METHODS: The attributable fraction (AF) was calculated based on the counterfactual scenario of no occupational exposure to carcinogens. We included exposures classified as IARC group 1 and with reliable evidence of exposure in Italy. Relative risk estimates for selected cancers and prevalences of exposure were derived from large-scale studies. Except for mesothelioma, a 15-20-year latency period between exposure and cancer was considered. The data on cancer incidence in 2020 and mortality in 2017 in Italy were obtained from the Italian Association of Cancer Registries.
RESULTS: The most prevalent exposures were UV radiation (5.8%), diesel exhaust (4.3%), wood dust (2.3%) and silica dust (2.1%). Mesothelioma had the largest AF to occupational carcinogens (86.6%), followed by sinonasal cancer (11.8%) and lung cancer (3.8%). We estimated that 0.9% of cancer cases (N~3500) and 1.6% of cancer deaths (N~2800) were attributable to occupational carcinogens in Italy. Of these, about 60% were attributable to asbestos, 17.5% to diesel exhaust, followed by chromium and silica dust (7% and 5%).
CONCLUSIONS: Our estimates provide up-to-date quantification of the low, but persistent, burden of occupational cancers in Italy.
方法:归因分数(AF)是根据没有职业性接触致癌物的反事实情景计算的。我们纳入了分类为IARC第1组的暴露,并在意大利有可靠的暴露证据。选定癌症的相对风险估计和暴露的患病率来自大规模研究。除了间皮瘤,我们考虑了暴露与癌症之间的15-20年潜伏期.意大利2020年癌症发病率和2017年死亡率的数据来自意大利癌症登记协会。
结果:最普遍的暴露是紫外线(5.8%),柴油机尾气(4.3%),木尘(2.3%)和硅尘(2.1%)。间皮瘤对职业致癌物的AF最大(86.6%),其次是鼻窦癌(11.8%)和肺癌(3.8%)。我们估计,在意大利,0.9%的癌症病例(N〜3500)和1.6%的癌症死亡(N〜2800)归因于职业性致癌物。其中,约60%可归因于石棉,17.5%的柴油废气,其次是铬和二氧化硅粉尘(7%和5%)。
结论:我们的估计提供了对低,但坚持不懈,意大利职业性癌症的负担。