Mortality among dock-yard workers in Genoa, Italy

Our plain-English summary of Mortality among dock-yard workers in Genoa, Italy, by R. Puntoni, L. Russo, D. Zannini, et al (Tumori, 1977).

The study

• Authors: R. Puntoni, L. Russo, D. Zannini, M. Vercelli, R.P. Gambaro, F. Valerio, L. Santi
• Journal: Tumori
• Published: 1977;63(1):91-6
• Cited by: 9 articles, as counted by NIH iCite
• Read it: PubMed · Publisher

Abstract

The causes of death among the dock-yard workers of Genoa from December 31, 1959 to January 1, 1970, have been investigated. These workers, mainly assigned to ship repair, refitting and construction, are exposed to several noxious substances, such as: asbestos, silica, paint solvents, welding smoke and volatile products of petroleum. Two different control groups were selected: the male population of Genoa and the staff of the San Martino Hospital in Genoa. Causes of death showing a significant increase were: gastric cancer (only in comparison with the hospital staff), cancer of colon excluding rectum, lung cancer, cancer of kidney, urinary bladder and other urinary organs, respiratory diseases, cirrhosis of the liver, cardiovascular diseases (only in comparison with the hospital staff).

In plain English

This study examined deaths among 2,348 workers of the Industrial Branch of the Port of Genoa, Italy, who were working or retired on December 31, 1959, and were followed to January 1, 1970. They mainly repaired, refitted and built ships and were exposed to asbestos, silica, paint solvents, welding smoke and volatile petroleum products. The article gives no asbestos fiber types or doses. Their 659 deaths were compared with deaths expected from rates in Genoa's male population and in the male staff of San Martino Hospital. There were 61 lung cancer deaths, against 36.78 expected from Genoa rates (risk ratio 1.66) and 20.91 from hospital rates (2.92). Significant excesses were also reported for cancer of the colon excluding rectum, cancer of kidney, bladder and other urinary organs, respiratory diseases (which included 6 asbestosis deaths) and liver cirrhosis. Stomach cancer and cardiovascular diseases were significantly raised only against hospital staff. The authors incriminated asbestos as responsible for the lung cancer and respiratory disease excess. They noted the mixed exposures and that smoking and drinking had not yet been surveyed.

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: Mortality study of a group of workers followed over time, comparing observed deaths with deaths expected from the age-specific death rates of two comparison groups (risk ratio = observed divided by expected)
• Who was studied: 2,348 workers of the Industrial Branch of the Port of Genoa, Italy, working or retired on December 31, 1959, followed to January 1, 1970 (22,188 person-years; 659 deaths). Workers not resident in Genoa were excluded. Comparison groups: the male population of Genoa and the male staff of San Martino Hospital, Genoa (660 men, 108 deaths).
• Exposure: Ship repair, refitting and construction work with exposure to several substances: asbestos, silica, paint solvents, welding smoke and volatile petroleum products. Job categories included insulation workers, welders, ship-demolishers, painters and others. No asbestos fiber type is named and no exposure levels are given.
• Main results:
  • Lung, bronchus and trachea cancer among dockyard workers: 61 deaths observed. Against Genoa male rates, 36.78 were expected (risk ratio 1.66, p less than 0.001). Against hospital staff rates, 20.91 were expected (risk ratio 2.92, p less than 0.001).
  • Total deaths among dockyard workers: 659 observed. Against Genoa male rates, 621.24 were expected (risk ratio 1.06, not significant). Against hospital staff rates, 460.12 were expected (risk ratio 1.43, p less than 0.001).
  • Cancer of all sites: 181 deaths observed. Against Genoa male rates, 159.24 were expected (risk ratio 1.14, not significant). Against hospital staff rates, 81.63 were expected (risk ratio 2.22, p less than 0.001).
  • Cancer of colon excluding rectum: 17 deaths observed. Against Genoa male rates, 8.19 were expected (risk ratio 2.08, p less than 0.01). Against hospital staff rates, 4.52 were expected (risk ratio 3.77, p less than 0.001).
  • Cancer of kidney, urinary bladder and other urinary organs: 18 deaths observed. Against Genoa male rates, 9.64 were expected (risk ratio 1.87, p less than 0.01). Against hospital staff rates, 4.52 were expected (risk ratio 3.99, p less than 0.001).
  • Stomach cancer: 28 deaths observed. Against Genoa male rates, 20.82 were expected (risk ratio 1.34, not significant). Against hospital staff rates, 13.16 were expected (risk ratio 2.13, p less than 0.001).
  • Respiratory diseases: 75 deaths observed. Against Genoa male rates, 58.96 were expected (risk ratio 1.27, p less than 0.05). Against hospital staff rates, 32.88 were expected (risk ratio 2.28, p less than 0.001).
  • The respiratory disease deaths included 6 deaths from asbestosis and 1 from silicosis.
  • Cirrhosis of the liver: 37 deaths observed. Against Genoa male rates, 15.54 were expected (risk ratio 2.38). The authors list cirrhosis among the significant excesses.
  • Cardiovascular diseases: 185 deaths observed. Against Genoa male rates, 211.49 were expected (risk ratio 0.87, not significant). Against hospital staff rates, 147.98 were expected (risk ratio 1.25, significant).
• The authors' conclusion: The authors said the mixed exposures made it difficult to say which substances were involved in cancer. They held asbestos responsible for the excess of lung cancer and respiratory diseases, given its considerable spread in the port. They suggested intestinal cancer might also be due to swallowing fibres. They proposed that bladder cancer might relate to hydrocarbon vapors and smoke common to all job categories, which they said should be investigated.
• Limitations the authors state:
  • Workers were exposed to several harmful substances, so it was difficult to say which caused the cancers.
  • Smoking and drinking habits were not accounted for; a survey comparing dockyard workers with hospital staff was still to be carried out.
  • Results were not yet broken down by job category or duration of exposure.

Topics

The National Library of Medicine indexes this study under subjects our site covers: Shipyards and maritime work.

Medical terms in this study, explained in our Lexicon: Stomach Cancer, Lung Cancer.

Related studies

• Mortality among shipyard workers in Genoa, Italy — R. Puntoni, M. Vercelli, et al. (1979)
• Mortality among workers exposed to asbestos at the shipyard of Genoa, Italy: a 55 years follow-up — D.F. Merlo, M. Bruzzone, et al. (2018)
• A historical cohort mortality study among shipyard workers in Genoa, Italy — R. Puntoni, F. Merlo, et al. (2001)
• Mortality among shipyard Coast Guard workers: a retrospective cohort study — S. Krstev, P. Stewart, et al. (2007)
• Assessment of the future mesothelioma disease burden from past exposure to asbestos in ship recycling yards in India — R. Singh, J.W. Cherrie, et al. (2020)
• Cancer risks among iron and steel workers in Anshan, China, Part I: Proportional mortality ratio analysis — Z. Xu, G.W. Pan, et al. (1996)

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