Mortality among shipyard Coast Guard workers: a retrospective cohort study.

BACKGROUND: The mortality experience of 4702 (4413 men and 289 women) civilian workers in a US Coast Guard shipyard was evaluated. METHODS: All workers employed at the shipyard between 1 January 1950 and 31 December 1964 were included in the study and were followed through 31 December 2001 for vital status. Detailed shipyard and lifetime work histories found in the shipyard personnel records and job descriptions were evaluated. Workers were classified as likely exposed to any potential hazardous substances. In addition, 20 job groups were created on likely similar exposures. Standardised mortality ratios (SMRs) were calculated based on the general population of the state and adjusted for age, calendar period, sex and race. RESULTS: The follow-up was successful for 93.3% of the workers. Among all men employed in the shipyard, there was an excess of mortality from all causes of death (SMR 1.08; 95% CI 1.04 to 1.12), respiratory cancers (SMR 1.29; 95% CI 1.15 to 1.43), lung cancer (SMR 1.26; 95% CI 1.12 to 1.41), mesothelioma (SMR 5.07; 95% CI 1.85 to 11.03) and emphysema (SMR 1.44; 95% CI 1.01 to 1.99) and a decrease for cardiovascular diseases (OR 0.95; 95% CI 0.90 to 1.00), vascular lesions of the central nervous system (SMR 0.80; 95% CI 0.67 to 0.96), cirrhosis of the liver (SMR 0.38; 95% CI 0.25 to 0.57) and external causes of death (SMR 0.55; 95% CI 0.44 to 0.68). A similar pattern was observed for the men classified as exposed. No increasing trend of mortality was found with duration of employment in the shipyard, with the exception of mesothelioma (SMRs of 4.23 and 6.27 for <10 years and > or =10 years, respectively). In occupations with at least three cases and with an SMR of > or =1.3, the authors observed a significantly elevated mortality for lung cancer among machinists (SMR 1.60; 95% CI 1.08 to 2.29) and shipfitters, welders and cutters (SMR 1.34; 95% CI 1.07 to 1.65) and for oral and nasopharyngeal cancers among wood workers (SMR 6.20; 95% CI 2.27 to 13.50). CONCLUSION: Employment in this Coast Guard shipyard revealed a small but significant excess mortality from all causes, lung cancer and mesothelioma, most of which is probably related to asbestos exposure.

Occupation and risk of stomach cancer in Poland.

BACKGROUND: In spite of the dramatic decline in the incidence of stomach cancer in the twentieth century, Poland has one of the highest rates in the world. AIMS: To evaluate the risk of stomach cancer by grouped occupations and industries, as well as by some specific occupational exposures. METHODS: Cases (n = 443) were newly diagnosed with stomach adenocarcinomas between 1994 and 1996. Controls (n = 479) were randomly selected from the general population in Warsaw. RESULTS: Only a few occupations and industries were associated with significantly increased risks of stomach cancer. The most suggestive finding was for work in the leather goods industry. Risk was also significantly increased among men working in fabricated metal production and among women ever employed as managers and governmental officials. Men ever employed as teaching professionals and women employed as technical and science professionals had significantly decreased risks of stomach cancer. Among men, a significant positive trend in risk with duration of employment was observed for work in the leather industry and special trade construction. No significantly increased risks were observed for specific exposures assessed by a job-exposure matrix or by self-reports. However among men there were non-significantly increased risks with 10 or more years exposure to asbestos, metal dust, and nitrosamines assessed by a job-exposure matrix. CONCLUSIONS: Employment in the leather goods industry, special trade construction, and metal fabrication was associated with an increased risk of stomach cancer among men. However, there were only weak associations with specific exposures. Occupational exposures do not contribute substantially to the high rates of stomach cancer in Poland.

Work practice and some adverse health effects in nurses handling antineoplastic drugs.

BACKGROUND: Widespread use of antineoplastic drugs has led to higher health risks of personnel who prepare and administer these drugs. The short-term, non-specific health effects in nurses handling antineoplastic drugs (AND) have been documented. OBJECTIVES: To establish work practices and preventive measures for nurses handling antineoplastic drugs and to determine the risk of developing symptoms. METHODS: In eight Belgrade hospitals, 263 nurses were selected (response rate 90.1%) for the study. Among these, 186 were involved in preparation and administration of AND, and 77 were not exposed. Data on exposure, work practice, safety precautions, and symptoms were obtained via a questionnaire. The mean age of exposed nurses was lower than in a control group (35 vs. 39 yrs). RESULTS: Only 38% of all nurses used vertical laminar safety cabinets while mixing AND, 82% used gloves, and 57% masks. Special medical rooms for mixing AND, written instructions and special containers for waste material were available only sporadically. No exposure monitoring had ever been performed in any hospital or department. Periodic medical check-ups were rare (24.7% of all nurses). In exposed nurses ORs adjusted for age, smoking habit and shift work were significantly elevated for almost all symptoms, mostly for the following: hair loss (OR = 7.14), skin rash (OR = 4.70), and light-headedness (OR = 4.33), as well as the disappearance of symptoms during the weekend (OR = 4.78). The mean number of symptoms revealed an exposure-effect relationship, with the highest number of symptoms in daily exposed nurses and lowest in non-exposed nurses (6.3 vs. 3.1) (p < 0.001). CONCLUSIONS: Our results indicate without doubt that exposed nurses reported more symptoms than non-exposed nurses, an effect that was not dependent on age, smoking, or night shift. The use of safety precautions was inadequate and reflected the lack of awareness of potential hazards due to occupational exposure to AND.

Asbestos and cancer: An overview of current trends in Europe.

This review assesses the contribution of occupational asbestos exposure to the occurrence of mesothelioma and lung cancer in Europe. Available information on national asbestos consumption, proportions of the population exposed, and exposure levels is summarized. Population-based studies from various European regions on occupational asbestos exposure, mesothelioma, and lung cancer are reviewed. Asbestos consumption in 1994 ranged, per capita, between 0. 004 kg in northern Europe and 2.4 kg in the former Soviet Union. Population surveys from northern Europe indicate that 15 to 30% of the male (and a few percent of the female) population has ever had occupational exposure to asbestos, mainly in construction (75% in Finland) or in shipyards. Studies on mesothelioma combining occupational history with biologic exposure indices indicate occupational asbestos exposure in 62 to 85% of the cases. Population attributable risks for lung cancer among males range between 2 and 50% for definite asbestos exposure. After exclusion of the most extreme values because of methodologic aspects, most of the remaining estimates are within the range of 10 to 20%. Estimates of women are lower. Extrapolation of the results to national figures would decrease the estimates. Norwegian estimates indicate that one-third of expected asbestos-related lung cancers might be avoided if former asbestos workers quit smoking. The combination of a current high asbestos consumption per capita, high exposure levels, and high underlying lung cancer rates in Central Europe and the former Soviet Union suggests that the lung cancers will arise from the smoking-asbestos interaction should be a major concern.

Risk for prostate cancer by occupation and industry: a 24-state death certificate study.

Current knowledge of the etiology of prostate cancer is limited. Numerous studies have suggested that certain occupations and industries may be associated with the occurrence of prostate cancer. Information on occupation and industry on death certificates from 24 states gathered from 1984 to 1993 was used in case control study on prostate cancer. A total of 60,878 men with prostate cancer as underlying cause of death was selected and matched with controls who died of all other causes except cancer. Similar to the findings of our parallel large case control study of prostate cancer, we observed excess risks in some white-collar occupations, such as administrators, managers, teachers, engineers, and sales occupations. However, some blue-collar occupations, such as power plant operators and stationary engineers, brickmasons, machinery maintenance workers, airplane pilots, longshoreman, railroad industry workers, and other occupations with potential exposure to PAH also showed risk of excess prostate cancer. Risk was significantly decreased for blue-collar occupations, including farm workers, commercial fishermen, mechanics and repairers, structural metal workers, mining, printing, winding, dry cleaning, textile machine operators, cooks, bakers, and bartenders. Although we observed excess risks of prostate cancer among some low socioeconomic status (SES) occupations, the overall results suggest that the effects of higher SES cannot be ruled out in associations between occupational factors and the risk of prostate cancer.

Occupational risk factors and prostate cancer in U.S. blacks and whites.

Although prostate cancer is a major disease, causal factors are only partially understood. We examined occupational risk factors for this disease in a large case control study among U.S. blacks and whites. The study included 981 new pathologically confirmed prostate cancer cases (479 blacks and 502 whites) diagnosed between 1986 and 1989, and 1,315 population controls (594 blacks and 721 whites) who resided in Atlanta, Detroit, and 10 countries in New Jersey, covered by population-based cancer registries. Information on occupation, including a lifetime work history, was collected by in-person interview. No clear patterns of risk were found for U.S. whites versus blacks, nor for white-collar versus blue-collar jobs. Farming was related to prostate cancer (OR = 2.17; 95% CI = 1.18-3.98). Risk was restricted, however, to short-term workers and workers in crop production. Risk was not limited to those farming after 1950, when widespread use of pesticides started. Risks increased with increasing years of employment in firefighting (chi 2trend, p = 0.02) and power plant operations (chi 2trend, p = 0.03), and were elevated among long-term railroad line-haulers (OR = 5.85; 95% CI = 1.25-27.4); jobs with potential polycyclic aromatic hydrocarbon (PAH) exposures. Risk was elevated among athletes (OR = 5.38; 95% CI = 1.48-19.6). However, most of the cases were athletes before 1960, so the potential use of anabolic steroids was excluded. Although some clues about potential occupational associations were found, the overall results show that occupation is not a major determinant of prostate cancer risk.

Environmental and biological monitoring in carbon disulfide exposure assessment.

Carbon disulfide (CS2) exposure was assessed in several ways in a viscose fiber plant. Environmental exposure was measured by static area sampling and by personal monitoring using diffusive passive ORSA-5 Draeger badges. At the same time, as biological indicators of exposure the iodine-azide test (IAT) and 2-thiothiazolidine-4-carboxylic acid (TTCA) in urine samples obtained at the end of work shift were performed. The aim was to estimate the relationship between parameters of environmental exposure and biological indicators of internal exposure as well as to determine the influence of the exposure duration on urinary TTCA values. Environmental exposure determined by personal samplers as time-weighted average (TWA) concentrations was twice as high than when measured by static area sampling: 62.2 vs. 31.1 mg/m3 in the spinning rooms, and 18.3 vs 12.2 mg/m3 in the viscose manufacturing departments. The iodine-azide test showed high linear correlation with CS2, but only for very high CS2 values. In highly exposed spinners, higher urinary TTCA levels were found related to longer exposure to CS2, but without statistical significance. For TTCA levels in urine a high correlation coefficient existed, but in this case even for low CS2 levels. Using a linear regression equation, a biological limit value for TTCA which corresponds to the Yugoslav MAC of 30 mg/m3 for CS2 was calculated (9.89 mg/g creatinine) for the study population, which is higher than in other investigations.(ABSTRACT TRUNCATED AT 250 WORDS)

The effects of long-term occupational exposure to carbon disulphide on serum lipids.

No definite conclusion can be made from many epidemiological and clinical studies of lipid metabolism in workers exposed to carbon disulphide (CS2). The aim of our investigation was to study the serum lipid levels in workers exposed to different CS2 levels to establish possible exposure-response relationships. The first group, spinners, were exposed to high CS2 levels; the second group, workers in viscose production, to low CS2 levels; and the third group included non-exposed workers. As a part of a large examination, total and free serum cholesterol, total lipid and triglyceride levels were determined. Mean total lipid levels were similar in high and low CS2 exposed workers, but significantly lower in non-exposed workers. The total serum cholesterol mean levels were also similar in both groups, but significantly higher in the non-exposed group. Only serum triglyceride values were related to the CS2 levels: the most elevated were in the high exposed workers, somewhat lower in the low exposed, and the lowest in the non-exposed group. The finding is especially important as triglycerides are the most specific for developing atherosclerosis, which is often reported in workers with long-term exposure to carbon disulphide.

[Evaluation of the health status of workers exposed to carbon disulfide]. / Evaluacija zdravstvenog stanja radnika izlozenih ugljen disulfidu.

The investigation included 134 workers from a viscose rayon factory who were exposed to average concentrations of carbon disulphide exceeding MAC values (x = 119.3 mg/m3) for more than 75% of their working hours. Workers' chronic morbidity from carbon disulphide exposure was analysed over a three-year period, and results were compared with those for a control group of the same age but with a shorter exposure duration. The percentage of ill workers and the prevalence rate were both similar to those of the control group. However, as concerns the specific morbidity caused by carbon disulphide exposure, toxic polyneuropathy was present only among the exposed workers. In that group hypertension too reached a higher prevalence rate, statistically significant, although both groups consisted of younger workers of similar age. The prevalence of other diseases was comparable, possibly because of the selection bias, and the healthy worker effect. Owing to that effect workers with the most distinct symptoms had been removed from their jobs and, consequently, excluded from examinations. That could have been a reason for underestimating exposure effects.