温石棉与肺癌——二十七年追踪研究

目的 探讨单纯接触温石棉的工人恶性肿瘤,尤其肺癌是否超高。方法 采用固定队列研究方法。研究队列为515例男性石棉工人,人列条件为1972年1月1日工资在册,工龄满1年,没有明显心肺疾患者。对照队列为650例不接尘男性工人,其余条件同研究队。追踪27年（1972－1998）。结果 （1）研究队列全癌死亡50例（SMR＝144）,其中肺癌22例（SMR＝652）;．对照队列全癌死亡1例（SMR＝34）,肺癌3例（SMR＝89）。两队列间全癌和肺癌差异均有显著性（P＜0．05）。（2）不接触石棉的吸烟者肺癌RR为2．6,不吸烟的石棉接触者肺癌RR为12．2,而接触石棉的吸烟者RR高达32．1。吸烟和石棉暴露协同指数为2．2。（3）研究队列发生胸膜间皮瘤2例。结论 单纯暴露于温石棉的工人肺癌显著超高。     

沥青接触工人与癌症关系的Meta分析

目的：研究沥青接触工人与癌症的关系。方法：应用Meta分析方法国内八有关沥青接触工人与癌症关系的队列研究进行定性和定量综合分析。采用固定效应模型和随机效应模型方法对沥青接触工人余死因,全癌死因、肺癌死因、胃癌死因的标化率比率（SRR）进行综合分析。结果：沥青接触工人全癌是其第一位死因,肺癌又居癌症死亡之首,全死因、癌症死因、肺癌死因、胃癌死因综合SRR（95％的可信区间）分别为1．4073（1．2328－1．614）、1．6225（1．4813－1．7770）、1．8905（1．4880－2．4044）、1．1757（0．9614－1．4378）;四个工龄组肺癌死率综合SRR都大于1（P＜0．05）。结论,沥青作业工人在存在癌症、特别是肺癌的高发趋势,沥青是工人肺癌的一个危险因素。     

滑石粉尘对陶瓷工人的健康效应

目的：探讨滑石粉尘对陶瓷工人呼吸系统疾病发生发展的影响。方法：采用历史前瞻性队列研究，全体队列成员按是否接触矽尘和滑石尘分为不接尘组，矽尘组和滑石尘矽尘组，运用优势比（Odds Ratios,OR)方法作计算分析。结果：滑石尘矽尘组工人的非恶性呼吸道疾病（如尘肺）和肺心病的死亡危险度与矽尘组类似，但其癌症的死亡危险度，特别是肺癌死亡比不接尘组明显超高，OR＝4．73，P＜0．01）。结论：认为颗粒型滑石可能是瓷厂工人中致肺癌因子，滑石粉尘对矽肺发病也有明显的促进作用。     

职业接触粉尘及吸烟对死亡影响的前瞻性队列研究

目的 研究接尘和吸烟对死亡的影响。方法 以1989－1992年广州实施并建立的职工职业健康监护档案为基础资料，选年龄≥30岁的接尘工人和无任何粉尘及其他有害物质接触的职工（对照组）61648名为研究对象，进行前瞻性队列研究。结果 （1）队列失访28例，死亡1186例，以恶性肿瘤死亡为主；（2）本队列男性多于女性，年龄35－44岁，主要为工人，中学文化，已婚，率42．2％，饮酒率32．8％；（3）调整相应混杂因素后，全死因、恶性肿瘤和呼吸系疾病死亡接尘者相对危险度（RR）分别为1．24、1．34和1．96，与对照组比较，差异均有显著性（P＜0．01），吸烟者RR分别为1．16、1．37和1．63，与不吸烟者比，前二者差异有显著性（P＜0．01）；既接尘又吸烟者上述相应死因死亡1RR分别为1．48、1．85和3．12，明显高于单纯接尘或单纯吸烟者，差异有显著性（P＜0．01）；（4）接尘对死亡的影响主要表现在职业接触矽尘和木尘。结论 接尘与吸烟均可致死亡危险性增加，并存在协同作用。     

煤工尘肺死亡的回顾性队列研究

为探索煤工尘肺病人的主要死因以及煤工尘肺与恶性肿瘤死亡之间的关系，采用流行病学回顾性队列研究方法对开滦矿务局１９５２～１９９５年诊断的３２２８例煤工尘肺患者（全部为男性）的结局进行了调查。队列观察从１９７０年１月１日开始，至死亡病例的死亡日期或１９９５年１２月３１日终止，以全国男性人群为参照。用标化死亡比（ＳＭＲ）作为统计指标，并计算９５％可信区间（９５％ＣＩ）。结果：全死因ＳＭＲ较全国人群高１１％（ＳＭＲ＝１．１１，９５％ＣＩ：１．０４～１．１８）。其中肺心病死亡（ＳＭＲ＝５．９７，９５％ＣＩ：５．２３～６．７７）、肺结核死亡（ＳＭＲ＝３．６８，９５％ＣＩ：３．０１～４．４６）均高于全国人群。全癌死亡低于全国人群（ＳＭＲ＝０．８１，９５％ＣＩ：０．７１～０．９２），但肺癌死亡高于全国人群（ＳＭＲ＝１．３６，９５％ＣＩ：１．１０～１．６６）。按不同死亡年代及粉尘种类进一步分析，均发现肺癌高发。结果表明：煤工尘肺病人的全死因死亡比稍高于全国人群，其中，肺心病和肺结核有明显的超额死亡。煤工尘肺病人中肺癌死亡超高。提示：煤工尘肺与肺癌的发生有关。     

某焦化厂职工癌症死因的调查分析

目的研究焦化厂职业有害因素对癌症死亡的影响.为预防癌症,保护工人健康提供依据.方法采用队列与队列内病例对照研究相结合的方法.计算主要死因的标化死亡比(SMR),相对危险度(RRMH)和绝对危险度(OR).结果观察人群24 923人年,从1975～1995年21年间癌症死亡59人,其中肺癌21人,占第一位死因.炼焦工人的肺癌显著超高,SMR＝4.17,P＜0.01.并随着接触工龄的延长,RRMH呈递增趋势.病例对照研究表明,肺癌与焦炉逸散物之间有显著性关联;与吸烟和呼吸系统疾病史亦有显著性关联.白血病与苯溶物之间没有关联.其它癌未见有意义的结果.结论接触焦炉逸散物与炼焦工人肺癌发生有关,重度吸烟和呼吸系统疾病史与肺癌发生也有关.     

上海某冶炼厂铅接触工人肿瘤死亡的回顾性队列研究

目的 了解职业铅接触工人肿瘤死亡情况,探讨职业铅接触与肿瘤的关系。方法 1985年1月1日前在本厂工人1年以上,且1985年1月1日仍存活的男性工人共6971名组成全队列,其中3344名在铅接触车间工作的工人组成的亚队列为接触队列。随访从1985年1月1日至1997年12月31日。以上海市人口的肿瘤死亡率作为标准对照,计算标化死亡比（SMR）;以本厂非接触人群作内对照计算相对危险度（RR）;估计累计接触剂量进行剂量－反应关系分析。结果 全队列6971人共观察87576人年,接触队列3344人共观察41505人年。全队列中,肺癌的SMR（95％CI）为128．0（101．1－159．7）。1965年后入厂的工人肺癌的SMR为463．7（P＜0．01）。有铅接触工作史且工龄超过20年的工人鼻咽癌的SMR＝408．0（P＜0．01）,肺癌的SMR＝156．6（P＜0．01）。肿瘤总计、恶性肿瘤总计、食管癌、胃癌、肝和胆道癌、肺癌和膀胱癌的RR（95％CI）分别为3．25（2．43－3．89）、3．28（2．54－4．32）、3．57（1．08－10．47）、2．93（1．15－4．87）、4．58（2．03－9．97）、8．58（4．82－15．11）、6．66（2．83－13．01）。将累计接触剂量分为高、中、低3个组,中、高组工人恶性肿瘤RR分别为1．62（P＜0．05）和1．70（P＜0．05）,且有随累计接触剂量增加危险性升高的趋势。中、高组工人的肺癌RR分别为2．55（P＜0．05）,和2．31（P＜0．05）。结论 工人肿瘤死亡危险性升高可能与铅接触有关,但还需要在控制其他职业有害因素接触和非职业性有害因素接触的情况下作进一步的研究。     

广东省2867例尘肺死亡病例分析

作者对广东省２８６７例尘肺死亡病例进行研究分析。结果显示：接尘工龄长短与尘肺死亡年龄呈密切相关（ｒ＝０．３６７８，Ｐ＜０．０５）。在不同接尘工龄组中，接尘工龄越短，尘肺患者的平均死亡年龄越低（Ｆ值＝７１．２７＞Ｆ０．０１，Ｐ＜０．０１）。随着年代发展，尘肺的平均死亡年龄逐渐增高（Ｆ值＝２３２．８７＞Ｆ０．０１，Ｐ＜０．０１）。说明机体对粉尘反应的敏感程度有明显个体差异。为及时发现尘肺易感人群，应加强接尘工人的健康监护工作。     

某化工厂恶性肿瘤死亡的回顾性队列研究

目的：了解职业因素对化工厂工人恶性肿瘤死亡的影响。方法：采用流行病学队列研究方法对该厂接触毒物工人疾病死亡原因进行29年回顾性分析。结果：硫酸、磷肥两车间肝癌死亡明显高于对照组（P＜0．05或0．01）;磷肥车间全癌死亡也明显高于对照组（P＜0．05）。此外,磷肥车间累计接毒工龄15－20年（或年龄40－50岁）全癌死亡、累计接毒工龄20年以上（或年龄50岁以上）肝癌死亡标化相对危险度（SRR）明显高于对照组（P＜0．05或0．01）;硫酸车间累计接毒工龄20年以上（或年龄50岁以上）肝癌死亡SRR也明显高于对照组（P＜0．05或0．01）。结论：本研究表明,某化工厂癌症发生可能与其生产环境中存在的铁金属矿尘、磷矿石粉尘以及氟化物等职业危害因素的综合作用有关。     

淄博矿区煤矿尘肺死亡回顾性队列研究

应用回顾性队列研究方法对淄博矿区１２个煤矿１９７７年１月１日在册的２０３７例煤矿尘肺的死因进行了调查。队列成员追访至１９８６年，共死亡４４３人，煤矿尘肺全死因死亡率为２４０８．８／１０万，与用山东省居民死亡率计算的期望值比较显著超高，ＳＭＲ＝２３５，９５％ＣＩ＝２１４～２５８。４非恶性呼吸道疾病（主要是尘肺病）死亡为全死因之首，占２５．１％，其次是恶性肿瘤、心血管疾病和肺结核。恶性肿瘤死亡明显超高，ＳＭＲ＝１９０，且主要集中于肺癌（占５９．２％，ＳＭＲ＝５５６），与呼吸道疾病相关的肺心病ＳＭＲ＝１９０，以及肺结核ＳＭＲ＝１００６的死亡率也明显超高。在掘进工和采煤工尘肺中，全死因、呼吸系疾病、恶性肿瘤、肺结核的死亡率显著增高，Ｐ＜０．０１。此外，在掘进工尘肺中心血管疾病，尤其是肺心病的死亡人数高于预期值（ＳＭＲ＝２７１，Ｐ＜０．０１）。     

Proportionate mortality among union members employed at three Texas refineries

The cause-specific mortality (1940–1993) of 2,985 male workers employed in three oil refineries was examined using a proportionate mortality study design. Separate analyses were undertaken by race, refinery, employment status (active and retired), and time since entry into the Oil, Chemical, and Atomic Workers (OCAW) union. Proportionate cancer mortality ratio (PCMR) analyses also were conducted. Proportionate mortality ratios (PMR) were significantly increased (P < 0.05) for cancers of the lip (PMR = 384), stomach (PMR = 142), unspecified sites of the liver (PMR = 238), pancreas (PMR = 151), connective tissues (PMR = 243), prostate (PMR = 135), eye (PMR = 407), brain (PMR = 181), benign and unspecified neoplasms (PMR = 289), and leukemia (PMR = 175) for the entire cohort. Significantly decreased mortality was observed for respiratory tuberculosis (PMR = 29), esophageal cancer (PMR = 45), rectal cancer (PMR = 49), and cancers of the bladder and other urinary organs (PMR = 40). Skin cancer was observed to be significantly increased (PMR = 242) for workers with less than 20 years since union initiation. Significantly increased PCMRs were seen for cancers of unspecified sites of the liver (PCMR = 205), brain (PCMR = 147), benign and unspecified neoplasms (PCMR = 243), and leukemia (PCMR = 146). Among nonwhites, an increased risk of bone cancer was observed in the PCMR analysis (PCMR = 704), although based on only two deaths. Analyses of mortality patterns for white males by refinery revealed similar patterns in each refinery as was seen in the overall cohort of refinery workers. Mortality patterns for whites and nonwhites also were similar. Additional analyses of deaths between 1960 and 1993 demonstrated increased mortality due to asbestosis (PMR = 683) and multiple myeloma (PMR = 124), although the multiple myeloma excess was not statistically significant. Ten deaths due to mesotheliomas were observed among these refinery workers. Am. J. Ind. Med. 33:327–340, 1998. © 1998 Wiley-Liss, Inc.     

A proportionate mortality study of granite cutters

Several recent studies (animal and human) have suggested an association between lung cancer and silica exposure. To test the hypothesis, we have studied death benefit records of 1,905 members of the Granite Cutters Union. A proportionate mortality analysis (PMR) was conducted, using U.S. deaths as a comparison population. Statistically (PMR) was conducted, using U.S. deaths as a comparison population. Statistically significant excesses were observed for death from nonmalignant respiratory significant excesses were observed for death from nonmalignant respiratory disease (largely silicosis) (183 obs, 43.7 exp) and for tuberculosis (largely silicotuberculosis) (262 obs, 19.3 exp). Other significant excesses were observed for bone cancer (6 obs, 1.9 exp) and arthritis (5 obs, 1.5 exp). A significant decrease was observed for leukemia (5 obs, 13.0 exp). For lung cancer a slight but nonsignificant excess was observed (97 obs, 81.1 exp, PMR = 1.19, 95% CI 0.97-1.46). A proportionate cancer mortality analysis (PCMR) showed similar results for lung cancer (PCMR = 1.09, 95% CI 0.89-1.33). Lung cancer mortality also failed to show any trend with either calendar time or duration of exposure. Although no significant excess of lung cancer was observed for the entire silica-exposed cohort, there was an indication that those who were silicotic had an excess risk of lung cancer, based on a review of contributing causes on the death certificate.     

Cancer mortality among jewelry workers

Mortality was investigated for the years 1950–1980 for 1,009 male members of a New York jewelry workers union, and for the years 1984–1989 among 919 men and 605 women identified as jewelry workers on death certificates from 24 states. Malignant neoplasms were excessive for male union members (proportional mortality ratio [PMR] = 1.17; 95% confidence interval [CI]: 1.02–1.33) and female jeweler deaths from the 24 states (PMR = 1.24; 95% CI: 1.07–1.42). Deaths due to nonmalignant causes were not unusual, except for excesses, in union males, of the circulatory system (PMR = 1.10; 95% CI: 1.02–1.19), including arteriosclerotic heart disease (PMR = 1.25; 95% CI: 1.14–1.37) and rheumatic heart disease (PMR = 3.02; 95% CI: 1.94–4.50). Cancers of the digestive tract were proportionally elevated among union males (proportional cancer mortality rate [PMR] = 1.13; 95% CI: 0.89–1.41) and among deaths from the 24 states (PCMR = 1.22; 95% CI: 1.01–1.47). For the 24 states, excesses for digestive cancer were found for both males (PCMR = 1.19; 95% CI: 0.90–1.54) and females (PCMR = 1.26; 95% CI: 0.96–1.62). Regarding specific sites in the digestive tract, colon cancer excesses were found in union males (PCMR = 1.53: 95% CI: 1.05–2.15), and for men (PCMR = 1.27; 95% CI: 0.82–1.88) and women (PCMR = 1.36; 95% CI: 0.92–3.27) in 24 states. Also, in the 24 states, excesses were noted for esophageal cancer (PMR = 2.03; 95% CI: 1.08–3.47) and stomach cancer (PCMR = 1.66; 95% CI: 0.95–2.69), due to excess stomach cancer in women (PCMR = 2.50; 95% CI: 1.20–4.61). Marginal proportional excesses were found for malignancies of the hematolymphopoietic system in union males (PCMR = 1.12; 95% CI: 0.72–1.67) and among deaths from 24 states (PCMR = 1.23; 95% CI: 0.90–1.66), particularly due to non-Hodgkin's lymphoma deaths (PCMR = 1.39; 95% CI: 0.93–2.00). The wide variety of exposures in this industry, particularly to metals and solvents, could possibly involve excess risk for malignancy at these sites. © 1993 Wiley-Liss, Inc.

1 This article is a US Government work and, as such, is in the public domain in the United States of America.

     

Mortality of Carpenters' Union members employed in the U.S. construction or wood products industries, 1987–1990

This study evaluated the mortality of 27,362 members of the U.S. Carpenters' Union who died 1987–1990. Age-adjusted proportionate mortality ratios (PMRs) and proportionate cancer mortality ratios (PCMRs) were computed using the U.S. age-, gender-, and race-specific proportional mortality for the years of the study. For white male carpenters who were last employed while in construction industry locals, raised mortality was observed for lung cancer (PCMR = 107, CI = 103, 111), bone cancer (PCMR = 181, CI = 107, 286), asbestosis (PMR = 283, CI = 158, 457), emphysema (PMR = 115, CI = 102, 130), transportation injuries (PMR = 121, CI = 109, 135), and falls (PMR = 122, CI = 104, 142). For white male carpenters who were last employed while in industrial wood products locals, significantly raised mortality occurred for stomach cancer (PCMR = 187, CI = 136, 250), male breast cancer (PCMR = 469, CI = 128, 720), and transportation injuries (PMR = 136, CI = 110, 173). Excess breast cancer was associated with last employment in wood machining trades. Nasal cancer mortality was not elevated. A total of 121 mesotheliomas were observed. Contributing cause of death analyses revealed raised mortality for these and additional causes; 4,594 (18%) death certificates mentioned occupational and other lung disease as a contributing factor, resulting in significantly elevated mortality. These data show that construction carpenters have moderately elevated mortality for the diseases caused by asbestos (lung cancer and malignant mesothelioma) and from traumatic injuries. The finding of elevated mortality for stomach, bone, and breast cancer was unexpected and requires further evaluation of possible occupational factors. This study confirms that construction carpentry is an extremely hazardous trade. The data suggest that additional preventive action guarding against asbestos exposure and occupational injury is urgently needed in this occupation. (This is a US Government work, and, as such, is in the public domain in the United States of America.) © 1996 Wiley-Liss. Inc.     

Mortality of a cohort of road construction and maintenance workers with work disability compensation

BACKGROUND: Surveillance systems of occupational mortality are useful tools to identify cases of diseases suspected as occupational and to monitor their occurrence over time, in space and in population subgroups. Many surveillance systems make use of administrative data in which information about occupations and/or economic sectors of the subjects enrolled is reported, such as death certificates, hospital discharge data, census data, tax and pension records, and workers' compensation archives. OBJECTIVES: In the present study we analyzed the mortality of a cohort of road construction and maintenance workers enrolled through the Italian national archive of work disability compensations, also in order to evaluate the possible use of this administrative source to monitor occupational mortality. METHODS: 8,000 subjects (7,879 males) receiving a disability compensation while working in the "road construction and maintenance" sector were identified from INAIL (National Institute for Insurance of Accidents at Work) archives. Vital status of these subjects was ascertained using the information available in INAIL archives and in the national tax register. For those found to be deceased from INAIL or tax archives, or without any information on vital status, a mail follow-up was started. We considered as observation period the years from 1980 to 1993. A record linkage with the ISTAT (Italian Institute of Statistics) national mortality registry was performed and the cause of death was retrieved for 964 out of 1,259 subjects. The analysis was restricted to males, leaving altogether 863 observed deaths with ascertained cause (84.7% of 1,019 total male deaths). SMR for overall mortality and PMR for specific cause mortality were computed, using the general Italian male population as reference. RESULTS: Overall mortality was significantly reduced (SMR = 79.0; 95% CI = 74.2-84.0). Proportional mortality analysis revealed significant excess risks for all malignant tumours (332 deaths, PMR = 1.08) and for digestive diseases (87 deaths, PMR = 1.34), while mortality for cardiovascular diseases was significantly decreased (288 deaths, PMR = 0.90). Among specific causes of death, significant excess mortality was found for cancer of testicles (2 deaths, PMR = 5.98), liver and biliary ducts (32 deaths, PMR = 1.40), and for silicosis (10 deaths, PMR = 3.07) and cirrhosis (64 deaths, PMR = 1.40). CONCLUSIONS: The excess mortality observed for all cancers, digestive diseases and silicosis, and the decreased risk for cardiovascular diseases are in agreement with the results of other studies conducted on workers in road construction and maintenance. As expected, the low overall mortality and the reduced risk from cardiovascular diseases indicate that these workers present a strong "healthy worker effect".     

Proportionate mortality among construction laborers

This report presents the results of proportionate mortality ratio (PMR) analyses and proportionate cancer mortality ratio (PCMR) analyses among the 11,685 members of the Laborers' International Union of North America (LIUNA), who died between 1985-1988, using U.S. proportionate mortality rates as the comparison population. Statistically significant elevated mortality risks were observed for all malignant neoplasms (N = 3285, PMR = 1.13, CI = 1.09-1.17), as well as for site-specific neoplasms of the lung (N = 1208, PCMR = 1.06, CI = 1.00-1.12), stomach (N = 170, PCMR = 1.44, CI = 1.23-1.68), and thyroid gland (N = 10, PCMR = 2.24, CI = 1.07-4.12). The PCMRs for these malignant neoplasms were elevated among both white and non-white males, regardless of length of union membership, in most 10-year categories of age at death above 40 and for the three largest LIUNA regions examined. The study also observed 20 mesothelioma deaths, which indicated that some LIUNA members had been previously exposed to asbestos. Statistically significant elevated risks were also observed for deaths from transportation injuries (N = 448, PMR = 1.37, CI = 1.25-1.51), falls (N = 85, PMR = 1.34, CI = 1.07-1.66), and other types of injuries (N = 245, PMR = 1.61, CI = 1.42-1.83). The deaths due to injuries were most often observed among those members who had the shortest amount of time within the union, were younger, and first entered the union after 1955. This is the first study that has examined the general mortality experience limited to construction laborers only (Bureau of Census code 869). © 1995 Wiley-Liss, Inc.     

Mortality patterns in female domestic workers.

To investigate mortality patterns for domestic workers, proportional mortality ratios (PMRs) were calculated for the 1,382 female domestic workers who died in British Columbia at age 20 years or over between 1950 and 1984. This group experienced fewer deaths than expected from cerebrovascular accidents (PMR = 84) and hypertension (PMR = 39). The proportion of deaths from cirrhosis was higher than expected (PMR = 152). An excess of observed deaths was also noted for all accidents (PMR = 126), accidents due to environmental factors (PMR = 439), and homicide (PMR = 235). Mortality from pneumonia was elevated for domestic workers aged 20 to 65 (PMR = 180). Further studies using more sophisticated epidemiologic methods are necessary to evaluate whether these deaths are a result of occupational exposures or of poor socioeconomic conditions.     

Mortality patterns among electrical workers employed in the U.S. construction industry, 1982-1987

BACKGROUND: Studies of electrical workers in the utility and manufacturing industries have reported excess site-specific cancer. No previous studies of electrical workers in the construction industry have been conducted. METHODS: Our study evaluated the mortality patterns of 31,068 U.S. members of the International Brotherhood of Electrical Workers who primarily worked in the construction industry and died 1982-1987. RESULTS: Comparison to the U.S. population by using the NIOSH life table showed significantly elevated proportionate mortality for many causes. Excess mortality for leukemia (proportionate mortality ratio (PMR)=115) and brain tumors (PMR=136) is similar to reports of electrical workers with occupational exposure to electric and magnetic fields in the electric utility or manufacturing industry. Excess deaths due to melanoma skin cancer (PMR=123) are consistent with findings of other PCB-exposed workers. A significantly elevated PMR was observed for the diseases caused by asbestos: lung cancer (PMR=117), asbestosis (PMR=247), and malignant mesothelioma (PMR=356) and from fatal injuries, particularly electrocutions (PMR=1180). The findings of statistically significant excess deaths for prostate cancer (PMR=107), musculoskeletal disease (PMR=130), suicide (PMR=113), and disorders of the blood-forming organs (PMR=141) were unexpected. CONCLUSIONS: Results suggest that more detailed investigations of occupational risk factors and evaluation of preventive practices are needed to prevent excess mortality in this hazardous occupation. Am. J. Ind. Med. 36:630-637, 1999. Published 1999 Wiley-Liss, Inc.     

Proportionate mortality among unionized construction operating engineers

This report presents the results of proportionate mortality ratios (PMR) and proportionate cancer mortality ratios (PCMR) among 15,843 members of the International Union of Operating Engineers who had died between 1988–1993. Operating engineers represent one of the 15 unions in the Building and Construction Trades Department and are responsible for the operation and maintenance of heavy earthmoving equipment used in the construction of buildings, bridges, roads, and other facilities. Using U.S. proportionate cancer mortality as the referent, statistically significant elevated mortality was observed for cancers of the lung (PCMR = 1.14, 95% confidence interval (CI) = 1.09–1.19) and bone (PCMR = 2.14, CI = 1.19–3.52). Using U.S. proportionate mortality as the referent, statistically significant elevated mortality was observed for other benign and unspecified neoplasms (PMR = 1.54, CI = 1.09–2.13), emphysema (PMR = 1.37, CI = 1.20–1.55), other injuries (PMR = 1.43, CI = 1.20–1.70) (which included crushing under/in machinery, tractor rollover, run over by crane), and suicide (PMR = 1.22, CI = 1.06–1.40). The PMR for leukemia and aleukemia (PMR = 1.19, CI = 1.02–1.37), but not the PCMR (1.07, CI = 0.92–1.24), was also significantly elevated. Some of the occupational exposures that may have contributed to these excesses include diesel exhaust, asphalt and welding fumes, silica dust, ionizing radiation, and coal tar pitch. The present study underscores the need to control airborne exposures to these substances and for injury prevention efforts aimed at operating engineers in the construction industry. Am. J. Ind. Med. 32:51-65, 1997. © 1997 Wiley-Liss, Inc.

1 This article is a US Government work and, as such, is in the public domain in the United States of America.

     

Proportionate mortality study of workers in the garment industry exposed to formaldehyde

In order to evaluate the human carcinogenicity of formaldehyde, we conducted a proportionate mortality study of garment workers engaged in the production of shirts from formaldehyde-treated cloth. This study included three plants, and was based upon 256 deaths identified from a death-benefit insurance fund. No deaths due to nasal cancer were observed, and the mortality from respiratory cancer (11 cases, PMR = 95) was slightly less than expected. Statistically significant (p less than .05) elevations in proportionate mortality were observed for malignant neoplasms of the "buccal cavity" (three cases, PMR = 750), for "biliary passages and liver" (four cases, PMR = 313) and for "other lymphatic and hematopoietic sites" (four cases, PMR = 400). A proportionate cancer mortality (PCMR) analysis also was conducted, and cancer of the "buccal cavity" (three cases, PCMR = 682), and other "lymphatic and hematopoietic sites" (four cases, PCMR = 342) were still significantly elevated. The observed excesses in cancer mortality were primarily experienced by white females, who made up the major portion of the workforce, and workers with more than 10 years of latency and duration of exposure, a criterion for inclusion for most workers in the study group. The neoplasms observed were not equally distributed among the three facilities included in the study. Because of the small number of deaths involved and the lack of consistency with other studies, we believe that these findings should be viewed cautiously, pending the outcome of more definitive studies.