Mortality Patterns among Workers Exposed to Acrylamide

Collins, James J.; Swaen, Gerard M. H.; Marsh, Gary M.; Utidjian, H M; Caporossi, J C; Lucas, Lorraine J.

doi:10.1097/00043764-198907000-00013

Cited by 118 publications

(84 citation statements)

References 9 publications

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“…These investigators found that the acrylonitrile exposure-response relationship for lung cancer that had been suggested in the original Lima cohort study (Marsh et al [12]) was likely to be positively confounded by smoking. In the original NCI study (Blair et al [2]), the Lima, OH (Marsh and Zimmerman [7]) study, and another study of acrylonitrile workers (Collins et al [6]), the prevalence of smoking was found to increase with increasing acrylonitrile exposure, thus creating the potential for positive confounding of any association between acrylonitrile exposure and lung cancer mortality. Furthermore, in a reanalysis of the original NCI nested case-cohort study of lung cancer (Blair et al [2]) that addressed missing and misclassified smoking data, Cunningham and Marsh 1 found still further evidence that lung cancer risk estimates reported in the original full NCI study were positively confounded by smoking.…”

Section: Issue 6 -Do Alternative Metrics Lead To Results Consistent Wmentioning

confidence: 99%

“…Substantial evidence that lung cancer mortality is not associated with acrylonitrile exposure has been obtained from four large acrylonitrile worker cohort studies: NCI (Blair et al [2]), DuPont (Symons et al [3]), Dutch (Swaen et al [4]), and United Kingdom (Benn and Osborne [5]), as well as from independent studies of subcohorts of workers from two of the NCI study sites in Fortier, LA/Santa Rosa, FL (Collins et al [6]) and Lima, OH (Marsh and Zimmerman [7]). Nevertheless, in 2014, Kopylev [1] speculated that a significant positive association may have been missed in the Blair et al [2] analysis because the NCI investigators did not employ the "correct" metric for acrylonitrile exposure.…”

Section: Introductionmentioning

confidence: 99%

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Methodological Challenges in the Statistical Analysis of Epidemiology Studies: use of Average Exposure Metrics in Historical Cohort Designs

Starr¹,

Marsh²

2016

MEDJ

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An important methodological challenge in the analysis of historical occupational cohort data is choosing the most appropriate metric for the average exposure of the workers under study. We describe and illustrate the many issues associated with this challenge using a recent re-analysis by Kopylev [1] of lung cancer mortality in the National Cancer Institute (NCI) acrylonitrile cohort study. Kopylev proposed the routine use of both Average Exposure and Average Intensity when analyzing epidemiological cohort data. However, due to the methodological issues that arise with these metrics, we have concerns about the validity of his finding of a significant positive association between workers' acrylonitrile exposure and increased lung cancer mortality in a subset of the NCI cohort. These include 1) the opportunity for substantial selection bias to have impacted the results; 2) the failure to account properly for latency; 3) the absence of a convincing biological rationale or other a priori justification for Kopylev's preferred exposure metrics; 4) the absence of meaningful differences in Average Exposure-and Average Intensity-based risk estimates; 5) the lack of a logical basis for using either of these exposure metrics and 6) the conclusion that smoking was not a significant positive confounder, which is at odds with all other such findings for this cohort.

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Section: Issue 6 -Do Alternative Metrics Lead To Results Consistent Wmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Methodological Challenges in the Statistical Analysis of Epidemiology Studies: use of Average Exposure Metrics in Historical Cohort Designs

Starr¹,

Marsh²

2016

MEDJ

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“…All other studies have been retrospective, descriptive, observational studies; standardized mortality rate (SMR) studies comparing observed to expected death rates; or meta-analyses, which have simply lumped prior studies for analysis, including ones by the same authors (Table 5) [4][5][6][7][8]. The design of this study permitted the exact confirmation of professional lifetime occupations and underlying causes of death.…”

Section: Discussionmentioning

confidence: 99%

“…Most MMA carcinogenicity studies in humans have been combined retrospective cohort studies from the 1930s through the 1990s, or meta-analyses of the same and similar studies [4][5][6][7][8][9][10]. In addition, most of the negative cancer studies were authored by epidemiologists employed by major chemical manufacturers of MMA in the USA (American Cyanamid Company, Wayne, NJ; Rohm and Hass Co., Croydon, PA) and in the UK (Imperial Chemical Industries; Lucite International UK Ltd.) [6][7][8].…”

Section: Introductionmentioning

confidence: 99%

Proportionate Cancer Mortality in Methyl Methacrylate-Exposed Orthopedic Surgeons Compared to General Surgeons

Diaz

2011

J. Med. Toxicol.

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Methyl methacrylate (MMA), a volatile liquid used to make dentures, hearing aids, joint prostheses, and medical adhesives, has been associated with colorectal carcinomas in acrylic sheet manufacturing workers. A casecontrol proportionate cancer mortality investigation was conducted to determine cancer death differences in orthopedic surgeons performing total joint replacements (TJRs) (MMA-exposed cases) and general surgeons not performing TJRs (unexposed controls). The American Colleges of Orthopedic Surgeons and General Surgeons provided complete demographic information on 468 male orthopedic surgeons and 1,890 male general surgeons who died during 1991-2001. Decedent data was submitted to the National Death Index for matching with underlying causes of death on state death certificates. Proportionate differences in ages at death, deaths from cancer, and deaths from site-specific cancers were analyzed for statistically significant differences by unpaired, two-tailed t tests for continuous variables and by both proportionate cancer mortality ratios and Yates-corrected chi squares for categorical variables. Orthopedic surgeons died of cancer more often (χ 2 =7.699, P=0.006) and at younger (t=5.53, P<0.001) ages (mean=69.4 years) than general surgeons (mean=79.2 years). For site-specific cancers, orthopedic surgeons died of esophageal cancer (χ 2 =4.372, P=0.037) and myeloproliferative malignancies (χ 2 =4.369, P=0.037) more often than general surgeons. Orthopedic surgeons are chronically exposed to MMA and are proportionately more likely to die from cancer, especially esophageal and myeloproliferative cancers, than general surgeons. MMA-exposed healthcare workers may be at increased risks of untimely deaths from site-specific malignancies.

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“…A large prospective study found no evidence that dietary intake of acrylamide is associated with cancers of the colon or rectum (Mucci et al, 2006). In addition, a study of some 9000 workers exposed to acrylamide between the years 1925 and 1976 found a statistically significant decrease in deaths from all causes (Collins et al, 1989). A follow-up study of these workers through year 1994 corroborated many of the initial findings (Marsh et al, 1999).…”

Section: Hormetic Acrylamidementioning

confidence: 96%

Nutritional hormesis

Hayes

2006

Eur J Clin Nutr

109

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Objective: Hormesis, the biological and toxicological concept that small quantities have opposite effects from large quantities, is reviewed with emphasis on its relevance to nutrition. Results: Hormetic and other dose-response relationships are categorized, depicted, and discussed. Evidence for nutritional hormesis is presented for essential vitamin and mineral nutrients, dietary restriction, alcohol (ethanol), natural dietary and some synthetic pesticides, some herbicides, and acrylamide. Some of the different hormetic mechanisms that have been proposed are reviewed. Conclusions:The credence and relevance of hormesis to nutrition are considered to be established. The roles of hormesis in nutritional research and in formulating nutritional guidelines are discussed.

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Mortality Patterns among Workers Exposed to Acrylamide

Cited by 118 publications

References 9 publications

Methodological Challenges in the Statistical Analysis of Epidemiology Studies: use of Average Exposure Metrics in Historical Cohort Designs

Methodological Challenges in the Statistical Analysis of Epidemiology Studies: use of Average Exposure Metrics in Historical Cohort Designs

Proportionate Cancer Mortality in Methyl Methacrylate-Exposed Orthopedic Surgeons Compared to General Surgeons

Nutritional hormesis

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