Mortality among a cohort of United Kingdom steel foundry workers with special reference to cancers of the stomach and lung, 1946-90.

OBJECTIVE--The aim was to describe cause specific mortality among steel foundry workers and to determine if any part of the experience may be due to occupation. DESIGN--Historical prospective cohort study. SETTING--Nine steel foundries in England and one in Scotland. SUBJECTS--10,438 male production employees first employed in the period 1946-65 and with a minimum period of employment of one year. MAIN OUTCOME MEASURES--Observed and expected numbers of deaths for the period 1946-90. RESULTS--Compared with the general population of England and Wales, standardised mortality ratios (SMRs) for all causes and all neoplasms were 115 (observed deaths (Obs) 3976) and 119 (Obs 1129) respectively. Statistically significant excesses were found for cancer of the stomach (Obs 124, expected deaths (Exp) 92.5, SMR 134, 95% confidence interval (95% CI) 111-160) and cancer of the lung (Obs 551, Exp 378.3, SMR 146, 95% CI 134-158). A raised SMR (153) was also found for non-malignant diseases of the respiratory system. Classifications of jobs attracting either higher dust or higher fume exposures did not usefully predict these increased SMRs. Poisson regression was used to investigate risks of mortality from all cancers, cancer of the stomach, cancer of the lung, and non-malignant diseases of the respiratory system associated with duration of employment in the foundry area, the fettling shop, the foundry area/fettling shop, and the industry in general. Monotonic dose-response relations were not found, although there were positive trends for lung cancer and employment in the foundry area/fettling shop (1.0, 1.21, 1.44, 1.26) and for diseases of the respiratory system and employment in the fettling shop (1.0, 1.37, 1.18, 1.35). CONCLUSIONS--Confident interpretation of the causes of the raised SMRs was not possible. There was limited evidence of an occupational role in the excesses of lung cancer and diseases of the respiratory system. Smoking history was shown, in an indirect way, to be an unlikely explanation.     

Mortality from lung cancer among a cohort of nickel cadmium battery workers: 1946-84.

The lung cancer mortality experienced by a cohort of 3025 workers from a nickel cadmium battery factory during the period 1946-84 has been investigated. Occupational histories were described in terms of 75 jobs: eight with "high," 14 with "moderate" or slight, and 53 with minimal or zero exposure to cadmium oxide (hydroxide) dust. The Mantel-Haenszel technique applied to prospective (or historical prospective) studies was used to compare the estimated cadmium exposures (durations of exposed employment) of those dying from lung cancer with those of matching survivors in the same year of follow up, while controlling for sex and year, and age of starting employment. Among workers first employed in the period 1923-46, there was some evidence of an association between the risk of dying from lung cancer and duration of employment in "high or moderate" exposure jobs, although the evidence relied heavily on the findings for the single highest exposure category. Among workers first employed in the period 1947-75, there was no evidence whatsoever of such an association.     

Mortality from lung cancer among a cohort of nickel cadmium battery workers: 1946-84

The lung cancer mortality experienced by a cohort of 3025 workers from a nickel cadmium battery factory during the period 1946-84 has been investigated. Occupational histories were described in terms of 75 jobs: eight with "high," 14 with "moderate" or slight, and 53 with minimal or zero exposure to cadmium oxide (hydroxide) dust. The Mantel-Haenszel technique applied to prospective (or historical prospective) studies was used to compare the estimated cadmium exposures (durations of exposed employment) of those dying from lung cancer with those of matching survivors in the same year of follow up, while controlling for sex and year, and age of starting employment. Among workers first employed in the period 1923-46, there was some evidence of an association between the risk of dying from lung cancer and duration of employment in "high or moderate" exposure jobs, although the evidence relied heavily on the findings for the single highest exposure category. Among workers first employed in the period 1947-75, there was no evidence whatsoever of such an association.     

Mortality from non-malignant respiratory diseases in Andalusia,Spain, 1975-1997

This study aims to assess mortality trends of nonmalignant respiratory diseases from 1975 through 1997 in the population of Andalusia (a region of Spain in the southwest, population 7,000,000). The death records containing codes 460–519 of the International Classification of Diseases, Eighth Revision (ICD-8) and Ninth Revision (ICD-9) in effect through the 23-year period were used in this study. Deaths from nonmalignant respiratory diseases accounted for 12.4 and 10% of all deaths in males and females in 1975 and for 12.1 and 8.3% in 1997. Crude death rates decreased from 107.5 to 102.7 per 100,000 amongst men, and from 76.9 to 62.2 per 100,000 amongst women. Age-adjusted death rates decreased from 167.6 to 111.6 per 100,000 in men and from 84.4 to 41.2 per 100,000 in women. Age-adjusted death rate by potential years of life lost decreased from 5.8 to 2.4 per 1000 in men and from 2.4 to 0.8 per 1000 in women. Total percentage of change, adjusted by age, showed a decrease of 24.3% in men and 45.9% in women. Gender-adjusted rates for each category of nonmalignant respiratory disorders showed an upward trend of obstructive lung diseases in men and a downward trend of diseases of the upper airways and pneumonia both in men and women. Specific death rates by age groups for 1975–1985 and 1986–1997 showed an increased in mortality in infants under 1 year of age and an abrupt decrease up to the age of 50 followed by an exponential increase up to the age of 85.     

Mortality in gold and coal miners in Western Australia with special reference to lung cancer.

Cohorts of 1974 gold miners and 213 coal miners in Western Australia surveyed for respiratory symptoms, smoking habits, occupational history and radiographic evidence of pneumoconiosis have been followed up for 13-14 years. Overall, neither group had a significantly higher mortality than expected from the experience of Western Australian men in general. Lung cancer mortality was relatively high in the gold miners (59 deaths observed, 40.8 expected) but weakly and inconclusively related to the extent of their underground mining experience. Cigarette smoking may explain the excess of lung cancer in the gold miners because the prevalence of the habit in the latter (66.3%) was higher than in the coal miners (58.7%) or in other men in Western Australia (53.2%). Radiographic evidence of silicosis was present in 21.7% of the gold miners but did not appear to have contributed substantially to their mortality. The coal miners showed a lower than expected rate of lung cancer but an excess of deaths from all other forms of cancer (11 observed, 5.6 expected). This excess was not attributable to any one cancer site and cannot be explained readily.     

Mortality in gold and coal miners in Western Australia with special reference to lung cancer.

Cohorts of 1974 gold miners and 213 coal miners in Western Australia surveyed for respiratory symptoms, smoking habits, occupational history and radiographic evidence of pneumoconiosis have been followed up for 13-14 years. Overall, neither group had a significantly higher mortality than expected from the experience of Western Australian men in general. Lung cancer mortality was relatively high in the gold miners (59 deaths observed, 40.8 expected) but weakly and inconclusively related to the extent of their underground mining experience. Cigarette smoking may explain the excess of lung cancer in the gold miners because the prevalence of the habit in the latter (66.3%) was higher than in the coal miners (58.7%) or in other men in Western Australia (53.2%). Radiographic evidence of silicosis was present in 21.7% of the gold miners but did not appear to have contributed substantially to their mortality. The coal miners showed a lower than expected rate of lung cancer but an excess of deaths from all other forms of cancer (11 observed, 5.6 expected). This excess was not attributable to any one cancer site and cannot be explained readily.     

Mortality study of nickel platers with special reference to cancers of the stomach and lung, 1945-93.

OBJECTIVES: To re-examine mortality patterns in a cohort of nickel platers with no history of chromium plating. METHODS: All 284 men first employed by the company in 1945-75 with a minimum employment of three months in the nickel plating department were identified. Workers who had worked in the chromium plating or nickel/chromium plating departments were excluded. Standardised mortality ratios (SMRs), P values, and 95% confidence intervals were calculated. Poisson regression was used to carry out statistical modelling of mortalities within the cohort (internal standard). Four variables were considered to have the potential to influence mortality within the cohort: attained age (age at follow up or age at death), year of starting nickel work, period of follow up (measured from the first period of work with nickel exposure), and duration of exposure to nickel. RESULTS: The only significant difference between observed and expected numbers, when investigated by site of cancer and by broad non-cancer groupings, was that for stomach cancer (observed eight, expected 2.49, SMR 322). CONCLUSIONS: The study provides only weak evidence that nickel plating is associated with an excess risk of stomach cancer. This cohort of nickel platers does not seem to have experienced any discernible risk of occupational lung cancer. Other studies of nickel platers rather than nickel/chromium platers would be useful.     

Non-malignant respiratory diseases and lung cancer among Chinese workers exposed to silica

The objective of this study was to explore whether a medical history for non-malignant respiratory disease contributes to an increased lung cancer risk among workers exposed to silica. We analyzed data from a nested case-control study in 29 dusty workplaces in China. The study population consisted of 316 lung cancer cases and 1356 controls matched to cases by facility type and decade of birth who were alive at the time of diagnosis of the index case and who were identified in a follow-up study of about 68,000 workers. Age at first exposure and cigarette smoking were accounted for in the analysis. Smoking was the main risk factor for both lung cancer and chronic bronchitis. Lung cancer risk showed a modest association with silicosis and with cumulative silica exposure, which did not vary by history of previous pulmonary tuberculosis. Among subjects without a medical history for chronic bronchitis or asthma, lung cancer risk was associated with silicosis (odds ratio [OR], 1.6; 95% confidence interval [CI], 1.1 to 2.2), and it was increased in each quartile of cumulative silica exposure. However, risk was not elevated in the highest quartile (OR, 1.3, 1.6, 1.8, 1.4). Among subjects with a medical history for chronic bronchitis or asthma, lung cancer risk was associated with neither silicosis (subjects with chronic bronchitis: OR, 0.6; subjects with asthma: OR, 0.4) nor with silica exposure. In this study population, we observed a modest association of both silicosis and cumulative exposure to silica with lung cancer among subjects who were not previously diagnosed with chronic bronchitis or asthma, but not among subjects who had a medical history for either disease. Risk of lung cancer associated with silicosis or cumulative exposure to silica did not vary by previous medical history of pulmonary tuberculosis.     

Mortality from lung cancer and respiratory disease among pottery workers exposed to silica and talc

A cohort mortality study of white men employed for at least one year between 1939 and 1966 at three plants of a single United States company was conducted to evaluate the risk of lung cancer and nonmalignant respiratory disease among workers exposed to silica dust and nonfibrous (nonasbestiform) talc in the manufacture of ceramic plumbing fixtures. Follow-up of 2,055 men through January 1, 1981, indicated a substantial excess of nonmalignant respiratory disease among those with high levels of exposure to silica dust (standardized mortality ratio = 2.26). The risk of nonmalignant respiratory disease rose with the number of years exposed, was not further enhanced by talc exposure, and appeared to be appreciably lower among those exposed in more recent time periods. For lung cancer, men exposed to high levels of silica dust with no talc exposure had a nonsignificant standardized mortality ratio of 1.37. However, those exposed to nonfibrous talc in addition to high levels of silica had a significant 2.5-fold excess risk of lung cancer. Among this group, the lung cancer standardized mortality ratio rose with increasing years of talc exposure to 3.64 among those exposed for 15 or more years. Although the role of silica as a cofactor cannot be ruled out, these data suggest that nonfibrous talc exposure is associated with excess lung cancer risk.     

Mortality and cancer morbidity experience of female workers at the British Nuclear Fuels Sellafield plant, 1946-1998

BACKGROUND: Studies of nuclear workers have focused mainly on the experience of male workers. To date, little has been published specifically on the experience of female workers in the nuclear industry. METHODS: We report on the mortality, cancer morbidity, and tracing experience of the 6,376 females ever employed at the British Nuclear Fuels Ltd. plant at Sellafield to the end of 1998. These workers have accumulated 142,337 person-years of experience. RESULTS: Radiation workers were exposed to low doses of radiation. No statistically significant associations were noted between mortality or cancer morbidity and cumulative assessed organ-specific internal plutonium dose or cumulative external whole body radiation dose overall, or for any of the individual disease groupings examined. The power of the study was insufficient to detect the risks indicated in other radiation studies. CONCLUSION: This study offers reassurance that there is no detrimental effect on the health of the female workers from occupational exposures at Sellafield. Am. J. Ind. Med. 44:653-663, 2003.     

Mortality from cancer and chronic respiratory diseases among workers who manufacture carbon electrodes

OBJECTIVES—To investigate the risk of cancer and non-neoplastic respiratory diseases among workers who manufacture carbon electrodes, as this industry entails exposure to mixtures of polycyclic aromatic hydrocarbons.
METHODS—A historical cohort study was carried out of 1006 male workers employed for at least 1 year between 1945 and 1971 in a carbon (graphite) electrode production plant in central Italy, who were followed up for mortality between 1955 and 1996. The ratio of observed to expected deaths (standardised mortality ratios, SMRs) was computed from both national and (for the period 1964-96) regional age and period specific mortalities. A multivariate Poisson regression analysis was performed to investigate the relative risk (RR) of death according to duration of employment and time since first employment in the factory.
RESULTS—A total of 424 workers had died, 538 were still alive, and 44 were lost to follow up. Mortalities from all causes, all cancers, and respiratory tract cancer were in line with the regional figure. An excess was found over the expected deaths from skin cancer including melanoma (SMR 3.16, 95% confidence interval (95% CI) 0.65 to 9.23) and from non-neoplastic respiratory diseases (SMR 1.58, 95% CI 1.16 to 2.11). Poisson regression analysis including age as a covariate showed an increased risk of dying from gastric cancer with increasing duration of employment, and an increase in the RR of dying from lung cancer and from non-neoplastic respiratory diseases with increasing time since first employment, although the linear trend was not significant.
CONCLUSION—This study supports previous findings that working in the carbon electrode manufacturing industry may not increase the risk of dying from respiratory cancer. However, a possible association with non-malignant respiratory diseases cannot be excluded.


Keywords: carbon electrode manufacturing; polycyclic aromatic hydrocarbons; historical cohort study     

Mortality of newspaper workers from lung cancer and bronchitis 1952-66

Moss, E., Scott, T. S., and Atherley, G. R. C. (1972).Brit. J. industr. Med,29, 1-14. Mortality of newspaper workers from lung cancer and bronchitis 1952-66. The mortality experience of 3 485 men who worked full-time in the newspaper printing industry in London and Manchester and died in the period 1952-66 has been analysed for occupation and cause of death.

There was an excess of deaths from cancer of the lung and bronchus (I.C.D. 162, 163) in printing trade workers as a whole compared with the male population of the region in which they worked, adjusted for age and calendar year of death. The excess was about 30% in London and about 40% in Manchester. Both these excesses are significant at the 1% level. In Manchester, but not in London, there was a concentration of excess (about 100%) in machine room men, again significant at the 1% level. White collar workers showed no difference between observed and expected deaths in London and only a small excess (20%, not significant at the 5% level) in Manchester.

There were small deficits of deaths from bronchitis (I.C.D. 500 to 502), about 10% for printing trade workers, and 30 to 40% for white collar workers, with little difference between London and Manchester. Neither deficit is significant at the 5% level because of the small numbers involved.

This survey does not provide any evidence about the cause of the overall small excess of deaths from lung cancer, which might or might not be occupational. The larger excess in the Manchester machine room men is more likely to be due to an occupational hazard.

     

Mortality and cancer morbidity in workers from an aluminium smelter with prebaked carbon anodes--Part III: Mortality from circulatory and respiratory diseases.

OBJECTIVE--To investigate associations between exposure to pot emissions (fluorides, sulphur dioxide) and mortality from chronic obstructive lung disease, coal tar pitch volatiles and mortality from diseases related to atherosclerosis, and carbon monoxide and mortality from ischaemic heart disease. METHODS--Mortality between 1962 to 1991 was investigated in a cohort of 1085 men hired by a Norwegian aluminium smelter between 1922 and 1975. Associations between cumulative exposure and mortality were investigated through SMR analysis based on national mortality rates; temporal relations were explored by considering exposures only within specific time windows. Circulatory mortality was also investigated by Poisson regression analysis. RESULTS--There were 501 deaths v 471.3 expected in the cohort. The excess was confined to short term workers and did not seem to be associated with exposures in the smelter. Analysis of mortality among the 661 men with at least three years employment showed associations between cumulative exposure to tar 40 years before observation and atherosclerotic mortality (P = 0.03), and between exposure to pot emissions 20-39 years before observation and mortality from chronic obstructive lung disease (P = 0.06). No association was found between exposure to carbon monoxide and mortality from ischaemic heart disease, but cerebrovascular mortality was associated with exposure to pot emissions (P = 0.02). Results for atherosclerotic and cerebrovascular diseases were confirmed through Poisson regression analysis. CONCLUSIONS--The data support previous findings of increased mortality from ischaemic heart disease in workers exposed to tar, and some support is also provided for earlier reports of increased respiratory mortality in potroom workers.     

Mortality from non-malignant diseases in a cohort of female pulp and paper workers in Norway

Objectives

The objective of the present study was to investigate the risk of death from non‐malignant diseases in female pulp and paper workers in Norway.

Methods

A total of 3143 women first employed between 1920–93 were included in the study cohort. Information about each cohort member was obtained from personnel record files in the mills in order to identify employment periods and job categories. Data on cause and date of death were added by linkage to the Cause of Death Register using unique personal identification numbers. The follow up period was 1951–2000. Standardised mortality ratios (SMRs) with 95% confidence intervals (95% CIs) were calculated using the national female mortality rates as reference. Poisson regression analysis was used to examine internal relations between the duration of employment in paper departments and the risk of death from selected causes. Relative risks (RRs) and 95% CIs were calculated.

Results

The study showed a significantly increased risk for total non‐malignant mortality (SMR = 1.14, 95% CI 1.05 to 1.24), mainly due to increased mortality from ischaemic heart disease (SMR = 1.22, 95% CI 1.03 to 1.43) and cerebrovascular diseases (SMR = 1.16, 95% CI 0.94 to 1.42). Analysis by department showed the highest risk of death in paper department workers with short term employment. Internal analyses showed a 5% and 9% increase in risk of dying from ischaemic heart disease and respiratory diseases, respectively, among paper department workers exposed to paper dust. The risk decreased with increasing duration of employment.

Conclusion

The increased risk of ischaemic heart diseases and respiratory diseases seen among employees of paper departments may be related to exposure to paper dust.