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.

Cohort mortality study of 57,000 painters and other union members: a 15 year update.

OBJECTIVES: To study mortality patterns in the largest existing cohort of painters. METHODS: 15 years of follow up were added to a study of 42,170 painters and 14,316 non-painters based on union records. There were 23,458 deaths, compared with 5313 in the earlier follow up. RESULTS: Comparisons with the United States population showed significantly increased rates in painters for lung cancer (standardised mortality ratio (SMR) 1.23, 95% confidence interval (95% CI) 1.17 to 1.29), bladder cancer (SMR 1.23, 95% CI 1.05 to 1.43), liver cancer (SMR 1.25, 95% CI 1.03 to 1.50), and stomach cancer (SMR 1.39, 95% CI 1.20 to 1.59). However, in direct comparisons with non-painters only the excesses for lung cancer (SRR 1.23, 95% CI 1.11 to 1.35, increasing to 1.32, 95% CI 16 to 1.93 with 20 years latency) and bladder cancer (SRR 1.77, 95% CI 1.13 to 2.77) were confirmed. Some confounding by smoking may affect these two outcomes, particularly with external referents. Cirrhosis of the liver was increased for both painters and non-painters (SMRs 1.21, 95% CI 1.07 to 1.35, and 1.26, 95% CI 1.03 to 1.51, respectively), possibly indicating high alcohol consumption. Suicide (SMR 1.21, 95% CI 1.05 to 1.38) and homicide (SMR 1.36, 95% CI 1.04 to 1.75) were increased for painters but not for non-painters; neuropsychiatric diseases have been associated with painters in earlier studies. CONCLUSIONS: The results suggest modest occupational risks for lung and bladder cancer; these results are consistent with existing publications. The International Agency for Research on Cancer has classified painting as an occupation definitely associated with cancer.

End-stage renal disease among silica-exposed gold miners. A new method for assessing incidence among epidemiologic cohorts.

OBJECTIVE: To examine the association between silica exposure and end-stage renal disease (ESRD). DESIGN: Retrospective cohort study. PARTICIPANTS: A cohort of 2412 white male gold miners was studied. Eligible gold miners worked underground for at least 1 year between 1940 and 1965 in a South Dakota gold mine and were alive on January 1,1977. Of primary interest was exposure to silica. METHODS: The ESRD Program Management and Medical Information System (PMMIS) was used to identify members of the gold mine cohort who had treated ESRD and to create a US rate file for treated ESRD. The ESRD incidence among the gold miners was compared with that in the US population. RESULTS: Based on the 11 cohort members identified with treated ESRD, the risk for ESRD in the cohort was elevated (standardized incidence ratio [SIR], 1.37; 95% confidence interval [CI], 0.68-2.46). The risk was greatest for nonsystemic ESRD (ESRD caused by glomerulonephritis or interstitial nephritis) for which the SIR was 4.22 (95% CI, 1.54-9.19), increasing to 7.70 (95% CI, 1.59-22.48) among workers with 10 or more years of employment underground. CONCLUSIONS: To our knowledge this is the first epidemiologic study to examine ESRD incidence in an occupational cohort. This study provides evidence that silica exposure is associated with an increased risk for ESRD, especially ESRD caused by glomerulonephritis. This study also demonstrates the usefulness of the ESRD PMMIS to assess ESRD risk among cohorts exposed to potential nephrotoxins.

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 in 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 (PMR = 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 (PMR = 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 inn 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.

Cancer incidence in the National Health and Nutrition Survey I. Follow-up data: diabetes, cholesterol, pulse and physical activity.

We examined cancer incidence among 14,407 men and women who were enrolled in the National Health and Nutrition Survey I in the early 1970s and then followed through 1987. We studied 657 male and 593 female cancer cases, using Cox regression. Analyses were conducted for all cancers, lung, colorectal, breast, and prostate cancer. Analyses focused on diabetes, cholesterol, pulse, and physical activity, four risk factors with limited or inconsistent prior evidence. All four risk factors were modestly associated with all cancers for men but not for women. For diabetic men, the rate ratio for all cancers was 1.38 [95% confidence interval (CI) = 1.00-1.91]; the elevated risk was particularly evident for colorectal and prostate cancer. Slight inverse trends of cancer risk with cholesterol were apparent for men but not for women and were diminished compared to prior analyses of these data with less follow-up. Males with the lowest quartile of cholesterol versus the highest had a rate ratio of 1.21 (CI = 0.98-1.51) for all cancers. A modest positive trend between pulse and all cancers was seen for males [rate ratio of 1.27 (CI = 1.04-1.57)] for the highest versus the lowest quartile). The rate ratio for men with the least amount of nonrecreational physical activity was 1.29 (CI = 0.99-1.69). There is some evidence in these data that findings for cholesterol and nonrecreational physical activity could be artifacts of the early effects of disease because they diminished when cases were restricted to those with longer follow-up.