Exposure to carcinogens and mortality in a cohort of restoration workers of water-damaged library materials following the River Arno flooding in Florence, 4 November 1966.

Background: In Florence, Italy, the Arno River overflowed on 4 November 1966 and the rare library collections of the National Central Library in Florence (FNCL) were flooded. A Restoration Centre was immediately set up. For book restoration many toxic chemicals were used, such as chlorinated solvents, ethylene oxide (EtO), formaldehyde, petroleum distillates, and pesticides. The study's aims were: (I) to document the restoration process, (II) to identify the potential chemical exposures, (III) to evaluate the mortality experience of restorers.

Methods: A small cohort of 168 workers was identified. The restorers were employed in the FNCL's Restoration Centre during the years 1967-1976. We excluded 9 subjects from the analysis because no working period data were available. Mortality from all causes, from all cancers, and from cancers of specific sites was compared with that of the Italian general population. Standardized Mortality Rates (SMRs) and their 95% confidence intervals were estimated.

Results: Restorers were exposed to relatively low levels of several carcinogens. A non-significant excess of cancer mortality was found. Significant increases in brain neoplasm among men and in uterine cancer among women were found,

Conclusions: The small cohort size hampers interpretation of the results. Larger epidemiology studies on library material restorers are needed in order to evaluate risks in this activity. Recommendations to improve future studies are given.