Background: A private company in Bologna worked for the Italian State Railways (FS) from 1919 to 1998; since the early '60s it used asbestos for new carriage insulation and renovation of carriages already circulating which were entirely spray-coated with asbestos.
Objectives: The study aimed to investigate all causes mortality, in particular mortality from asbestos-related neoplasms in blue-collar workers.
Methods: The cohort consisted of 1,849 people, active in 1960 or hired in 1960-86: 1,704 (92.2%) blue-collar workers and 145 (7.8%) white-collar workers. The end date of the follow up was established as 31/12/2008. Regional reference mortality rates were used.
Results: Mortality from all causes (SMR = 1.16; 95% CI 1.08-1.25) and from malignant neoplasms (SMR = 1.20; 95% CI 1.06-1.35) significantly exceeded expected rates. In particular, a statistically significant increase was observed for pleural malignant cancer (SMR = 24.43; 95% CI 17.37-34.37), lung cancer (SMR = 1.24; 95% CI 1.00-1.53), peritoneal cancer (SMR = 6.35; 95% CI 2.64-15.25) and bladder cancer (SMR = 1.71; 95% CI 1.03-2.84). The excess lung cancer SMR was highly significant after 20 years of exposure and with a latency longer than 40 years. An association between pleural malignant cancer and duration of exposure and latency (trend test p value < 0,0001) was observed
Conclusion: This study on a cohort of asbestos-exposed workers showed an increase in lung cancer SMRs by risk that was statistically significant in workers exposed for at least 20 years and after 40 years of latency. The neoplasm of pleura was strongly associated with both duration of exposure and latency.