The results support the hypothesis that chronic exposure to high levels of traffic noise increases the risk for cardiovascular diseases.

The aim of the reanalysis is to reassess lung cancer risk associated with occupational exposure to diesel motor exhaust in potash miners, while controlling for potential confounders such as smoking and previous occupational history. Our investigation is based on a cohort study of nearly 6,000 German potash miners, who were followed up from 1970 to 2001. The reanalysis also takes into account the employment periods before potash mining, in particular uranium mining. Different approaches (nested case-control study and Cox model) were used to adjust for confounding. The exposure estimates were recalculated, lagging the exposure by 5 years. Exposure groups were defined by tertiles of cumulative respirable elemental carbon (REC) exposure estimates and occupational categories, where exposure was estimated originally by representative measurements of total carbon for different occupations. The highest REC concentration was measured for production workers, about twice as much as for other occupations. The reanalysis revealed that while about 4 % of all study subjects had worked earlier in uranium mines, 10.3 % of later lung cancer cases did so. Although their absolute number was small, the corresponding relative risk estimator was significantly elevated. Our analysis did not show any notable association between cumulative REC exposure and lung cancer risk. Introducing cumulative REC exposure as a continuous variable into the conditional logistic regression model yielded an odds ratio of OR = 1.04 [0.70-1.53]95 % adjusted for smoking and previous employment. The study results give no evidence for an association between REC exposure and lung cancer risk. Only for very high cumulative dose, corresponding to at least 20 years of exposure in the production area, some weak hints for a possible risk increase could be detected. The study underlines the importance of assessing the entire occupational history in occupational studies, especially if the supposed dose-response-relationship is weak.

International health authorities have graded diesel motor emissions (DME) as probably cancerogenic in human beings. There are gaps in epidemiological evidence regarding exact exposure quantification, confounder control and the investigation of highly exposed populations. We investigated the association of DME and lung cancer mortality in a historical cohort study of 5,862 German potash miners who were followed from 1970 to 2001. Cumulative exposure (CE) was measured by representative concentrations of total carbon multiplied with exposure years from the mines' medical records. Exposure and smoking behavior were validated by interviews of 3,087 participants. We computed standardized mortality ratios (SMR, external comparison) and performed Cox regression (internal comparison). The relative risk estimates (RR) with 95%-confidence intervals were adjusted for age and smoking. Vital status and causes of death were confirmed for 98.1% of participants. Sixty-one lung cancer deaths occurred. SMR-analysis showed lower than expected lung cancer mortality (healthyworker-effect). Internal comparisons revealed risk elevations from moderate to risk doubling depending on the exposure categories used (dichotomized: up to RR 1. ]*years). Additional adjustment of length of follow-up leads to further RR increases and indicates healthy-worker-survivor-phenomena. The analyses of a sub-cohort (n 5 3,335) with particularly accurate exposure measurement revealed a nonsignificant dose-response-relationship. Our results support an association of DME and lung cancer mortality.

The present analysis aims to differentiate the association of noise on myocardial infarction (MI) by job specific demands using International Standard Classification of Occupations (ISCO)-88 codes as a proxy. Data of a German case-control study were supplemented by job descriptions (indicated by ISCO-88). It was examined whether the demands in the various occupational groups modify the effect of noise. Noise and occupational groups are combined to form new exposure categories. Conditional logistic regression models were fitted to identify effects of combined job-noise categories. For the highest noise range (95-124 dB(A)) we found a significant odds-ratio (OR) of 2.18 (confidence interval [CI]0.95 = 1.17-4.05) independent of the profession. Some interesting results were found indicating ISCO groups with possible risk. In men, noticeable effects for the exposure category between 62 dB(A) and 84 dB(A) are calculated in the group of legislators and senior officials (ISCO-group 11; OR=1.93; CI0.95 = 0.50-7.42), the group consisting of life science and health professionals (ISCO-group 22; OR=2.18; CI0.95 = 0.36-13.1), the group of life science and health associate professionals (ISCO-group 32; OR = 2.03; CI0.95 = 0.50-8.24), and the group of “precision, handicraft, printing, and related trades workers” (ISCO-group 73; OR = 2.67; CI0.95 = 0.54-13.0). In the exposure range of 85-94 dB(A), high ORs are calculated for “skilled agricultural, fishery, and forestry workers” (ISCO-group 6; OR = 4.31; CI0.95 = 0.56-33.3). In women, there are high (nonsignificant) ORs in ISCO-group 1 (OR = 2.43; CI0.95 = 0.12-50.0), ISCO-group 2 (OR = 1.80; CI0.95 = 0.31-10.5), and ISCO-group 9 (OR = 2.45; CI0.95 = 0.63-9.51) for a noise exposure between 62 dB(A) and 84 dB(A). When investigating noise at the workplace in relation to cardiovascular diseases it is important to take the specific requirements of a job into account. Thus, work tasks with high health risks can be identified that helps to develop appropriate prevention strategies.

This paper adds further evidence on the long-term effects of exposure to respirable quartz, which include a decline in pulmonary function parameters and an increase in the incidence of COPD.