second follow-up (to 2000) of Fibronit workers: the text gives SMRs of 121.5 for all causes, 149 for all cancers, 229 for respiratory cancer, 2,989 for pleural cancer and 15,270 for pneumoconiosis. The table lists 10 pleural mesothelioma deaths with SMR 2,963.
  • Among Fibronit workers, differences between observed and expected deaths appeared 20 years after first exposure for lung cancer, and 30 years after first exposure for all cancers and for pleural and peritoneal cancers.
  • In the cited geographic study of 64 mesothelioma deaths among Bari residents, the estimated risk within 1 km of the asbestos-cement plant was 2.38 times the reference level.
  • Non-asbestos finding: in southern Italy the industrial injury rate peaked at 325.42 per 1,000 workers per year in 1955, and it was consistently higher than in northern Italy.
• The authors' conclusion: The authors stated that the Fibronit worker findings were consistent with published data on asbestos-cement workers and could not be entirely explained by smoking. More broadly, they suggested that southern Italy's experience of late industrialization could offer lessons for developing countries.

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