DESIGN, RATIONALE AND OBJECTIVES
The Olivetti Heart Study (OHS) is an occupational based surveillance investigation carried out in Campania, a region of Southern Italy, and one of the main research programmes driven by the Department of Clinical and Experimental Medicine at Federico II University of Naples.
The study was born in the early ‘70s thanks to the initiative of Prof. Mario Mancini and Prof. Eduardo Farinaro at the University of Naples Medical School. The Olivetti factory located in Pozzuoli, very close to Naples metropolitan area, was chosen because of the relatively high number of workers employed at that time, almost 1600 (for the large majority males) and because of the collaboration offered by Dr. Edoardo Paggi, the physician in charge of the factory medical centre. The idea was to carry out a survey of an otherwise unselected sample of working population to gather information about the prevalence of major cardiovascular risk factors (cigarette smoking, hypercholesterolemia, high blood pressure) in our region. It was expected that this information could have been combined with that coming from other similar studies in other parts of the country.
Several surveys were performed at the Olivetti factory in the ‘70s and ‘80s with the participation of large proportions of the original study population.
In the early ‘90s, substantial changes were introduced in the study design, rationale and objectives by decision of the newly settled Steering Committed of the study coordinated by Prof. Pasquale Strazzullo. Basically, it was decided to make of OHS an instrument for a prospective study of the metabolic, nutritional and genetic precursors of cardiovascular disease and for the investigation of cardiovascular morbility and mortality in our region. To this purpose, the study population was enlarged to include the workforce (again for the large majority males) of a second Olivetti factory located in Marcianise (Campania), close to the metropolitan area of Caserta. The Olivetti Prospective Heart Study population included 970 men, all employees or former employees of the Olivetti factory. This sample of adult male population was aged 52 years on average at the time of the examination performed in 1994-1995.
At the time of that visit, the information collected by medical history, physical and instrumental examination was much larger than in previous occasions. In addition, a biological bank and, in particular, a DNA bank were instituted and were made available for collaborations with other research centres. This was possible also thanks to the collaboration of Drs. Antonio Scottone and Umberto Candura, the physicians in charge of the Olivetti medical centres in Pozzuoli and Marcianise, respectively, and of Mrs. Maria Bartolomei, who has been in charge of the nursing procedures and of the contacts with participants throughout the study from 1970 till nowadays.
The OHS population has been re-examined in 2002-2004 (average follow-up time from previous examination 8 years, average age 59 years) with a response rate of 83%. At the time of this visit, the same anthropometric, biochemical and clinical variables investigated at the previous visit were measured and still new instrumental variables were added, obtained by echocardiography and carotid ultrasound examination.
Since 1994 all deaths and cardiovascular events occurring to participants in the Prospective OHS are being registered. The causes of death are investigated by death certificates and by interview with relatives of the participants.
The OHS has been carried through Research Projects (PRIN) supported by the Italian Ministry of University and Research. Additional local funds have been provided by the Department of Clinical and Experimental Medicine and the Department of Hygiene and Preventive Health Sciences at Federico II University of Naples. Further financial support has been provided by St. George’s Hospital Medical School, University of London and by the Institute of Food Science and Technology, National Research Council, Avellino.
The invaluable collaboration of a large number of research fellows, physicians and other medical operators, technicians and nutritionists who have worked for OHS at different times over almost four decades is gratefully acknowledged by the Steering Committee.
The OHS has been the object of numerous collaborative analyses performed in conjunction with qualified research centers in Italy and abroad. Its products are several fold: a remarkable number of publications in peer-reviewed international scientific journals and an even larger number of scientific communications at national and international congresses; a very large and ever expanding data bank that is available for testing statistical associations and new working hypotheses upon decision of the study scientific committee and/or upon request by qualified investigators and research centres; a rich biological bank and a DNA bank available for further collaborative studies; the potential for further follow-up examinations in order to gather new biochemical and instrumental information (depending on successful fund raising).
In addition to this, the fallout of the OHS enterprise can be found in the benefit for participants’ health derived from the regular communication to the participants’ family doctors of the results of physical examinations, biochemical analyses and instrumental tests. Although the medical staff of OHS has never directly interfered with the medical care of the participants, it is presumable that the information provided to family physicians has been functional to better care delivery.
Also, the possibility to serve for OHS either as medical and technical staff or as member of the group in charge of statistical handling of the data and of the preparation of scientific communications and of research articles has been and will be an instrument of learning for many physicians, technicians and research fellows.
A substantial contribution to the success of OHS has come from the sustained collaboration of the study participants and by the consciousness shared by the investigators and participants alike that the scientific results were not to be the only product of this cooperative job but that an important outcome is each participant’s feeling to be taken care of as a real person.
Chronology of The Olivetti Heart Study surveys
1970-72 Initial survey of the employees of the Olivetti factory in Pozzuoli
1975 Second survey at Olivetti factory in Pozzuoli
1982 Third survey at Olivetti factoy in Pozzuoli
1987 Forth survey at Olivetti factory in Pozzuoli
1994-95 Survey of the employees of the Pozzuoli and Marcianise Olivetti factories (940 participants)
2002-04 Follow up examination of the 1994-95 cohort (83% response rate)
2006 Telephone interviews to study participants