Long-Term Mortality Study Steelworkers

Lloyd, J. William; Lundin, Frank E.; Redmond, Carol; Geiser, Patricia B.

doi:10.1097/00043764-197005000-00002

Cited by 48 publications

(11 citation statements)

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“…In American mortality studies of steelworkers (Lloyd et al, 1970;Lerer et al, 1974;Mazumdar et al, 1975;Redmond et al, 1975;Rockette and Redmond, 1976) certain job classifications had a significant relative increase of associated cardiovascular disease. These included men working as janitors, maintenance mechanics, crane operators and workers in the batch pickling and sheet drying areas.…”

Section: Carbon Monoxidementioning

confidence: 99%

Cardiovascular disease and environmental exposure.

Rosenman

1979

Occupational and Environmental Medicine

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This paper reviews the possible association between cardiovascular disease and occupational and environmental agents. The effects ofcarbon monoxide, fibrogenic dusts, carbon disulphide, heavy metals, noise, radiation, heat, cold, solvents and fluorocarbons are discussed. New directions for investigation are suggested.There has been a growing awareness of the relationship between the quality of the environment and the incidence of human disease, particularly in relation to chemical carcinogenesis and lung disease. In contrast, studies of the aetiology of coronary arteriosclerotic heart disease (CAHD) have not usually been concerned with exposure to environmental toxins. Those studies which have examined cardiovascular disease in relation to occupation have largely been concerned with the effect of sedentary as opposed to active work (Morris, 1959;Karvonen et al., 1961;Pell and D'Alonzo, 1963;Paffenbarger and Hale, 1975;Baxter et al., 1976;Menotti and Puddu, 1976) or the psychological stress of the work (Jenkins, 1976 The information presented in the following discussion will explore possible environmental risk factors and, in the process, new means of intervention may be suggested. The inconclusiveness of much of the data, rather than indicating an absence of effect, underlines the need for further study.The discussion of cardiovascular disease will be mainly limited to possible environmental aetiological factors of CAHD. By inference one might assume that many of these same factors would be important in the incidence of cerebrovascular disease. Included in the discussion of CAHD will be agents that cause arrhythmias or vasospasm. Although these two physiological responses are not necessarily related to arteriosclerosis it is impossible, without good autopsy data, to separate sudden death caused by these mechanisms from sudden death secondary to myocardial infarcts of atherosclerotic origin. Agents having a direct effect on myocardial tissue will also be reviewed. Environmental causes of congenital heart disease will not be discussed.The Table lists of men in the workplace, where one finds the highest exposure to the agents in the Table, may contribute, to some extent, to the known differences in incidence of heart disease between the sexes. Carbon monoxide may be an important factor in the strong association between cigarette smoking and CAHD. Carbon disulphide-exposed workers may have more CAHD because of increased blood pressure and/or cholesterol levels. Certain heavy metals may increase the incidence of CAHD by their toxic renal effect which may subsequently cause hypertension.The monoclonal theory ofarteriosclerosis (Benditt, 1977) suggests a possible mechanism for environmental agents. Cells in aortic atherosclerotic plaques from women heterozygous for X-linked glucosephosphate dehydrogenase deficiency were examined at autopsy for their clonal origin. The cells in fibrous plaques were found to be of monoclonal origin, compared with cells in normal intima (Benditt and Benditt, 1973 (Benditt, 1977)...

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Section: Carbon Monoxidementioning

confidence: 99%

Cardiovascular disease and environmental exposure.

Rosenman

1979

Occupational and Environmental Medicine

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“…Coke oven emissions are now widely recognized as lung carcinogens, 3 and in the previously described steelworker study, nonwhites were more likely than whites to work where exposure to coke oven emissions was greatest. 8 In 1996, the injury or illness rate for the 10 occupations with the highest percentage of black workers was substantially greater (4.34 per 100 full-time workers) than that for the 10 occupations with the highest percentage of white workers (0.85 per 100 full-time workers). 5 Other examples such as the Hawks Nest Incident and the chromate industry have been summarized elsewhere.…”

Section: Race Occupation and Lung Cancer Riskmentioning

confidence: 99%

“…An initial analysis of 58,282 steelworkers revealed "a striking disparity in mortality"; among coke-plant workers, nonwhite employees had twice as many deaths as expected due to malignant neoplasms, while white employees had no excess risk. 8 This discovery prompted the researchers to examine the coke plant data in detail, revealing that nonwhite employees were five times more likely to work on the topside of the coke oven than were white employees-an important clue that exposures at the topside of the coke oven might be responsible for increased cancer risk. Analysis confirmed that those who worked full-time at the topside of the ovens for 5 or more years had 10 times the risk of lung cancer when compared with non-oven workers, regardless of race.…”

mentioning

confidence: 99%

Race, Occupation, and Lung Cancer: Detecting Disparities With Death Certificate Data

Birdsey

Alterman

Petersen

2007

Journal of Occupational &Amp; Environmental Medicine

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“…Based on his review the industries with the highest PAH exposures and highest lung cancer risks were aluminum production, coal gasification, and coke production. Boffetta noted that "the most informative" aluminum production worker study (22) and "the most important" coke production worker study (23,24) showed roughly two-fold increases in lung cancer risk.…”

Section: Pah Exposures In Coal Tar Roofing and Pavingmentioning

confidence: 99%

Meta-Analysis of Lung Cancer in Asphalt Roofing and Paving Workers with External Adjustment for Confounding by Coal Tar

Fayerweather

2007

Journal of Occupational and Environmental Hygiene

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The study's objectives were to update Partanen's and Boffetta's 1994 meta-analysis of lung cancer among roofing and paving asphalt workers and explore the role of coal tar in explaining the statistical heterogeneity among these studies. Information retrieval strategies and eligibility criteria were defined for identifying the epidemiologic studies to be included in the analysis. The relative risk ratio (RR) for lung cancer was selected as the effect measure of interest. Coal tar bias factors were developed and used to externally adjust each eligible study's published RR for confounding by coal tar. Confidence intervals on adjusted RRs were estimated by the Monte Carlo methods outlined by Steenland and Greenland (2004). The meta-Relative Risk (meta-RR) and its variance were estimated by general variance-based methods. Heterogeneity of the RRs was assessed by heterogeneity chisquare and I 2 tests. Also explored were the influences of study design; differences between internally and externally adjusted RRs; and the potential impact of coal tar misclassification. The results from this update were similar to those in Partanen's and Boffetta's original meta-analysis. The unadjusted meta-RR (random effects model) for the roofing studies was elevated (meta-RR = 1.67, 95% CI = 1.39-2.02, I 2 = 80%) and significantly greater than the meta-RR for the paving studies (meta-RR = 0.98, 95% CI = 0.81-1.18, I 2 = 59%). After adjustment for confounding by coal tar, however, the corrected roofers' meta-RR dropped to 1.10 (meta-RR = 1.10, 95% CI = 0.91-1.33, I 2 = 60%), while the corrected pavers' meta-RR was nearly unchanged at 0.96 (meta-RR = 0.96, 95% CI = 0.80-1.16, I 2 = 56%). Although the meta-RRs for the roofers and the pavers were no longer statistically significantly different from one another, significant heterogeneity remained within each of the coal tar-adjusted sectors. Stratifying the roofing and paving studies by study design revealed that statistical heterogeneity was concentrated in the weaker designs such as those relying on death certificates for work history. When the weaker studies were excluded, the remaining roofing and paving studies had a combined meta-RR close to 1.0 (meta-RR = 1.01, 95% CI = 0. 88-1.17) with no significant heterogeneity (I 2 = 0%). Meta-analysis of non-experimental epidemiologic studies is subject to significant uncertainties as is externally correcting studies for confounding. Given these uncertainties, the specific quantitative estimates in this (or any similar) analysis must be viewed with caution. Nevertheless, this analysis provides support for the hypothesis proposed by several major reviewers that confounding by coal tar-related PAH exposures may explain most or all of the lung cancer risks found in the epidemiologic literature on asphalt roofing and paving workers.

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Long-Term Mortality Study Steelworkers

Cited by 48 publications

References 0 publications

Cardiovascular disease and environmental exposure.

Cardiovascular disease and environmental exposure.

Race, Occupation, and Lung Cancer: Detecting Disparities With Death Certificate Data

Meta-Analysis of Lung Cancer in Asphalt Roofing and Paving Workers with External Adjustment for Confounding by Coal Tar

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