Lung cancer mortality among chromate production workers

Aims: To assess mortality in 1997 among 493 former workers of a US chromate production plant employed for at least one year between 1940 and 1972.

Methods: Cohort members were followed for mortality to 31 December 1997. Standardised mortality ratios (SMRs) were calculated for selected cause specific categories of death including lung cancer. Lung cancer mortality was investigated further by calculation of SMRs stratified by year of hire, duration of employment, time since hire, and categories of cumulative exposure to Cr(VI).

Results: Including 51 deaths due to lung cancer, 303 deaths occurred. SMRs were significantly increased for all causes combined (SMR = 129), all cancers combined (SMR = 155), and lung cancer (SMR = 241). A trend test showed a strong relation between lung cancer mortality and cumulative hexavalent exposure. Lung cancer mortality was increased for the highest cumulative exposure categories (1.05 to <2.70 mg/m³-years, SMR = 365; 2.70 to 23 mg/m³-years, SMR = 463), but not for the first three exposure groups. Significantly increased SMRs were also found for year of hire before 1960, 20 or more years of exposed employment, and latency of 20 or more years.

Conclusions: The finding of an increased risk of lung cancer mortality associated with Cr(VI) exposure is consistent with previous reports. Stratified analysis of lung cancer mortality by cumulative exposure suggests a possible threshold effect, as risk is significantly increased only at exposure levels over 1.05 mg/m³-years. Though a threshold is consistent with published toxicological evidence, this finding must be interpreted cautiously because the data are also consistent with a linear dose response.

     

Lung cancer mortality among workers making lead chromate and zinc chromate pigments at three English factories

Lung cancer mortality among 1152 men working at three English chromate pigment factories was studied from the 1930s or 1940s until 1981. Workers at factory C were exposed only to lead chromate and experienced normal mortality (Obs/Exp deaths 7/6.45). Workers at factories A and B were exposed to both lead and zinc chromate; mortality was normal among those who had only low exposure (O/E 7/6.95). For workers with high or medium exposure lung cancer mortality was significantly raised among men remaining at least a year after entering service at factory A during 1932-54 (O/E 21/9.45) and at factory B during 1948-67 (O/E 11/2.50). At factory A, 1933-46 entrants staying only 3-11 months were not affected (O/E 6/5.04) and 1955-63 entrants also appeared unaffected (O/E 2/2.00); working conditions there improved in 1955. The hazard at factories A and B affected workers who left after one year as well as those with longer service, and latent intervals were unusually short. The results indicate that moderate or heavy exposure to zinc chromate may give rise to a severe risk of developing lung cancer, but that exposure which is relatively mild or lasts less than a year may not constitute an effective risk. The results provide no indication that lead chromate induces lung cancer in man, even under conditions conducive to lead poisoning.     

Lung cancer mortality among workers making lead chromate and zinc chromate pigments at three English factories.

Lung cancer mortality among 1152 men working at three English chromate pigment factories was studied from the 1930s or 1940s until 1981. Workers at factory C were exposed only to lead chromate and experienced normal mortality (Obs/Exp deaths 7/6.45). Workers at factories A and B were exposed to both lead and zinc chromate; mortality was normal among those who had only low exposure (O/E 7/6.95). For workers with high or medium exposure lung cancer mortality was significantly raised among men remaining at least a year after entering service at factory A during 1932-54 (O/E 21/9.45) and at factory B during 1948-67 (O/E 11/2.50). At factory A, 1933-46 entrants staying only 3-11 months were not affected (O/E 6/5.04) and 1955-63 entrants also appeared unaffected (O/E 2/2.00); working conditions there improved in 1955. The hazard at factories A and B affected workers who left after one year as well as those with longer service, and latent intervals were unusually short. The results indicate that moderate or heavy exposure to zinc chromate may give rise to a severe risk of developing lung cancer, but that exposure which is relatively mild or lasts less than a year may not constitute an effective risk. The results provide no indication that lead chromate induces lung cancer in man, even under conditions conducive to lead poisoning.     

启东1958—1989年肺癌死亡率分析及趋势预测

An epidemiologic study of lung cancer mortality in Qidong in the years 1958-1989 was performed based on the data from retrospective survey and registry on cancer. The mortality of the cancer was found to be increasing since 1958. For instance, the rate was 1.04/100,000 in 1958, 9.00/100,000 in 1972, and 21.38/100,000 in 1989. Grey dynamic model was used and the equation established was written in the form Yt = (X1 + 285.078676) exp [0.040 851 (t-1)]-285. 078 676. The rising trend in lung cancer leads to the prediction that this disease will rank second instead of stomach at the end of this century, and may eventually overtake liver cancer as the number one cancer death cause two decades later. As a research strategy lung cancer studies in the rural area should be equally stressed.     

Lung cancer in the meat industry

Routine statistics of occupational mortality and incidence of cancer have consistently shown high rates of lung cancer in butchers. Possible explanations include infection by carcinogenic papilloma viruses, exposure to polycyclic aromatic hydrocarbons and nitrites in the preservation of meat, or a confounding effect of tobacco. To explore these possibilities, we have examined the mortality of 1610 men employed at three British companies processing pork, beef, lamb, bacon, and other meat products. The overall death rate was less than in the national population (271 deaths observed, 310 expected) but there was an excess of deaths from cancer (87 observed, 80 expected), and in particular from lung cancer (42 observed, 32 expected). The risk of lung cancer was concentrated in subjects exposed to recently slaughtered meat, especially after an interval of 10 or more years. These findings increase suspicions of a risk of lung cancer in butchers, although further information is needed about smoking habits in the meat industry. If there is a hazard infection by a papilloma virus would seem the most likely cause.     

Lung cancer in the meat industry.

Routine statistics of occupational mortality and incidence of cancer have consistently shown high rates of lung cancer in butchers. Possible explanations include infection by carcinogenic papilloma viruses, exposure to polycyclic aromatic hydrocarbons and nitrites in the preservation of meat, or a confounding effect of tobacco. To explore these possibilities, we have examined the mortality of 1610 men employed at three British companies processing pork, beef, lamb, bacon, and other meat products. The overall death rate was less than in the national population (271 deaths observed, 310 expected) but there was an excess of deaths from cancer (87 observed, 80 expected), and in particular from lung cancer (42 observed, 32 expected). The risk of lung cancer was concentrated in subjects exposed to recently slaughtered meat, especially after an interval of 10 or more years. These findings increase suspicions of a risk of lung cancer in butchers, although further information is needed about smoking habits in the meat industry. If there is a hazard infection by a papilloma virus would seem the most likely cause.     

Lung cancer, proximity to industry, and poverty in northeast England.

This study assesses whether deprived populations living close to industry experience greater mortality from lung cancer than populations with comparable socioeconomic characteristics living farther away. Mortality data, census data, a postal survey of living circumstances, historic and contemporary data on air quality and a historic land-use survey were used. Analysis was based on two conurbations in England, Teesside and Sunderland. Housing estates in Teesside were selected based on socioeconomic criteria and distinguished by proximity to steel and chemical industries; they were grouped into three zones: near (A), intermediate (B), and farther (C), with a single zone in Sunderland. We included 14,962 deaths in 27 estates. Standardized mortality ratios (SMR) for lung cancer [International Classification of Diseases #9 (ICD-9) 162] and cancers other than lung (ICD-9 140-239, excluding 162), and sex ratios were calculated. Mortality from lung cancer was well above national levels in all zones. For men, a weak gradient corresponding with proximity to industry at younger ages reversed at older ages. In women 0-64 years of age, stronger gradients in lung cancer mortality corresponded with proximity to industry across zones A, B, and C (SMR = 393, 251, 242, respectively). Overall rates in Teesside were higher than Sunderland rates for women aged 0-64 years (SMR = 287 vs. 185) and 65-74 years (SMR = 190 vs. 157). The association between raised lung cancer mortality and proximity to industry in women under 75 years of age could not be explained by smoking, occupation, socioeconomic factors, or artifact. Explanations for differences between men and women may include gender-specific occupational experiences and smoking patterns. Our judgment is that the observed gradient in women points to a role for industrial air pollution.     

Bronchial carcinoma mortality in the German chromate-producing industry: the effects of process modification

Summary This study updates a 1982 report on mortality at two German chromate-producing factories. The main objective of the study was to establish whether the change-over to a production process using lime-free conversion of chromite ore, thus eliminating the formation of calcium chromate, had resulted in a distinct reduction in bronchial carcinoma mortality among workers exposed for the first time after the change-over (completed in 1958 in Leverkusen and 1964 in Uerdingen). A total of 1417 workers with at least 1 year of exposure were enrolled in the study. The observation period ended on 31 December 1988. The expected number of deaths was calculated using population statistics for North Rhine-Westphalia. The risk was determined in the form of a standardised mortality ratio (SMR), i.e. the ratio of observed deaths to expected deaths. In the group of 739 workers exposed before the process change-over was completed, 432 died during the observation period, 66 of them from bronchial carcinoma. This significant excess produced an SMR of 2.27 (95% confidence interval: 1.78–2.85). Where the cause of death was unknown, cases were allocated to a cause of death on the basis of the percentage occurrence of various causes of death in the specific subcohort. The cohort of 678 workers first exposed after the process modification had been completed had a slightly increased SMR for lung cancer of 1.26 (95% confidence interval: 0.58–2.38) based on nine cases. The SMR was considerably lower than in the pre change cohort, indicating the probable success of the process modification. The different age distributions in both cohorts were adjusted by analysis according to latency period. In the pre-change cohort the SMRs were 1.90 ( 10 years), 2.93 (11–20 years) and 2.14 (> 20 years). The corresponding values in the post-change cohort were 1.32, 1.32 and 0.91 (the last figure based on only one case). The SMR of 1.26 in the post-change cohort has to be seen in the light of a number of factors: smoking is more common in industrial cohorts than in the general population; the cause of death was ascertained using the best available information; there was additional exposure to asbestos; the latency period was short; and the SMR decreased with increasing latency period. There was no significant excess of deaths from nasal cancer.     

An occupational cohort mortality study of women in the German rubber industry: 1976 to 1991.

Few previous studies of workers in the rubber industry have focused on women. We examined patterns of mortality among 2871 women employed in one of five German rubber plants for at least 1 year on or after January 1, 1976, and observed through December 31, 1991. All-causes mortality was near that expected (standardized mortality ratio [lsqbSMR], 101; 95% confidence interval [CI], 87 to 118), but cancer mortality was decreased (SMR, 90; 95% CI, 70 to 115). Nevertheless, excesses were observed for mortality from stomach cancer (SMR, 156; 95% CI, 63 to 322), lung cancer (SMR, 140; 95% CI, 56 to 289), and lymphatic system cancers (SMR, 175; 95% CI, 48 to 448). Stronger associations were observed among sub-cohorts defined by time period hired. Despite limited numbers of deaths, modest excesses of mortality due to specific cancers were observed and are consistent with previous studies.     

Incidence and mortality due to cancer in Navarre, 1998-2002. Trends in the last 30 years

Between 1998-2002, 16,952 new cases of cancer were registered in Navarre. In men, the most frequently diagnosed cancers were in the following order: prostate, lung, colon and rectum, bladder and stomach, which accounted for 63.2%. In women, the sites were breast, colon and rectum, corpus uteri, stomach and ovary, which accounted for 57.6% of the cases. In the same period, 1998-2002, 4,127 men and 2,470 women died from cancer. Sixty percent of all deaths due to malign tumours in men were due to cancer of the lung, prostate, colon and rectum, stomach and bladder. In women this was due to cancers of colon and rectum, breast, stomach, pancreas and lung, which accounted for 49% of the cases. In men in Navarre there has been an increase in the incidence rates of cancer of the prostate, kidney and non-Hodgkin lymphoma. Avoidable cancers such as those related to smoking (lung, oral cavity and pharynx or pancreas) continue to rise, and represent a greater global risk of dying from cancer in the latest period studied than in the decades of the 1970s and 1980s. From 1995 up to the present, mortality due to cancer has moved from occupying the second place to become the first cause of death among men in Navarre. The global risk of death due to cancer in men is now equal to the first period studied, 1975-1977. Amongst women the global risk of death due to cancer fell by 25% between 1975 and 2002, basically at the cost of breast and stomach cancer. Tumours related to smoking increased both in mortality and in incidence and appear as a significant health problem amongst women in Navarre. Breast cancer has increased in incidence, with lower mortality figures than those of the first period 1975-1977. Invasive cancer of the cervix remains at very low rates in comparison with many European countries, including Spain. In both sexes colorectal and skin cancer has increased, while the incidence and mortality of stomach cancer continues to fall.     

Cancer mortality among workers in the German rubber industry: 1981-91.

OBJECTIVES: To determine the cancer specific mortality of active and retired workers of the German rubber industry with emphasis on cancer sites which have been associated with the rubber industry in previous studies. METHODS: A cohort of 11,663 German men was followed up for mortality from 1 January 1981 to 31 December 1991. Cohort members were active (n = 7536) or retired (n = 4127) at the beginning of the study, and had been employed for at least one year in one of five study plants producing types or general rubber goods. Vital status was ascertained for 99.7% of the cohort members, and cause of death found for 96.8% of the 2719 decedents. Age and calendar year adjusted standardised mortality ratios (SMR) and 95% confidence intervals (95% CI) were calculated overall from national reference rates and stratified by year of hire and by years since hire. RESULTS: Mortalities from all causes (SMR 108; 95% CI 104-112) and all cancers (SMR 111; 95% CI 103-119) were significantly increased in the study cohort. Significant excesses in the mortalities from lung cancer (SMR 130; 95% CI 115-147) and pleural cancer (SMR 401; 95% CI 234-642) were identified. SMRs higher than 100 were found for cancers of the pharynx (SMR 144; 95% CI 76-246), oesophagus (SMR 120; 95% CI 74-183), stomach (SMR 110; 95% CI 86-139), rectum (SMR 123; 95% CI 86-170), larynx (SMR 129; 95% CI 69-221), prostate (SMR 108; 95% CI 84-136), and bladder (SMR 124; 95% CI 86-172), as well as for leukaemia (SMR 148; 95% CI 99-213). Mortalities from liver cancer, brain cancer, and lymphoma were lower than expected. CONCLUSIONS: Mortalities from cancer of several sites previously associated with the rubber industry were also increased among workers of the German rubber industry. Results of the stratified analyses are consistent with a role of occupational exposure in the aetiology of some of these cancers.     

Proportionate cancer mortality among workers in the Belarussian tanning industry

BACKGROUND: The tanning industry involves many occupational exposures. This study evaluates proportionate cancer mortality among workers employed in the Belarussian tanning plant in Minsk. METHODS: A total of 768 workers with seniority of not less than 6 months who were hired after January 1, 1953 and died before December 31, 2000 was investigated. Proportionate mortality ratios (PMRs) were calculated using the population of Minsk to generate expected numbers. RESULTS: Among women employed in the tannery, there was a significant excess of pancreatic cancer, based on eight deaths (expected = 2.56, PMR = 3.13, 95% CI = 1.35-6.17). Six of the eight pancreatic cancer deaths occurred among women occupied in dyeing-stuffing workshops (expected = 1.64, PMR = 3.67, 95% CI = 1.34-7.97), all among workers hired between 1962 and 1984 (expected = 1.06, PMR = 6.54, 95% CI = 2.6-13.4). CONCLUSIONS: Women in this tanning industry cohort experienced excess mortality of cancer of the pancreas, with suggested increases of corpus and cervix uteri, melanoma, and kidney cancers. For men, an insignificant increase in PMR of oral cavity-pharynx and pancreatic cancers was seen. Further prospective follow-up of living members of this cohort, will allow more in-depth analysis of rare cancer sites, latency, and duration of employment, and is warranted.     

Lung cancer mortality in nickel/chromium platers, 1946-95

OBJECTIVES: To investigate mortality from lung cancer in nickel/chromium platers. METHODS: The mortality experience of a cohort of 1762 chrome workers (812 men, 950 women) from a large electroplating and light engineering plant in the Midlands, United Kingdom, was investigated for the period 1946-95. All subjects were first employed in chrome work at the plant during the period 1946-75, and had at least six months employment in jobs associated with exposure to chromic acid mist (hexavalent chromium). Detailed job histories were abstracted from original company personnel records and individual cumulative durations of employment in three types of chrome work were derived as time dependent variables (chrome bath work, other chrome work, any chrome work). Two analytical approaches were used--indirect standardisation and Poisson regression. RESULTS: Based on mortalities for the general population of England and Wales, male workers with some period of chrome bath work had higher lung cancer mortalities (observed deaths 40, expected deaths 25.41, standardised mortality ratio (SMR) 157, 95% confidence interval (95% CI) 113 to 214, p < 0.01) than did other male chrome workers (observed 9, expected 13.70, SMR 66, 95% CI 30 to 125). Similar findings were shown for female workers (chrome bath workers: observed 15, expected 8.57, SMR 175, 95% CI 98 to 289, p = 0.06; other chrome workers: observed 1, expected 4.37, SMR 23, 95% CI 1 to 127). Poisson regression was used to investigate risks of lung cancer relative to four categories of cumulative duration of chrome bath work and four categories of cumulative duration of other chrome work (none, < 1 y, 1-4 y, > or = 5 y). After adjusting for sex, age, calendar period, year of starting chrome work, period from first chrome work, and employment status (still employed v left employment), there was a significant positive trend (p < 0.05) between duration of chrome bath work and risks of mortality for lung cancer. Relative to a risk of unity for those chrome workers without any period of chrome bath work, risks were 2.83 (95% CI 1.47 to 5.45), 1.61 (95% CI 0.75 to 3.44), and 4.25 (95% CI 1.83 to 9.87) for the second, third, and fourth exposure categories, respectively. Duration of other chrome work was not a useful predictor of risks of lung cancer. Similar findings for both variables were obtained when adjustment was made for sex and age only. Similar findings for both variables were obtained relative to risk of chrome nasal ulceration. CONCLUSIONS: The findings are consistent with the hypothesis that soluble hexavalent chromium compounds are potent human lung carcinogens.

 

     

International variation in pancreatic cancer mortality for the period 1955-1998

Background: Pancreatic cancer is an important cause of cancer mortality in developed countries. This article examines time trends for pancreatic cancer mortality rates in 38 countries on five continents between 1955 and 1998. Methods: We used the World Health Organization database on Age-Standardized World Population pancreatic cancer mortality rates by gender and fitted these data with linear regression models. This allowed us to (1) investigate the statistical significance of temporal trends; and (2) consider differences in trends among countries; and (3) predict future pancreatic cancer mortality rates. Results: Over 44 years, pancreatic cancer mortality rates increased for females worldwide. Pancreatic cancer mortality rates for men increased in Southern Europe. In contrast, pancreatic cancer mortality rates for men in North America and Oceania increased until about 1975 and then decreased or remained stable. Ourpredictive models suggest that by 2005 the relative burden of pancreatic cancer mortality will have shifted away from Northern Europe and North America toward Southern Europe and Asia. Conclusions: Future research on pancreatic cancer should concentrate separately on the assessment of risk attributable to exposure to environmental factors, lifestyle factors, genetic determinates of pancreatic cancer, and the interactive influences of these factors on pancreatic cancer.     

Lung cancer mortality in UK nickel-cadmium battery workers, 1947-2000

Aims: To investigate mortality from lung cancer in nickel-cadmium battery workers in relation to cumulative exposure to cadmium hydroxide.

Methods: The mortality of a cohort of 926 male workers from a factory engaged in the manufacture of nickel-cadmium batteries in the West Midlands of England was investigated for the period 1947–2000. All subjects were first employed at the plant in the period 1947–75 and employed for a minimum period of 12 months. Work histories were available for the period 1947–86; the factory closed down in 1992. Two analytical approaches were used, indirect standardisation and Poisson regression.

Results: Based on serial mortality rates for the general population of England and Wales, significantly increased mortality was shown for cancers of the pharynx (observed (Obs) 4, expected (Exp) 0.7, standardised mortality ratio (SMR) 559, p<0.05), non-malignant diseases of the respiratory system (Obs 61, Exp 43.0, SMR 142, p<0.05), and non-malignant diseases of the genitourinary system (Obs 10, Exp 4.1, SMR 243, p<0.05). Non-significantly increased SMRs were shown for lung cancer (Obs 45, Exp 40.7, SMR 111) and cancer of the prostate (Obs 9, Exp 7.5, SMR 116). Estimated cumulative cadmium exposures were not related to risks of lung cancer or risks of chronic obstructive pulmonary diseases, even when exposure histories were lagged first by 10, then by 20 years.

Conclusions: The study findings do not support the hypotheses that cadmium compounds are human lung carcinogens.

     

1998年-2007年常熟市居民胃癌死亡及减寿分析

目的：分析1998年-2007年常熟市居民胃癌死亡及减寿情况。方法：利用全死因登记报告资料,以死亡率和减寿率为主要指标分析胃癌死亡的分布特征。结果：常熟市1998年～2007年居民胃癌粗死亡率为46．42／10万,标化死亡率为21．98／10万,胃癌死亡人数占全部恶性肿瘤死亡人数的24．01％。常熟市居民胃癌死亡率男性高于女性,且均随着年龄的增加而上升。随着时间的推移,标化死亡率呈不断下降趋势。10年间因胃癌死亡导致的减寿年数（PYLL）、平均减寿年数（AYLL）、减寿率（PYLLR）和标化减寿率（SPYLLR）分别为25453人年、10．27年、2．69‰和2．41％。结论：胃癌对常熟市居民健康影响较大,必须加强防治研究工作。