The objective of this paper is to investigate mortality among 1247 male asbestos-cement workers employed in an asbestos-cement plant located in Naples. The cohort included 1247 men hired between 1950 and 1986. The follow-up began on January 1st 1965. The vital status and causes of death were ascertained up to December 31 2005. Cause-specific mortality rates of the Campania Region population were used as reference. Relative risks were estimated using Standardized Mortality Ratios (SMRs), and the confidence intervals were calculated at a 95% level (95% CI). A significant increase in mortality was observed for respiratory disease (81 deaths; SMR = 187; 95% CI = 149-233), particularly for pneumoconiosis (42 deaths; SMR = 13 313; 95% CI = 9595-17 996) of which 41 deaths for asbestosis (SMR = 43 385; 95% CI = 31 134-58 857), for pleural cancer (24 deaths; SMR = 2617; 95% CI = 1677-3893), for lung cancer (84 deaths; SMR=153; 95% CI = 122-189) and for peritoneal cancer (9 deaths; SMR = 1985; 95% CI = 908-3769). Non-significant increases were also observed for rectum cancer (6 deaths; SMR = 157; 95% CI = 58-342). In conclusion, consistently with other mortality studies on asbestos-cement workers performed in different countries, an increased mortality from asbestosis, lung cancer, pleural and peritoneal mesothelioma was detected in the present cohort.

Obiettivo del presente studio è descrivere la mortalità di una coorte di 1247 lavoratori della Eternit di Bagnoli (NA). è stato condotto uno studio di coorte, ristretto agli uomini, che ha incluso 1247 soggetti assunti a partire dal 1950 sino al 1986, con follow up iniziato nel 1965. Lo stato in vita e le cause di morte sono state accertate al 31/12/2005. La mortalità osservata è stata confrontata con quella attesa in base ai tassi di riferimento della popolazione campana. Sono stati calcolati i rapporti di mortalità standardizzati (SMR) per il periodo 1965-2005 ed i corrispondenti intervalli di confidenza al 95% (IC 95%). Un incremento significativo della mortalità è stato osservato per le malattie respiratorie (81 deceduti; SMR = 187; IC 95% = 149-233), in particolare per le pneumoconiosi (42 deceduti; SMR = 13313; IC 95% = 9595-17996; dei quali 41 deceduti per asbestosi; SMR = 43385; IC 95% = 31134-58857), per tumore maligno della pleura (24 decessi; SMR = 2617; IC 95% = 1677-3893), per tumore del polmone (84 decessi; SMR = 153; IC 95% = 122-189) e per tumore maligno del peritoneo (9 decessi; SMR = 1985; IC 95% = 908-3769). Un incremento non statisticamente significativo è stato osservato per il tumore del retto (6 decessi; SMR = 157; IC 95% = 58-342). In conclusione, i risultati del presente studio, coerentemente con l'insieme dell'evidenza epidemiologica relativa agli effetti sulla salute dell'esposizione a cemento-amianto, mostrano un'aumentata mortalità per asbestosi, cancro polmonare, mesotelioma pleurico e peritoneale.

Background and Objectives: 1) To identify the sociodemographic, anamnestic characteristics and presentation symptoms of patients, at the time of first hospitalization, associated with a discharge diagnosis of schizophrenic versus non-schizophrenic psychoses; 2) to define risk factors, at the time of the first admission, for a rehospitalization, regardless of reasons for readmission; 3) to assess the diagnostic stability between first and second hospitalization. Methods: This study includes 245 patients first admitted to the University Psychiatric Clinic of Novara in a period of seven years, discharged with a diagnosis of psychosis as reported in the Discharge Register (ICD-9-CM codes 290-299). Data were collected by consulting medical records and registers of community-based services of the South Novara Mental Health Department. A logistic regression model was used to determine the characteristics associated with a discharge diagnosis of schizophrenia. The relationship between the risk of rehospitalization and patients characteristics was studied using Cox,s regression analysis. Results: Risk factors for a discharge diagnosis of schizophrenia were age, compulsory admission, positive symptoms, and previous non-psychotic psychiatric episodes. Risk factors for rehospitalization were a diagnosis of schizophrenia, an age of less than 40 years, the absence of a stable affective relationship, and living with the family of origin. The 92% of the patients diagnosed as schizophrenic on the first hospitalization had the same diagnosis on readmission. Conclusions: Schizophrenia differs from other psychoses in terms of the greater prevalence of both some symptomatological characteristics and an history of previous non psychotic episodes. Some sociodemographic and clinical characteristics at the time of the first hospitalization can provide indications useful in preventing rehospitalization.