Lung cancer mortality in a site producing hard metals. (73/1312)

OBJECTIVES: To study the mortality from lung cancer from exposures to hard metal dust at an industrial site producing hard metals--pseudoalloys of cobalt and tungsten carbide--and other metallurgical products many of which contain cobalt. METHODS: A historical cohort was set up of all subjects who had worked for at least 3 months on the site since its opening date in the late 1940s. A full job history could be obtained for 95% of the subjects. The cohort was followed up from January 1968 to December 1992. The exposure was assessed by an industry specific job exposure matrix (JEM) characterising exposure to hard metal dust from 1 to 9 and other possibly carcinogenic exposures as present or absent. Smoking information was obtained by interview of former workers. Standard lifetable methods and Poisson regression were used for the statistical analysis of the data. RESULTS: Mortality from all causes was close to the expected (standardised mortality ratio (SMR) 1.02, 399 deaths) whereas mortality from lung cancer was significantly increased among men (SMR 1.70; 46 deaths, 95% confidence interval (95% CI) 1.24 to 2.26). By workshop, lung cancer mortality was significantly higher than expected in hard metal production before sintering (SMR 2.42; nine deaths; 95%CI 1.10 to 4.59) and among maintenance workers (SMR 2.56; 11 deaths; 95%CI 1.28 to 4.59), whereas after sintering the SMR was lower (SMR 1.28; five deaths; 95%CI 0.41 to 2.98). The SMR for all exposures to hard metal dust at a level >1 in the JEM was in significant excess (SMR 2.02; 26 deaths; 95%CI 1.32 to 2.96). The risks increased with exposure scores, duration of exposure, and cumulative dose reaching significance for duration of exposure to hard metal dust before sintering, after adjustment for smoking and known or suspected carcinogens. CONCLUSION: Excess mortality from lung cancer was found among hard metal production workers which cannot be attributed to smoking alone. This excess occurred mostly in subjects exposed to unsintered hard metal dust.  (+info)

Cohort mortality and cancer incidence survey of recent entrants (1982-91) to the United Kingdom rubber industry: preliminary findings. (74/1312)

OBJECTIVES: To monitor the occurrence of stomach and lung cancer in a newly defined cohort of United Kingdom rubber workers and to report findings for other cancers in an early period of follow up. METHODS: A prospective cohort of 9031 male and female workers from 42 United Kingdom rubber factories has been enumerated. All employees had a minimum of 12 months employment and were first employed at one of the participating factories in the period 1982-91. Mortality data were available for the period 1983-98 and cancer registration data for the period 1983-94. The mortality and cancer incidence experienced by the cohort were compared with expected values based on national rates defined by period, age, and sex. RESULTS: Mortality from lung cancer was close to expectation (men: observed (obs) 11, expected (exp) 12.70, standardised mortality ratio (SMR) 87, 95% confidence interval (95% CI) 43 to 155; women: obs 0, exp 1.34, SMR 0, 95% CI 0 to 275). Mortality from stomach cancer was unexceptional (men: obs 1, exp 2.69, SMR 37, 95% CI 1 to 207; women: obs 0, exp 0.24, SMR 0, 95% CI 0 to 1537). Many statistical comparisons were made both for mortality data and for cancer registration data; only one difference between observed and expected numbers was significant (mortality from cancer of the testis: obs 3 exp 0.51, SMR 589, 95% CI 122 to 1722). Corresponding findings for incident cancers of the testis were unexceptional (obs 5, exp 5.13, standardised registration ratio (SRR) 97, 95% CI 32 to 227). CONCLUSION: The findings should be treated with caution as they relate to an early period of follow up. Nevertheless, they hold out the prospect that the increased SMRs for stomach and lung cancers reported for historical cohorts of United Kingdom rubber workers may not be apparent in more recent cohorts.  (+info)

John Snow: the first hired gun? (75/1312)

The 1854 English cholera outbreak led to reform of Victorian public health legislation, including the Nuisances Removal and Diseases Prevention Act. The reforms threatened the closure of many factories whose fumes were considered hazardous to the public's health. The second witness to appear before the Parliamentary committee considering the reforms was Dr. John Snow. Snow testified on behalf of the manufacturers threatened by the reforms. He stated that the fumes from such establishments were not hazardous. He contended that the workers in these factories did not become ill as a result of their exposures, and therefore these fumes could not be a hazard to the general public's health. Snow also presented data from the 1854 cholera outbreak as the basis for his belief that epidemic diseases were transmitted by water, not air. Although the data concerned cholera, Snow extended the inference to all epidemic diseases. When the committee's report was published, The Lancet chastised Snow in a stinging editorial. Parliament subsequently revised the bill in favor of the manufacturers and passed it into law. The implications of this particular episode in the history of epidemiology are discussed.  (+info)

Invited commentary: the testimony of Dr.(76/1312)

Snow.  (+info)

Toxic evaluation of organic extracts from airborne particulate matter in Puerto Rico. (77/1312)

In recent years, several hypotheses have emerged to explain the toxicologic activity of particulate matter. Organic compounds, ultrafine particles, biologic components, and transition metals are some of the constituents that reportedly exert some type of adverse effect on human health. A considerable fraction of the urban particulate matter consists of carbon compounds, which originate mostly from anthropogenic sources. The toxicity of organic fractions from particulate matter have been mainly evaluated by considering their mutagenic activity. This research expands on the toxicologic profile of organic compounds adsorbed to particulate matter, specifically in Puerto Rico, by using the cytotoxic neutral red bioassay (NRB). The NRB uses normal human epidermal keratinocytes or other types of cells to measure the effect on cell viability when exposed to organic compounds associated to the particles in the air. We validated the NRB for particulate matter by using a standard reference material (SRM 1649). We used the NRB to determine toxicologic differences of extracts between an urban industrialized site with anthropogenic activity versus a coastal region with less human activity. The cytotoxicity associated with organic compounds in particulate matter collected at the urban industrialized site was detected in both the particulate matter (3/4) 10 microm in aerodynamic diameter (PM(10)) and particulate matter (3/4) 100 microm in aerodynamic diameter (PM(100)). Greater toxic effects were observed in PM(10) extracts than in PM(100) extracts, but PM(10) toxic effects were not significantly different from those in PM(100). The extracts from the industrialized site were more cytotoxic than the extracts from coastal reference site, although in the summer, extracts from both sites were significantly cytotoxic to normal human epidermal keratinocytes. In addition, the nonpolar extracts of both PM(10) and PM(100) exerted the greatest cytotoxicity, followed by the polar, and, finally, the moderately polar extract. This study demonstrates that extracts from the Guaynabo industrialized site were more toxic than similar extracts obtained from a reference coastal site in Fajardo, Puerto Rico.  (+info)

Identifying industrial sites with potential for residential exposure to asbestos. (78/1312)

BACKGROUND: Non-occupational exposure to asbestos has been of increasing interest, but residential exposure to asbestos often focuses on a few high-profile asbestos users. This study aimed to identify industrial sites producing asbestos goods in a given area and time period. METHODS: A search of trade directories was carried out for industrial sites in West Yorkshire, England, where asbestos may have been used this century. RESULTS: A large number of factories with potential for residential exposure were found. A total of 269 factories in West Yorkshire used asbestos between 1900 and 1979, many for short periods only. CONCLUSIONS: Identification of potential sources of residential exposure to asbestos would have greatly underestimated their number if either only high-profile users or existing official listings had been used. Any consideration of asbestos use should aim to identify all users, not just the high-profile manufacturers.  (+info)

Investigation of the association between excess winter mortality and socio-economic deprivation. (79/1312)

BACKGROUND: Excess winter mortality is higher in England and Wales than in other European countries with similar or lower average winter temperatures. It might be expected that excess winter mortality would be higher in areas with greater socio-economic deprivation, and if this were so preventive interventions could be directed at populations in these areas. The association between deprivation and excess winter mortality has not been adequately investigated in the past. The aim of this study was to look at the association between excess winter mortality and socio-economic deprivation, so that policy decisions to reduce this excess mortality could be appropriately directed. METHODS: Super Profile groups derived from the 1991 Census were used as a measure of socio-economic status. The age-standardized excess winter death index (EWDI) was calculated for each Super Profile group, for the population of Bradford. The EWDI was also calculated for the manufacturing districts (Office for National Statistics area classification), a relatively deprived group, and compared with that for England and Wales. RESULTS: No significant trend was found in age-standardized excess winter mortality across the Super Profile groups. The manufacturing districts had a similar EWDI to the national value. CONCLUSION: Excess winter mortality is not associated with deprivation. Further research to identify the important aetiological factors and appropriate interventions to reduce excess winter mortality is needed.  (+info)

Nervous system cancer mortality in an industrialized area of Brazil 1980-1993. (80/1312)

OBJECTIVES: The industrialization process and nervous system cancer (NSC) mortality in a urban region of Brazil. METHOD: From registries of the State System of Data Analysis Foundation (SEADE), 103 males deaths by NSC (ICD-9) in Baixada Santista (BS), from 1980 to 1993 were selected. Mortality ratios were calculated comparing the standardized mortality rate for ages over 10 years old (G1) and for the age group from 35 to 64 years old, in the industrialized and non-industrialized areas in three periods: 1980-1993, 1980-86, 1987-93. RESULTS: A statiscally significant high mortality was observed in the industrialized area, for ages over 10 in all periods and only from 1980 to 1993 for ages from 34 to 64. The highest mortality ratio occurred from 1980-86 for ages over 10 - 4.12 (CI 1.79-9.42). CONCLUSION: High mortality was probably related to the environmental and occupational exposure to many organic and inorganic chemical substances, considered carcinogenics, such as aliphatic and aromatic hydrocarbons, organochlorinated, formaldehyde, nitrogenated compounds and heavy metals, found in the port and industrial complex. We discuss the importance of case-control studies in characterizing the association of these and other risk factors in the determination of NSC.  (+info)