No full-text available
To read the full-text of this research,
you can request a copy directly from the authors.
Proportionate mortality among unionized roofers and waterproofers
Abstract
The United Union of Roofers, Waterproofers, and Allied Workers (UURWAW) is one of the 15 building and construction trades departments in the AFL-CIO. The U.S. roofing industry, including both roofing and waterproofing applications, both unionized and nonunionized, comprises about 25,000 firms, employing approximately 300,000 people, about 200,000 of whom are involved in the application of roofs. The specific toxins to which roofers may be exposed at the job site include, among others, bitumens (asphalt and/or coal tar pitch) as well as asbestos and fiberglass from roof removal operations. Excess deaths from occupational injuries are also of concern.
This study evaluated causes of mortality among 11,144 members of the UURWAW. Age-adjusted proportionate mortality ratios (PMRs) were computed with 95% confidence intervals (CI) using U.S. age-, gender-, and race-specific proportional mortality rates for the years of the study, 1950-1996.
Statistically significant increased PMRs were found for all injuries (PMR = 142, CI = 134-150), especially falls (PMR = 464, CI = 419-513) and other injuries (PMR = 121, CI = 107-137), cancers of the lung (PMR = 139, CI = 131-148), bladder (PMR = 138, CI = 111-170), esophagus (PMR = 134, CI = 107-166), larynx (PMR = 145, CI = 106-193), and cancers of other and unspecified sites (PMR = 130, CI = 112-149), pneumoconioses and other nonmalignant respiratory diseases (PMR = 115, CI = 103-128), and homicides (PMR = 153, CI = 135-172). The occupational exposures which may have contributed to the excess risks of malignant and nonmalignant respiratory diseases include, among others, asphalt fumes, coal tar pitch volatiles and asbestos; however, cigarette smoking must also be considered a contributing factor.
The present study underscores the need to control airborne exposures to hazardous substances and especially to examine fall prevention efforts within the roofing industry. Am. J. Ind. Med. 37:478-492, 2000. Published 2000 Wiley-Liss, Inc.
... In one of the early studies, Suruda et al. [25] examined the data of 288 death certificates from the National Institute for Occupational Safety and Health National Traumatic Occupational Fatalities database and found that roofing contractors (SIC 1761 [26]) experienced the highest number of fatalities from falls to lower level (average annual rate of 18 fatalities per 100,000 workers). In another study, Stern et al. [27] reviewed the fatality causes among 11,144 roofers and waterproofers (members of the United Union of Roofers, Waterproofers, and Allied Workers) and discovered falls to be the most significant event resulting in fatalities. ...
... Regarding the literature review, three main limitations manifest among previous research studies analyzing roofing accident reports. First, the majority of past studies only focused on fatal injuries (e.g., Suruda et al. [25]; Stern et al. [27]; Dong et al. [6]; Moore and Wanger [7]) and therefore reveal few insights regarding the variables influencing fatal versus non-fatal injuries. Considering that non-fatal injuries are very common and, in the past, have impacted the direct and indirect costs of roofing contractors [4], investigating these injuries and how to mitigate their risks is important since preventing non-fatal and fatal injuries will enable roofing contractors, especially smaller ones, to achieve improved job site safety while increasing profits. ...
Given that roofing contractors in the construction industry have the highest fatality rate among specialty contractors, understanding the root cause of incidents among roofers is critical for improving safety outcomes. This study applied frequency analysis and decision tree data-mining techniques to analyze roofers’ fatal and non-fatal accident reports. The frequency analysis yielded insights into the leading cause of accidents, with fall to a lower level (83%) being the highest, followed by incidence sources relating to structures and surfaces (56%). The most common injuries experienced by roofing contractors were fractures (49%) and concussions (15%), especially for events occurring in residential buildings, maintenance and repair works, small projects (i.e., $50,000 or less), and on Mondays. According to the decision tree analysis, the most important factor for determining the nature of the injury is the nonfragile injured body part, followed by injury caused by coating works. The decision tree also produced decision rules that provide an easy interpretation of the underlying association between the factors leading to incidents. The decision tree models developed in this study can be used to predict the nature of potential injuries for strategically selecting the most effective injury-prevention strategies.
... Toren et al. [11] followed a large cohort of Swedish construction workers from 1971 to 2011 and found that workers with any occupational exposure to dust, fumes, gases, and vapors showed an increased mortality due to COPD. Some of the studies among construction workers have found a significant excess of pneumoconioses specifically, or non-malignant respiratory diseases (NMRD) overall [12][13][14][15]. Hutchings [16] and Rushton [17] assessed the burden of occupational cancer in Great Britain, and estimated that 16.5% of lung cancers were attributable to occupational exposure to known human carcinogens as defined by the International Agency for Research on Cancer (IARC); this increased to 21.6% if exposure to suspected human carcinogens was also included. ...
... Data from the Building Trades National Medical Screening Program (BTMed) showed that U.S. construction workers who worked in the Department of Energy sites had a noticeably higher prevalence of abnormal chest xrays and pulmonary function tests than those employed in administrative or support positions, which was consistent with their exposure levels to workplace hazards [18]. A number of previous cohort studies reported either an elevated proportional mortality ratio or an elevated standard mortality ratio for lung cancer among all construction workers or in a specific construction trade [12][13][14][15][19][20][21][22][23][24][25][26][27]. Excess risk of lung cancer has been reported for cement masons, roofers, operating engineers, laborers, electricians, ironworkers, carpenters, plumbers, brick masons, and sheet metal workers. ...
ABSTRACT
Objective: This study explored the risk of respiratory cancer- and non-malignant respiratory disease (NMRD)-related mortality among older construction workers.
Methods: Analyzed data from the 1992-2010 RAND Health and Retirement Study (HRS) and the HRS National Death Index – Cause of Death file. About 25,183 workers aged 50 years and older were examined, including 5,447 decedents and 19,736 survivors, of which 1,460 reported their longest job was in construction. Multinomial logistic regression assessed the differences in mortality between workers’ longest occupations, controlling for confounders.
Results: After adjusting for smoking and demographics, construction workers were almost twice as likely to die from respiratory cancer (OR = 1.65; CI: 1.10-2.47) or NMRD (OR = 1.73; CI: 1.16-2.58) compared to white-collar workers.
Conclusions: This study adds to the growing evidence that respiratory cancer and NMRD are frequently associated with construction exposure.
... Two studies reported elevated PMRs for conditions not likely to be occupational, including mental disorders, alcohol-related disease, digestive diseases, poisonings, and homicides [Robinson, 1995;Wang et al., 1999]. Many of these studies reported an excess of deaths from asbestosis or pneumoconiosis [Robinson et al., 1995[Robinson et al., , 1996[Robinson et al., , 1999Stern and Haring-Sweeney, 1997;Wang et al., 1999;Stern et al., 2000]. A study of cancer incidence among carpenters in New Jersey [Dement et al., 2003b] observed significantly excess standardized incidence ratios (SIRs) for cancers of the digestive system and peritoneum, lung cancer, and cancers of pleura and other parts of the respiratory system. ...
... Funding for this work is provided through cooperative agreement number DE-FC01-06EH06004 from the U.S. Department of Energy. The Amchitka, Hanford, Oak Ridge, and Savannah River construction workers medical screening (1) Robinson et al. [1995] (all), (2) Robinson et al. [1996] (carpenters), (3) Stern et al. [2000] (roofers), (4) Robinson et al. [1999] (electricians), (5) Stern et al. [1995] (laborers), (6) Stern et al. [2001] (masons), (7) (ironworkers), (8) (operating engineers), (9) Salg and Alterman [2005] (bricklayers and allied trades), (10) Michaels and Zoloth [1988] (sheet metal), (11) Dement et al. [2003] (carpenters), (12) Finkelstein and Verma [2005] (bricklayers and allied trades), and (13) Engholm and Englund [1995] (excess mortality or cancer incidence). ...
Background
The U.S. Department of Energy (DOE) established medical screening programs at the Hanford Nuclear Reservation, Oak Ridge Reservation, the Savannah River Site, and the Amchitka site starting in 1996. Workers participating in these programs have been followed to determine their vital status and mortality experience through December 31, 2004.MethodsA cohort of 8,976 former construction workers from Hanford, Savannah River, Oak Ridge, and Amchitka was followed using the National Death Index through December 31, 2004, to ascertain vital status and causes of death. Cause-specific standardized mortality ratios (SMRs) were calculated based on US death rates.ResultsSix hundred and seventy-four deaths occurred in this cohort and overall mortality was slightly less than expected (SMR = 0.93, 95% CI = 0.86–1.01), indicating a “healthy worker effect.” However, significantly excess mortality was observed for all cancers (SMR = 1.28, 95% CI = 1.13–1.45), lung cancer (SMR = 1.54, 95% CI = 1.24–1.87), mesothelioma (SMR = 5.93, 95% CI = 2.56–11.68), and asbestosis (SMR = 33.89, 95% CI = 18.03–57.95). Non-Hodgkin's lymphoma was in excess at Oak Ridge and multiple myeloma was in excess at Hanford. Chronic obstructive pulmonary disease (COPD) was significantly elevated among workers at the Savannah River Site (SMR = 1.92, 95% CI = 1.02–3.29).ConclusionsDOE construction workers at these four sites were found to have significantly excess risk for combined cancer sites included in the Department of Labor' Energy Employees Occupational Illness Compensation Program (EEOCIPA). Asbestos-related cancers were significantly elevated. Am. J. Ind. Med. 52:671–682, 2009. © 2009 Wiley-Liss, Inc.
... The IARC concluded that there is sufficient evidence that coal-tar pitches are carcinogenic in humans (IARC, 1985;. Several additional studies have been published (Armstrong et al., 1994;Cullen et al., 1996;Partanen and Boffetta, 1994;Ronneberg and Andersen, 1995;Ronneberg and Langmark, 1992;Stern et al., 2000;Tremblay et al., 1995;Armstrong et al., 2004). Quantitative cancer risk estimates have been calculated by Armstrong et al. (1986;, and Tremblay et al. (1995) attempted to quantify the relationship between exposure to CTPV in Søderberg potrooms and the risk of bladder and lung cancer (based on a Canadian cohort of aluminium production workers). ...
... An overview of these studies is given in Table B.4 (Appendix B). This review of Partanen & Boffetta (1994), who examined and combined the results of 20 epidemiologic studies conducted on asphalt workers and roofers, complemented with information from the IARC (1985) and more recent publications by Stern (2000), Boffetta et al.(2003; and Armstrong et al., (2003) were consulted. ...
Portable sawmilling trials with Acacia aneura (mulga) and A. cambagei (gidgee) have been undertaken to estimate the private landholder costs associated with small-scale timber production from
woodlands in western Queensland, Australia. A time study of harvesting and milling operations facilitated estimation of landholder
labour input requirements. The scarcity and small size of millable logs, coupled with the prevalence of timber defects, make
harvesting and portable sawmilling of western Queensland acacias an expensive undertaking for landholders. The cost of producing
sawn timber that meets the High Feature (HF) grade of Australian Standard AS2796 is estimated at between A3,000/m < sup > 3 < /sup > and A3,000/m3 and A3,400/m3 of HF timber.
... [52];), male chimney sweeps from Sweden, attributed to soot and asbestos with contributions from lifestyle factors (SMR, [28]), female Chinese chrysotile textile workers (SMR, [53]), shipyard workers in Genoa, Italy (SMR, [25]), and roofers and water-proofers potentially exposed to asbestos. However, it was noted that the observed elevated mortality may also have been due to cigarette smoking, exposure to asphalt and coal tar pitch volatiles (PMR, [54]). A population-based casecontrol study including 15,463 incident cancer cases employed in occupations and industries involving exposure to paints, solvents and textiles reported an excess bladder cancer risk suggesting that exposure to silica carries an increased risk [32]. ...
Abstract Background Silica and asbestos are recognized lung carcinogens. However, their role in carcinogenesis at other organs is less clear. Clearance of inhaled silica particles and asbestos fibers from the lungs may lead to translocation to sites such as the bladder where they may initiate carcinogenesis. We used data from a Canadian population-based case-control study to evaluate the associations between these workplace exposures and bladder cancer. Methods Data from a population-based case-control study were used to characterize associations between workplace exposure to silica and asbestos and bladder cancer among men. Bladder cancer cases (N = 658) and age-frequency matched controls (N = 1360) were recruited within the National Enhanced Cancer Surveillance System from eight Canadian provinces (1994–97). Exposure concentration, frequency and reliability for silica and asbestos were assigned to each job, based on lifetime occupational histories, using a combination of job-exposure profiles and expert review. Exposure was modeled as ever/never, highest attained concentration, duration (years), highest attained frequency (% worktime) and cumulative exposure. Odds ratios (OR) and their 95% confidence intervals (CI) were estimated using adjusted logistic regression. Results A modest (approximately 20%) increase in bladder cancer risk was found for ever having been exposed to silica, highest attained concentration and frequency of exposure but this increase was not statistically significant. Relative to unexposed, the odds of bladder cancer were 1.41 (95%CI: 1.01–1.98) times higher among men exposed to silica at work for ≥27 years. For asbestos, relative to unexposed, an increased risk of bladder cancer was observed for those first exposed ≥20 years ago (OR:2.04, 95%CI:1.25–3.34), those with a frequency of exposure of 5–30% of worktime (OR:1.45, 95%CI:1.06–1.98), and for those with
... As a matter of fact, the association between unionization and health is not only about health as such but also about whether workers declare work accidents or not (Morse et al., 2003). It might also be assumed that some sectors of activity, more likely to employ a unionized workforce, are particularly affected by occupational health issues (Laden et al.. 2007;Stern et al.. 2000 ;Stern et al.. 1997). ...
Objectives:
To assess whether there are mental and physical health benefits of being employed in a workplace where there is a union or staff association recognized by the management or being a member of such a union.
Methods:
Using four waves [W2 (2010-11), W4 (2012-13), W6 (2014-15), W8 (2016-18)] from Understanding Society (UKHLS), we use a propensity score matching method and apply a latent growth modeling on the original dataset and on the matched dataset to estimate the impact of change in union presence and union membership between wave 2 and wave 4 for the employed population on the change in mental health (Mental Component Summary - MCS) and physical health (Physical Component Summary - PCS), after controlling for socioeconomic characteristics, age and sector of activity.
Results:
Collective negotiation within the workplace plays a statistically significant role in supporting workers' mental and, to a greater degree, physical health. Being unionized does not add up significant physical health benefits but a slight positive effect on mental health is observed.
Conclusion:
About 50 per cent of the employed population is not represented by a labour union at company level and this has negative effects on health. A major health policy issue is also about promoting collective negotiation at the workplace and more research is needed about the impact of implementing such type of negotiation. The study shows the benefits of using a longitudinal approach when analysing the impact of union presence and union membership on workers' health.
... Coke manufacturing workers [125][126][127][128][180][181][182][183][184][185][186] Cokers ...
BACKGROUND:
The aim of this work was to establish recommendations for the medical follow-up of workers currently or previously exposed to carcinogenic substances for the bladder.
METHODS:
A critical synthesis of the literature was conducted. Sectors of activity where workers are or were exposed to carcinogenic substances for the bladder were listed and classified according to the level of bladder cancer risk. Performances of techniques available for the targeted screening of bladder cancer were analysed, including a simulation of results among high-risk populations in France.
RESULTS:
The risk level for the professional group and the latency period between the start of exposure and the natural history of the disease were selected to define a targeted screening protocol. The NMP22BC test, exclusive haematuria testing, and combinations of urine cytology with, respectively, the NMP22BC test and haematuria test, generated an extremely high proportion of false positive results.
CONCLUSION:
Urine cytology is the test that offers the best specificity. Although poor for all bladder cancer stages and grades combined, its sensitivity is better for high grades, which require early diagnosis since late-stage cancers are of very poor prognosis. These results suggest that urine cytology is currently the only technique suitable for proposal within the context of a first line targeted screening strategy for occupational bladder cancer. An algorithm summarising the recommended medical follow-up for workers currently or previously exposed to carcinogenic substances for the bladder is proposed, based on the level of risk of bladder cancer.
... Also, Injury Severity Score was selected as the dependent variable required for bivariate analysis section of the study, which will be addressed in the following section. Independent variables selected for this research were, in most part, consistent with those used in past research [28][29][30][31][32][33]. More information about the categories and variables listed under them are given below. ...
Majority of research in occupational safety and health area lean towards describing accidents with the aid of surveys and descriptive statistics, instead of using inferential statistical techniques. Therefore, an extensive archival study was performed in cooperation with Social Security Institute of Turkey, which included examination and reorganization of more than 2000 accident report forms to create a categorically identified data set, incorporating "Injury Severity Score" concept, followed by various statistical analysis techniques (univariate frequency, cross tabulation and binary logistic regression). As a result, a model was developed to identify the factors that contribute to severity. The findings of the analyses showed that four of the independent variables (work experience, accident type, unsafe condition and unsafe act) have statistically significant influence on workplace injury severity.
... Also, Injury Severity Score was selected as the dependent variable required for bivariate analysis section of the study, which will be addressed in the following section. Independent variables selected for this research were, in most part, consistent with those used in past research [28][29][30][31][32][33]. More information about the categories and variables listed under them are given below. ...
Consequently, majority of studies in occupational safety leaned towards describing accidents with the aid of surveys and descriptive statistics. This study intends to fill this gap by using inferential statistics to identify the factors that contribute to severity of injuries. Subsequently, cooperation with Social Security Institute of Turkey was achieved and an extensive archival study was performed. The information acquired from open-ended questions in forms were reorganized to be identified as variables. Categorically identified data set were analyzed statistically by using binary logistic regression analyses. The findings of the study showed that work experience, accident type, unsafe condition, unsafe act have statistically significant influence on Injury Severity Score.
... Confirming this hypothesis, Morse et al. 25 showed that workers at unionized facilities were 5.7 times more likely to file a claim for workers' compensation. An additional explanation for such findings is that some sectors of activity, more likely to employ a unionized workforce, are particularly affected by occupational health issues [26][27][28] . Finally, it 1 https://www.bls.gov/news.release/union2.t01.htm has been shown that higher rates of unionization nationally are associated with worker's health. ...
Objective
To assess whether unionization prevents deterioration in self‐reported health and depressive symptoms in late career transitions.
Methods
Data come from the Health and Retirement Study (N = 6475). The change in self‐perceived health (SPH) and depressive symptoms (CESD) between wave 11 and wave 12 is explained using an interaction effect between change in professional status from wave 10 to wave 11 and unionization in wave 10.
Results
The odds of being affected by a negative change in CESD when unionized are lower for unionized workers remaining in full‐time job (OR:0.73, CI95%:0.58;0.89), unionized full‐time workers moving to part‐time work (OR:0.66, CI95%:0.46;0.93) and unionized full‐time workers moving to part‐retirement (OR:0.40, CI95%:0.34;0.47) compared to non‐unionized workers. The same conclusion is made for the change in SPH but with odds ratios closer to 1.
Conclusion
The reasons for the associations found in this paper need to be explored in further research.
... WWA (fenantren, antracen, benzopiren) uwalniają się także ze smoły węglowej, szczególnie podczas destylacji lub obróbki termicznej. Wykazano zwiększone ryzyko raka pęcherza u osób narażonych, zatrudnionych przy pracach asfaltowych, dachowych oraz produkcji aluminium [24,25]. Także obecność WWA w powietrzu jest uważana za potencjalny czynnik ryzyka UBC [26]. ...
Every year the number of bladder cancer (UBC) cases is increasing. Global Analysis in 2009 registered 2.7 million diagnosed patients. Due to rising rates of morbidity and high costs of treatment, it is very important to identify risk factors for UBC and prevent at risk persons from further exposure. Environmental factors that have the proven strongest impact on the development of UBC include: smoking, aromatic amines, polycyclic aromatic hydrocarbons, nitrosamines, arsenic and cadmium. Experimental studies indicate carcinogenic effects of some urea-derived pesticides and organochloride pesticides on the uroepithelium. An important role is also played by inflammation, Schistosoma haematobium infections, exposure to ionizing radiation and immunosuppressive therapy. However, when exposure to second-hand smoking is considered, water disinfection byproducts, halogenated hydrocarbons, nitrites and nitrates, further studies are needed in order to clarify their role in the development of UBC. The relationship between environmental exposure and the morbidity rate is more pronounced in bladder cancer than in other cancers. Interaction between environmental factors and genetic susceptibility seems to be the most important risk factor. This was proven by studies of genotype of GST, NAT and other detoxifying enzymes genotypes. Genetic predisposition plays an important role and therefore prevention strategy should include determining such risk groups. This paper presents the current state of knowledge of the effects of environmental risk factors on the development of bladder cancer.
... An increased bladder cancer risk was reported for workers highly exposed to polycyclic aromatic hydrocarbons (PAH), e.g. for workers in aluminium reduction plants (50-53) and for coke oven workers in coking plants (36,54,55). In roofers, who have lower exposure to PAHs, also an increased bladder cancer risk was reported (56,57). The carcinogenic potency of tar was clearly shown in a tar chemical company where 13 bladder cancer cases and 7 bladder polyps (which would be classified today as G1Ta bladder cancer) were observed in 568 employees (58). ...
... Coal tar, pitch creosote, coke oven emissions, and asphalt exposure can also result in the formation of skin tumors and/or lung tumors in animals. Stern et al. [48] also reported that roofers were found to have a significant increased mortality for lung and bladder cancers. Although the major risk of CTPVs is the lung cancer, CTPVs may cause bladder cancer as well. ...
Urinary bladder cancer (UBC), which rinks ninth in worldwide cancer incidence, is a type of malignant growth of abnormal cells. UBC can be caused by: (A) Inhalation of cigarette smoke, smoke from cooking fume hoods, industrial/environmental carcinogens, volatiles of coal tar, and diesel exhaust. (B) Drugs such as cyclophosphazine, chloronaphazine, phenacetin, nitrosamines, and herbal remedies like aristolochic acids. (C) Contact of chlorinated water or hair dyes. (D) Ingestion of bracken fern (Pteridium aquilinum) and/or arsenic. (E) Infections of Schistosoma haematobium (schizosomiasis), Enterobacteria (Cystitis) and Papilloma viruses. (F) Endogenous carcinogens such as tryptophan metabolites and other amines. (G) Hereditary factors such as acetylator of the N-acetyltransferase, and mutations or malfunction of oncogenes/suppressor genes. Prevention of bladder cancer should include cessation of smoking, minimization of exposure to cooking fumes, and elimination of industrial and environmental carcinogens. Other measures worth considering include: (A) Intake of fruits, vegetables, soy products, vitamins, green tea, and decrease of fat consumption. Ingestion of food that is rich in selenium, garlic, lycopene, linoleic acid, various vitamins, gallic acid, and betulinic acid, etc. (B) Intake of non-nutritional factors including astaxanthin, procatachuic, diosmin, hesperidin, 1,4-phenylene diisothiocyanate, crytoxanthin, indomechacin, and silibinin, etc. (C) Administration of drugs such as difluoromethylornithine (DFMO), no steroid anti-inflammatory drugs (NSAIDs), astorvastatin, oitipraz, and Bacillus Calmette-Guerin (BCG). Retinoic acid in combination with ketoconazole was reported to be helpful to bladder cancer patients. In conclusion, the management of interplay of multiple factors of cause, cure and prevention, is the major concern of UBC.
... Coke manufacturing workers [125][126][127][128][180][181][182][183][184][185][186] Cokers ...
Background:
The aim of this work was to establish recommendations for the medical follow-up of workers currently or previously exposed to carcinogenic substances for the bladder.
Methods:
A critical synthesis of the literature was conducted. Sectors of activity where workers are or were exposed to carcinogenic substances for the bladder were listed and classified according to the level of bladder cancer risk. Performances of techniques available for the targeted screening of bladder cancer were analysed, including a simulation of results among high-risk populations in France.
Results:
The risk level for the professional group and the latency period between the start of exposure and the natural history of the disease were selected to define a targeted screening protocol. The NMP22BC test, exclusive haematuria testing, and combinations of urine cytology with, respectively, the NMP22BC test and haematuria test, generated an extremely high proportion of false positive results.
Conclusion:
Urine cytology is the test that offers the best specificity. Although poor for all bladder cancer stages and grades combined, its sensitivity is better for high grades, which require early diagnosis since late-stage cancers are of very poor prognosis. These results suggest that urine cytology is currently the only technique suitable for proposal within the context of a first line targeted screening strategy for occupational bladder cancer. An algorithm summarising the recommended medical follow-up for workers currently or previously exposed to carcinogenic substances for the bladder is proposed, based on the level of risk of bladder cancer.
... stomach (1.7, some of the excess risks may have been attributable to PAH from coal tar products. These findings have been confirmed by recent proportionate mortality study of 11,144 unionized roofers and waterproofers.19 For a comprehensive review of studies on the carcinogenic effects of coal tar emissions, see IARC Monographs Volumes34 and 35 (1984, 1985).15,20 ...
... Et kohortestudie fra USA undersøgte dødeligheden blandt medlemmer af en fagforening for tagdaekkere og fugtisoleringsarbejdere (Stern et al. 2000). De ca. ...
... An increased bladder cancer risk was reported for workers highly exposed to polycyclic aromatic hydrocarbons (PAH), e.g. for workers in aluminium reduction plants (50-53) and for coke oven workers in coking plants (36,54,55). In roofers, who have lower exposure to PAHs, also an increased bladder cancer risk was reported (56,57). The carcinogenic potency of tar was clearly shown in a tar chemical company where 13 bladder cancer cases and 7 bladder polyps (which would be classified today as G1Ta bladder cancer) were observed in 568 employees (58). ...
There is a considerable discrepancy between the number of identified occupational-related bladder cancer cases and the estimated numbers particularly in emerging nations or less developed countries where suitable approaches are less or even not known. Thus, within a project of the World Health Organisation Collaborating Centres in Occupational Health, a questionnaire of the Dortmund group, applied in different studies, was translated into more than 30 languages (Afrikaans, Arabic, Bengali, Chinese, Czech, Dutch, English, Finnish, French, Georgian, German, Greek, Hindi, Hungarian, Indonesian, Italian, Japanese, Kannada, Kazakh, Kirghiz, Korean, Latvian, Malay, Persian (Farsi), Polish, Portuguese, Portuguese/Brazilian, Romanian, Russian, Serbo-Croatian, Slovak, Spanish, Spanish/Mexican, Tamil, Telugu, Thai, Turkish, Urdu, Vietnamese). The bipartite questionnaire asks for relevant medical information in the physician's part and for the occupational history since leaving school in the patient's part. Furthermore, this questionnaire is asking for intensity and frequency of certain occupational and non-occupational risk factors. The literature regarding occupations like painter, hairdresser or miner and exposures like carcinogenic aromatic amines, azo dyes, or combustion products is highlighted. The questionnaire is available on www.ifado.de/BladderCancerDoc.
... Historically, asbestos was used in a variety of roofing products, such as a filler material in asphalt, roofing felts, and mastics (Stern et al., 2000), as well as a structural fiber in asphalt-and coal tar-saturated ply sheets and flashing felts (Brzozowski, 1989). In the early 1980s, the use of asbestos in roofing materials was discontinued in the USA, with the exception of roof coatings, mastics, and cements, which are widely used on various parts of 'roof systems' for waterproofing, adhering flashing to roof surfaces, and sealing around chimneys, air vents, and other penetrations (NRCA, 1994). ...
Historically, asbestos-containing roof cements and coatings were widely used for patching and repairing leaks. Although fiber releases from these materials when newly applied have been studied, there are virtually no useful data on airborne asbestos fiber concentrations associated with the repair or removal of weathered roof coatings and cements, as most studies involve complete tear-out of old roofs, rather than only limited removal of the roof coating or cement during a repair job. This study was undertaken to estimate potential chrysotile asbestos fiber exposures specific to these types of roofing products following artificially enhanced weathering. Roof panels coated with plastic roof cement and fibered roof coating were subjected to intense solar radiation and daily simulated precipitation events for 1 year and then scraped to remove the weathered materials to assess chrysotile fiber release and potential worker exposures. Analysis of measured fiber concentrations for hand scraping of the weathered products showed 8-h time-weighted average concentrations that were well below the current Occupational Safety and Health Administration permissible exposure limit for asbestos. There was, however, visibly more dust and a few more fibers collected during the hand scraping of weathered products compared to the cured products previously tested. There was a notable difference between fibers released from weathered and cured roofing products. In weathered samples, a large fraction of chrysotile fibers contained low concentrations of or essentially no magnesium and did not meet the spectral, mineralogical, or morphological definitions of chrysotile asbestos. The extent of magnesium leaching from chrysotile fibers is of interest because several researchers have reported that magnesium-depleted chrysotile fibers are less toxic and produce fewer mesothelial tumors in animal studies than normal chrysotile fibers.
Naturally occurring petroleum ranges in physical state from liquids to solids. Petroleum, its refining streams, and petroleum‐derived products are comprised of chemical compounds that can number in the thousands and that can vary in chemical composition due to variation in both source material and refining processes. As such, petroleum substances are Substances of Unknown or Variable Composition, Complex Reaction Products, and Biological Materials, also known as UVCBs. Petroleum and its distillates have been divided into categories in the United States and European Union based on refining processes. These categories have been used as an organization point for hazard characterization by regulatory authorities in the United States and European Union. This chapter describes the production, physicochemical properties, exposure, and hazards for petroleum, petroleum streams, and petroleum‐derived products. For substances for which chemical constituents have been identified that are key drivers of hazard (e.g., benzo[ a ]pyrene), these constituents are discussed. Additionally, for some substances, information is provided on regulatory and/or advisory hazard classifications, status regarding Harmonised Classification and Labelling, or recommended exposure limits from regulatory authorities.
Review of the literature cited in documentation of hazard assessments of PAH-involved industries and PAH-containing materials combined with the results of systematic reviews and meta-analyses of the many occupational exposure studies of PAH-involved industries indicates that authoritative review bodies should revisit hazard assessments and thoroughly update the assessments and documentation for PAH-involved occupations using quantitative methods. Current hazard classifications rely heavily on case reports and studies of uncertain or questionable quality with little documentation of review processes. The classification process should adopt transparent, systematic methods beginning with establishing criteria for inclusion of information in the review and should also assess potential biases. The methods of systematic review and meta-analysis should be adopted when data of sufficient quantity and quality are available. Published systematic reviews of occupational exposure studies conducted in PAH-involved industries demonstrate the feasibility of quantitative methods for assessing exposures to PAH-containing materials, and indicate that current assessments overstate associations with skin, lung, and other types of cancer. The review should include consideration of the ways quantitative measures may be useful in developing hazard classifications.
The aims of this work were to assess the PAH exposure among, roofers and to identify relevant biomarkers for monitoring occupational,exposure. Several campaigns were conducted between 2004 and 2017, with 28,individual air samples and 240 urinary samples collected from 73 roofers. Seventeen parent PAHs and 14 urinary biomarkers, metabolites of pyrene (1-OHP), benzo(a)pyrene (3-OHBaP and TetraolBaP), naphthalene (1- and 2-naphtols), fluorene (1-2-3-9-fluorenols) and phenanthrene (1-2-3-4-9-phenanthrols), were analysed. Three exposure groups were considered: soft-applied roofing using polymer-modified bitumen ("PMB"), hot-applied roofing using oxidized bitumen ("OB") and the tearing off of old roof coatings containing coal tar ("CT"). The PAHs containing 2-3 rings were much more abundant, and the highest airborne levels were observed in the "CT" group. The biomonitoring results were consistent with these results, with a large predominance of 2-3 ring PAH metabolites. 1-OHP, 3-fluorenol and 2-phenanthrol were better correlated with airborne levels and less influenced by smoking than the other metabolites. Conversely, 1-/2-naphtol levels were heavily influenced by smoking and not correlated with airborne naphthalene levels. Moreover, 3-OHBaP and TetraolBaP levels were very low when applying bitumen membranes, and much higher exposures were observed during tear-off activities. In this context, the recommended strategy for roofer biomonitoring should include 1-OHP, fluorenols and phenanthrols, as well as carcinogenic BaP metabolites (3-OHBaP or TetraolBaP) when evaluating the occupational exposure of roofers that are tearing off old roof coatings.
Background:
To determine if construction and trades workers employed at U.S. Department of Energy (DOE) nuclear sites facilities are at significant risk for diseases associated with occupational exposures, we compared the mortality experience of participants in the Building Trades National Medical Screening Program (BTMed) to that of the US population.
Methods:
The cohort includes 24,086 BTMed participants enrolled between 1998 and 2016 and 5203 deaths. Cause-specific standardized mortality ratios were calculated based on US death rates.
Results:
Mortality was elevated for all causes, all cancers, cancers of the trachea, bronchus, and lung and lymphatic and hematopoietic system, mesothelioma, chronic obstructive pulmonary disease, asbestosis, transportation injuries, and other injuries, particularly those caused by accidental poisoning, suggesting a possible effect of the opioid epidemic.
Conclusions:
Apart from other injuries, mortality patterns were very similar to those reported in the past in this population. Construction workers employed at DOE sites have a significantly increased risk for occupational illnesses. Risks are associated with employment during all time periods covered including possibly after 1990. The cancer risks closely match the cancers identified for DOE compensation from radiation exposures. The high risk of lung cancer supports the value of early lung cancer detection. Continued medical surveillance is important.
Coal tar pitch (CTP) exposure occurs in many manufacturing applications such as coke production, aluminum reduction, pipe coating, roofing and paving industries, and some of non-heated processes. Pitch workers are exposed to polycyclic aromatic hydrocarbons (PAHs) emitted from CTP which cause pitch-related oculocutaneous diseases and skin cancer. Environmental factors (e.g., sunlight, humidity, and temperature) can aggravate such skin problems in workers. Pitch-related oculocutaneous diseases include photosensitivity and tar erythema, pitch melanosis, folliculitis and acne, contact dermatitis, benign papillomas, premalignant pitch keratoses and acanthomas, and malignant skin lesions. The carcinogenesis of CTP, especially PAHs, has been confirmed by laboratory experiments. Long-term exposure to CTP increases the prevalence of pitch-induced squamous cell carcinomas and basal cell carcinomas. Early biopsy and diagnosis of premalignant and malignant skin lesions is important. Prevention, such as engineering environmental controls, employee education, especially for sunlight protection and medical monitoring, will minimize or eliminate the oculocutaneous exposure to CTP and promote workers’ health.
Reroofing markets account for approximately 75% of all roofing. Therefore, a roofer is exposed not only to roofing materials used today but also to materials used many decades in the past. Commercial roofers suffer a greater amount of occupational skin disease than do residential roofers. “Tar smarts,” a phototoxic reaction to pitch, is among the most common skin disorder seen in roofers. The advent of Type III bitumen, “low fuming,” pitch has significantly reduced “tar smarts.” Other occupational skin disease in roofers includes chemical burns, irritation from solvents, chronic melanosis, folliculitis/pitch acne, and precancerous and cancerous skin diseases. Although allergic contact dermatitis is much less frequent than irritant contact dermatitis among roofers, allergies are seen, especially to personal protective equipment and tools used in the workplace, as well as to sealants, glues, and other materials (e.g., woods).
Objective:
To evaluate whether cancer risks are increased among bitumen (asphalt) workers.
Methods:
Systematic review and meta-analysis of cancer risks (lung, upper aerodigestive tract (UADT), esophagus, bladder, kidney, stomach, and skin) and bitumen exposure. Certainty in the epidemiological evidence that bitumen-exposed workers experience increased cancer risks was rated using GRADE criteria.
Results:
After excluding lower quality studies, lung cancer risks were not increased among bitumen-exposed workers (meta-RR 0.94, 95% CI 0.74 - 1.20, 8 studies). Increased risks of UADT and stomach cancers were observed (meta-RR 1.31, 95% CI 1.03-1.67, 10 studies and meta-RR 1.29, 95% CI 1.03 -1.62, 7 studies, respectively).
Conclusion:
Except for lung cancer, evidence for increased cancer risks among bitumen-exposed workers was judged to be of low certainty, due to inadequate exposure characterization and unmeasured confounders (coal tar exposure, smoking, and alcohol consumption).
From 2000 to 2002, male patients at a Canadian cancer treatment center with new-incident head-and-neck or esophageal cancers were invited to participate in a population- basedstudy. The study population included 87 cases and 172 controls. A lifetime-history questionnaire was administered. Odds ratios (ORs) were calculated for occupational groups with a minimum of five cases, adjusted for duration of employment, age, smoking, alcohol, education, and income. A significantly increased risk was shown for construction workers (OR = 2.20; 95% CI 1.25–3.91). This investigation ofa set of rare cancers over a limited time period demonstrates the feasibility of this research approach. The increased risk among construction workers supports the need for more comprehensive study of exposures in this occupational group.
Asbestos-containing roofing products were widely used throughout the 20(th) century, and certain products are still used in limited quantities today. Roofing products are generally considered non-friable and are not expected to release appreciable amounts of airborne asbestos fibers; however, despite the variety of roofing products that have contained asbestos over time, there are no comprehensive analyses of the exposure data associated with these products in the published literature. The objective of this study was to analyze the available data and characterize asbestos exposures associated with the installation, removal, and replacement of built-up roofing (BUR), felts, flashings, shingles, coatings, cements, and mastics under a variety of work practices. Published and unpublished literature that contained the following information was included in the analysis: 1) airborne fiber concentrations determined by PCM, 2) a description of the product(s) used, and 3) a description of the task(s) performed. More than 800 personal air samples from 12 studies performed between 1982 and 2010 were identified which fit the inclusion criteria. The findings indicate that short-term and full-shift exposures from the use of asbestos-containing roofing products were typically well below applicable occupational exposure limits. Additionally, the cumulative exposures associated with roofing work would be well below published chrysotile no-observed-adverse-effect-levels (NOAELs) for asbestos-related diseases.
The International Agency for Research on Cancer qualitatively characterized occupational exposure to oxidized bitumen emissions during roofing as probably carcinogenic to humans (Group 2A). We examine chemistry, exposure, epidemiology and animal toxicity data to explore quantitative risks for roofing workers applying built-up roofing asphalt (BURA). Epidemiology studies do not consistently report elevated risks, and generally do not have sufficient exposure information or adequately control for confounders, precluding their use for dose-response analysis. Dermal carcinogenicity bioassays using mice report increased tumor incidence with single high doses. In order to quantify potential cancer risks, we develop time-to-tumor model methods [consistent with US Environmental Protection Agency (EPA) dose-response analysis and mixtures guidelines] using the dose-time-response shape of concurrent exposures to benzo[a]pyrene (B[a]P) as concurrent controls (which had several exposure levels) to infer presumed parallel dose-time-response curves for BURA-fume condensate. We compare EPA relative potency factor approaches, based on observed relative potency of BURA to B[a]P in similar experiments, and direct observation of the inferred BURA dose-time-response (scaled to humans) as means for characterizing a dermal unit risk factor. We apply similar approaches to limited data on asphalt-fume inhalation and respiratory cancers in rats. We also develop a method for adjusting potency estimates for asphalts that vary in composition using measured fluorescence. Overall, the various methods indicate that cancer risks to roofers from both dermal and inhalation exposure to BURA are within a range typically deemed acceptable within regulatory frameworks. The approaches developed may be useful in assessing carcinogenic potency of other complex mixtures of polycyclic aromatic compounds.
Background: The Building Trades National Medical Screening Program (BTMed) was established in 1996 to provide occupational medicine screening examinations for construction workers who have worked at US Department of Energy nuclear sites. Workers participating in BTMed between 1998 and 2011 were followed to determine their vital status and mortality experience through December 31, 2011. Methods: The cohort includes 18,803 BTMed participants and 2,801 deaths. Cause-specific Standardized Mortality Ratios (SMRs) were calculated based on US death rates. Results: Mortality was elevated for all causes, all cancers, cancers of the trachea, bronchus, and lung and lymphatic and hematopoietic system, mesothelioma, COPD, and asbestosis. Conclusions: Construction workers employed at DOE sites have a significantly increased risk for occupational illnesses. Risks are associated with employment during all time periods covered including after 1980. The cancer risks closely match the cancers identified for DOE compensation from radiation exposures. Continued medical surveillance is important.
The urinary bladder is a muscular hollow sac that sits on the floor of the pelvis and stores urine. A layer of epithelial cells lines the internal wall of the bladder. Since these cells are constantly exposed to numerous carcinogens prior to disposal through urine; cigarette smoking and occupational exposure to carcinogens increases the risk of developing bladder cancer. Another common human health issue related to the bladder is the sudden involuntary contraction of the bladder muscle that causes overactive bladder. It is an exceedingly common problem affecting men and women of all age groups. Two major discoveries have propelled expectations regarding the use of capsaicin as a potential therapeutic agent for bladder related diseases; (i) that capsaicin functions through the transient vanilloid receptor and (ii) vanilloid receptor has been shown to be present in the urinary tract. While capsaicin has been used to reduce bladder overactivity in people, its use in cancer therapy is still in preclinical stages. In this chapter we examine the pathology and molecular mechanisms of these two bladder diseases, the current treatment strategies and discuss the potential use of capsaicin as a therapeutic agent. In conclusion, we anticipate that development of capsaicin, as an intravesical agent for recurrent bladder cancer, will happen sooner rather than later.
Roofers continue to suffer frequent fall-related injuries and fatalities. The objectives of this research were (a) identifying the factors affecting roofer fall accidents; (b) investigating the frequency distributions of these factors; (c) examining the relationships between the factors; and (d) developing a statistical model for fatal and nonfatal fall outcomes. Occupational Safety & Health Administration (OSHA) accident data was analyzed using categorical variables. After establishing data demographics, cross-tabulation analysis was performed to determine factor relationships, and logistic regression modeling was done to predict accident outcomes using degree of injury as a dependent variable and the significant factors from cross-tabulation as independent variables. It was found that roofers most frequently experienced falls while working in smaller alteration/rehabilitation projects and at heights below 20 feet. Unguarded/improperly secured platforms, walkways, openings, edges and ladders, misjudgment of hazardous situation, and improper choice of equipment/process came out to be significant contributing factors. It was observed that the odds of fatality decreased when roofers were provided OSHA-compliant fall protection systems; used these systems; and received fall protection training per OSHA requirements. The model developed and validated in this study successfully predicted the fall accident outcomes in terms of fatality and nonfatal injury.
Polycyclic aromatic hydrocarbons (PAH) are genotoxic substances formed during combustion. Occupational PAH exposure has been shown to increase the risk of lung cancer and may be associated with other respiratory cancers. We conducted a systematic review and meta-analysis to clarify the relationship between occupational PAH exposures and larynx malignancies. We searched EMBASE and MEDLINE (until July 2014) using a series of search strings developed to seek case-control studies or longitudinal studies of workers (Population) exposed to PAHs (Exposure) and their risk for larynx cancer incidence and/or mortality (Outcome). Two independent reviewers screened the titles and abstracts for eligible articles and a third reviewer negotiated consensus. Further assessments of eligibility and sources of bias were conducted in a similar manner. The study results were pooled with random effects meta-analysis. The search resulted in 3377 records. The data of 92 full-text articles representing 63 studies were included and extracted. The majority of studies (n=47) was judged likely to be biased; only 16 studies were judged as methodologically adequate. The pooled effect size was 1.45 (95% CI 1.30 to 1.62; I(2)=30.7%; [Formula: see text]=0.03) for larynx cancer incidence and 1.34 (95% CI 1.18 to 1.53; I(2)=23.8%; [Formula: see text]=0.03) for larynx cancer mortality. While few studies allowed an investigation of dose-response, these indicate a positive dose-response effect. Although most studies may underestimate the true effect due to inexact approximations of PAH exposure, the meta-analysis suggests a robust positive association between PAH and larynx cancer.
Das Harnblasenkarzinom zählt zu den malignen Tumoren, bei denen exogene und damit vermeidbare Einflüsse als ursächlich belegt sind. Zigarettenrauchen ist der mit Abstand wichtigste Risikofaktor, wobei das Erkrankungsrisiko mit dem Ausmaß des Zigarettenkonsums ansteigt. Bemerkenswert ist, dass sich das erhöhte Harnblasenkarzinomrisiko bereits wenige Jahre nach Beendigung des Rauchens wieder verringert. Zweiter wichtiger Risikofaktor sind berufliche Expositionen v. a. gegenüber krebserzeugenden aromatischen Aminen wie Benzidin und β-Naphthylamin sowie bestimmten Azofarbstoffen. Gefährdet sind v. a. Beschäftigte bei der Herstellung dieser Stoffe und — wenn auch deutlich geringer — Personengruppen, die diese Stoffe verarbeiten. Risiken durch umweltbedingte Expositionen scheinen, soweit bisher bekannt, eine geringere Rolle zu spielen. Therapiebedingte Risiken, die zum Harnblasenkarzinom als Zweitmalignom führen, sind zu beachten. Die Prävention besteht gegenwärtig v. a. in der Expositionsvermeidung und in der Früherkennung von Harnblasenkarzinomen bei Hochrisikokollektiven.
The U.S. roofing industry employs about 200,000 workers and estimates indicate about 50,000 on-roof workers are exposed to asphalt fumes during approximately 40% of their working hours. Numerous epidemiological studies have been conducted to evaluate cancer outcomes among roofers, including exposure to asphalt/bitumen fume. However, most studies relied on job title as a surrogate for exposure to asphalt or asphalt fumes because individual exposure data were not available. Therefore, it is unclear whether reported results of an increased risk of lung cancer reflect the direct impact of asphalt exposure on employee health, or if findings are due to bias, such as the presence of other risk factors for lung cancer (i.e., “confounding” exposures) or the use of comparison populations that are inherently different with respect to lung cancer risk. We evaluated the likelihood and extent to which the observed increased risk of lung cancer may be due to confounding (a mixing of effects of multiple exposures) by co-exposure to other potential carcinogens present in roofing or to lifestyle variables. We conducted a review of the epidemiological and industrial hygiene literature of asphalt-exposed workers. Peer-reviewed epidemiological studies of asphalt fumes, related occupational exposures, and confounding factors were identified from MEDLINE (1966– early 2004). Industrial hygiene studies of asphalt workers were identified through MEDLINE, publicly available government documents, and asphalt industry documents. Using well-established statistical methods, we quantified the extent to which lung cancer relative risk estimates among roofers reflect confounding from other exposures, using different prevalence and risk scenarios. The relative risk of lung cancer varied from 1.2 to 5.0 in 13 epidemiological studies of roofers; most studies reported a relative risk between 1.2 and 1.4. Smoking, asbestos and coal tar were the most likely confounders, but the prevalence of these factors varied over time. For example, smoking prevalence declined more steadily in the general population than among roofers, and coal tar and asbestos exposures among roofers have declined over the past 50 years. Depending on prevalence estimates used, the relative risk due to confounding ranged from 1.17 to 1.52 (current smoking); 1.36 to 1.78 (asbestos); and 1.04 to 2.32 (coal tar). The results of the study indicate that much of the observed risk reported in epidemiological studies of cancer among roofers is well within the range of what may have resulted from confounding by reasonable and expected levels of smoking, asbestos or coal tar. This may be particularly true for those studies that did not adjust for these confounders and where the exposure was defined as employment in the roofing industry. In addition to poorly defined asphalt exposure, uncontrolled confounding cannot reliably be ruled out in studies of lung cancer among asphalt-exposed roofers. Therefore, it is not possible to conclude whether roofers are at increased risk of lung cancer due to asphalt exposure. Future studies of roofers will require improved quantification of asphalt/bitumen exposure and confounding factors to provide more direct evidence regarding the specific role of occupational asphalt exposure in the etiology of lung cancer among roofers.
" ABSTRACT "
" ANALYSIS AND MODELING OF"
" ROOFER AND STEEL WORKER FALL ACCIDENTS"
by
" Hulya Cakan"
" August 2012"
" Advisor: " Dr. Mumtaz Usmen
" Major: " Civil and Environmental Engineering
" Degree: " Doctor of Philosophy
There are more than nine million construction workers in the US. Roofers and steel workers are the highest risk construction trades according to BLS, and fall from elevation accounts for a large percentage of fatalities and injuries among the construction trades.
In this study, 2114 OSHA accident case reports involving roofers and steel workers were reviewed to identify and analyze the factors contributing to construction fall accidents. Using data for the years between 1994 and 2008, the relationships between these factors were determined and further studied to develop predictive models. Univariate frequency, cross tabulation and logistic regression analyses were used to estimate the effect of the statistically significant factors on the degree of injury (fatality vs. nonfatality)
Chi square tests on the entire data showed that there is a significant relationship between the degree of injury and union status, SIC code, construction operation prompting fall, environmental factor, human factor, project type, construction end use, safety protective system provision, safety protective system usage, fall distance, and fatality/injury cause.
Logistic regression model created for the combined SIC Codes of 1761 and 1791 showed that among the six independent dichotomous variables only four were significantly associated with the degree of injury. These factors were project type, SIC code, safety training and safety protection system usage.
Two separate logistic regression models, one for roofers and another for steel workers were also developed. The roofers' model showed that among the five independent categorical dichotomous variables only three showed significant association with injury severity. These were project type, safety training, and safety protection system usage. The steel worker model showed that only two independent variables had significant association with the degree of injury, and they were union status and project type.
The study showed that cross tabulation analysis and logistic regression modeling can be used for analyzing data on construction fall accidents in a meaningful way, producing useful results.
The equivocal experimental and epidemiological evidence of bitumen fumes and the possible mechanisms of toxicity remain uncertain. This study therefore aimed at investigating the genotoxicity of bitumen fumes, the biotransformation and urinary excretion of PAHs, and altered expression of a selected number of genes in lung, nasal epithelium, and white blood cells of rats. Animals were exposed to three different concentrations (low: 4 mg/m; medium: 20 mg/m; high: 100 mg/m) of bitumen fume condensate for 5 days, 30 days, and 12 months (6 hours per day) or ambient air. Notably, no dose-related signs of intolerance were observed throughout the inhalation period but dose dependent uptake of bitumen fumes was observed based on urinary excretion of PAHs and metabolites. At best, measurements of naphthols enabled an estimate of dose-dependent body burden. Excretion of 1-hydroxy- and 2-hydroxyphenanthrene was dose dependent and their production is catalyzed by the CYP1A1 monooxygenase which we found to be strongly induced upon exposure to bitumen fumes. Furthermore, pyrene, a minor component in bitumen fumes, produced hydroxypyrene levels close to the detection limit in rat urine. We additionally determined DNA adduct formation by the P-postlabelling assay and observed a dose and time dependent increase of 3 to 4 stable DNA adducts in lung, nasal, and alveolar epithelium. DNA adduct levels were highest in nasal epithelium, the relative adduct level (RAL) being 450 adducts per 10 nucleotides. For lung and alveolar epithelium the RAL was 114 and 76 adducts per 10 nucleotides, respectively. However, we did not observe micronucleated red blood cells of the peripheral blood or with polychromatic erythrocytes of the bone marrow (after 12 months). It is important to note that erythrocyte cell count in bone marrow smears was reduced in four out of six animals after 12 months of exposure, clearly demonstrating that components of bitumen fume had reached the bone marrow. Finally, we investigated by reverse transcription polymerase chain reaction regulation of genes with known functions in inflammation, asthma and other pulmonary diseases. Gene expression changed during the time of exposure. With the monooxygenases CYP1A1 and CYP2G1 we observed dose dependent regulation in nasal and lung tissue. We also observed significant, but dose independent, regulation of cathepsin K and D, cadherin 22, platelet activating factor acetylhydrolase isoform 1b alpha subunit and the regulator of G-protein signalling in nasal epithelium of male rats after exposure to bitumen fumes. We found bitumen fumes to be genotoxic in target tissue of exposure and observed altered regulation of genes involved in the metabolic activation of polycyclic aromatic hydrocarbons and cellular inflammatory processes. These findings are consistent with the histopathology observed in the respiratory tract of rats chronically exposed to bitumen fume. An understanding of the regulation of suspected disease candidate genes in target tissues of exposure will be an interesting objective for further research into the mechanisms of toxicity.
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 chi-square and I 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 = 80%) and significantly greater than the meta-RR for the paving studies (meta-RR = 0.98, 95% CI = 0.81–1.18, I = 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 = 60%), while the corrected pavers' meta-RR was nearly unchanged at 0.96 (meta-RR = 0.96, 95% CI = 0.80–1.16, I = 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 = 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.
Introduction: Bladder cancer is a malignant disease with exogenous and thus avoidable factors
which have been identified as causative. Methods: Selective literature review. Results: Cigarette
smoking is by far the strongest risk factor with a clear dose-response relationship. Within a few
years after smoking cessation bladder cancer risk begins to fall. Occupational exposure,
particularly to aromatic amines and to certain azo dyes, is another important risk factor. Workers
involved in the production of these chemicals and, to a lesser extent, those processing these
substances are at high risk. Environmental factors seem to play a minor role. Treatment-induced
secondary bladder cancer must also be considered. The prevention of bladder cancer is currently
based on avoiding exposure and by early detection of the disease in high risk populations.
Einleitung: Für das Harnblasenkarzinom sind exogene und damit vermeidbare Einflüsse als ursächlich belegt. Methoden: Diskussion ausgewählter Literatur. Ergebnisse: Zigarettenrauchen ist der mit Abstand wichtigste Risikofaktor, wobei das Erkrankungsrisiko mit dem Ausmaß des Zigarettenkonsums
ansteigt und sich bereits wenige Jahre nach Beendigung des Rauchens wieder verringert. Zweiter
wichtiger Risikofaktor sind berufliche Expositionen, vor allem gegenüber Krebs erzeugenden aromatischen Aminen sowie bestimmten Azofarbstoffen. Gefährdet sind vor allem Beschäftigte bei der Herstellung dieser Stoffe und – wenn auch deutlich geringer – Personengruppen, die diese Stoffe verarbeiten. Risiken durch umweltbedingte Expositionen scheinen eine geringere Rolle zu spielen. Therapiebedingte Harnblasenkarzinome sind zu beachten. Die Prävention besteht gegenwärtig vor allem in der Expositionsvermeidung und in der Früherkennung von Harnblasenkarzinomen bei Hochrisikokollektiven.
From 2000 to 2002, male patients at a Canadian cancer treatment center with new-incident head-and-neck or esophageal cancers were invited to participate in a population-based study. The study population included 87 cases and 172 controls. A lifetime-history questionnaire was administered. Odds ratios (ORs) were calculated for occupational groups with a minimum of five cases, adjusted for duration of employment, age, smoking, alcohol, education, and income. A significantly increased risk was shown for construction workers (OR = 2.20; 95% CI 1.25-3.91). This investigation of a set of rare cancers over a limited time period demonstrates the feasibility of this research approach. The increased risk among construction workers supports the need for more comprehensive study of exposures in this occupational group.
By R. G. Feldman . 1998. Pp. 500. Philadelphia: Lippincott–Raven. ISBN 0-7817-1739-6.
It is almost 20 years since the appearance of Spencer and Schaumburg's ground-breaking volume on experimental and clinical neurotoxicology, which gave us a comprehensive survey of the subject as understood at the time. That book served a useful purpose but is now largely out of date. Dr Feldman's new work has a different approach. It is a survey of the problems posed by occupational and environmental neurotoxicology as shown by a comprehensive and detailed account of the effects of 20 chemicals widely employed in industry. These include various metals, several types of widely employed solvent and agrochemicals to which workers in the field and in the factory become exposed. In the context of the title, the `environment' is that contaminated by man's industry and inventiveness stemming from his desire to improve the lot of his race, of which this book offers the most noteworthy examples. It does not include toxic substances of the natural environment derived from animals, plants, insects, dinoflagellates, bacteria or other living organisms, interesting though these certainly are. This is a handbook providing all relevant details of these 20 important chemicals, enabling clinicians and others to have ready access to such data. It even goes so far as to provide web site addresses, so that up-to-date information can be obtained about regulations governing the use of potentially hazardous compounds in the workplace, their threshold limit values, permissible exposure limits and so forth as laid down, in this instance, by various American government agencies. It is a pity that WHO …
The tumorigenicity to mouse skin of volatile components of roofing asphalts and coal tar pitches was investigated. Male CD-1 and C3H/H3J-mice were exposed to 25 milligrams per application of ashpalt volatiles or 1.5 to 4.2 milligrams per application of pitch preparations. Treatment was twice weekly for an 18 month period with two temperatures of generation of volatile materials and exposure or lack of exposure to simulated sunlight. The C3H strain of mice was more sensitive to the tumorigenic activity, while simulated sunlight had an inhibitory effect on the rate of appearance of tumors but not on the final tumor incidence. The higher temperature of preparation of the asphalt volatiles resulted in greater tumorigenic activity. The authors conclude that the asphalt volatiles were almost as tumorigenic and carcinogenic to C3H-mice as the pitch volatiles.
To improve the estimates of occupational fatality rates for persons employed in the construction industry, several sources of data on the number of fatalities (the numerator) and the number of persons engaged in construction work (the denominator) were examined. Based on this examination, the Census of Fatal Occupational Injuries (CFOI), compiled by the Bureau of Labor Statistics (BLS), was used to obtain numerators and the Current Population Survey, conducted by the Bureau of the Census for the BLS, was used to obtain denominators. Adjustments were made in the numerator to include only occupations that were included in the denominator. Occupations were divided into two groups—those in the construction trades and those in other occupations within construction (e.g., clerical, sales). The analysis found fatality rates of 14.2 and 13.3 per 100,000 person-years, respectively, for 1992 and 1993, with wide variation in rates among the different trades. There were also major differences among the trades in the types of fatal injuries. Self-employed workers had much lower death rates overall than wage workers, but this is largely due to much lower proportions of high hazard trades among the self-employed. There have been wide variations in the occupational fatality rates reported for construction workers each year due to the differing methods of estimating the number of fatalities by the different data sources. This study provides a baseline of fatality rates using the best available current data. It compares the results from these data sources with those from other sources that have been used and discusses some of the problems inherent in the data from other sources. This study provides a significantly improved protocol for the calculation of fatality rates against which later rates can be compared consistently. Nevertheless, many deficiencies in the data sources used are identified. There remains ample room for continued improvement. © 1996 Wiley-Liss, Inc.
Proportional mortality analyses are traditionally considered to be unreliable because they lack information on persons at risk. Standardized mortality ratios (SMRs) are often used in preference to proportional mortality ratios (PMRs) even when the denominator or numerator of rates is known to be biased. Examination of data from 30 randomly selected occupational units described by the U.K. Office of Population Censuses and Surveys (OPCS) revealed, however, that age-standardized cause-specific SMRs and PMRs have an almost constant relationship: the ratio of the cause-specific SMR to the cause-specific PMR closely approximating the all-cause SMR of the group under consideration. Hence, a PMR above 100 almost always indicates that the corresponding cause-specific SMR is greater than the all-cause SMR (and vice versa). Furthermore, approximately 70 per cent of conditions with significantly high PMRs above 200 have corresponding SMRs which are also significantly high. When cautiously interpreted, the PMR may, therefore, be a useful indicator of an increased frequency of disease in a particular occupational or other group.
Construction, one of the larger industries in the United States, employs 7.6 million workers, many in skilled trades occupations. Previously published data about potential worksite exposures and mortality of construction site workers are limited. We analyzed occupation and industry codes on death certificates from 19 U.S. states to evaluate mortality risks among men and women usually employed in construction occupations. Proportionate mortality ratios (PMRs) for cancer and several other chronic diseases were significantly elevated among 61,682 white male construction workers who died between 1984 and 1986. Men younger than age 65, who were probably still employed immediately prior to death, had significantly elevated PMRs for cancer, asbestos-related diseases, mental disorders, alcohol-related disease, digestive diseases, falls, poisonings, traumatic fatalities that are usually work-related, and homicides. Elevated PMRs for many of the same causes were observed to a lesser degree for black men and white women whose usual industry was construction. In addition, women experienced excess cancer of the connective tissue and suicide mortality. Various skilled construction trades had elevated PMRs for specific sites, such as bone cancer and melanoma in brickma-sons, stomach cancer in roofers and brickmasons, kidney and bone cancer in concrete/terrazzo finishers, nasal cancer in plumbers, pulmonary tuberculosis in laborers, scrotal cancer and aplastic anemia in electricians, acute myeloid leukemia in boilermakers, rectal cancer and multiple sclerosis in electrical power installers, and lung cancer in structural metal workers. Using a standard population of blue collar workers did not result in fewer elevated PMRs for construction workers. Despite lifestyle differences and other limitations of the study, the large numbers of excess deaths observed in this study indicate the need for preventive action for construction workers. © 1995 Wiley-Liss, Inc.
Twenty epidemiologic studies have described cancer risk in asphalt workers and roofers in various countries. A current concern for these workers is the potential carcinogenicity posed by inhalation of bitumen fumes or dermal exposure to bitumens. Bitumens are chemically different from many carcinogenic coal-tar based materials. Both have been employed in road paving and waterproofing. We examined and combined the results of the epidemiologic studies conducted on asphalt workers and roofers. We examined the cancer risk separately in three broad job categories: 1) roofers (exposed to bitumen fumes and previously often to coal-tar fumes); 2) highway maintenance workers (HMWs) and road pavers (exposed to bitumen fumes as well as possibly coal-tar fumes previously); and 3) miscellaneous and unspecified bitumen/asphalt workers. In roofers, an increased risk was suggested for cancers of the lung (aggregated relative risk 1.8, 95% confidence interval 1.5–2.1), stomach (1.7, 1.1–2.5), nonmelanoma skin (4.0, 0.8–12), and leukemia (1.7, 0.9–2.9). Some of the excesses may be attributable to polycyclic aromatic hydrocarbons (PAH) from coal-tar products. The aggregated relative risks in road pavers and HMWs were consistently lower than in roofers for cancers of the lung (0.9, 0.8–1.0), stomach (1.1, 0.8–1.5), bladder (1.2, 0.7–1.8), skin (2.2, 1.2–3.7), and leukemias (1.3, 0.9–1.8). Their risk of skin cancer was significantly increased, based on one study. Miscellaneous and unspecified workers had a significant excess (1.5, 1.2–1.8) of lung cancer. The data were poorly focused to address the carcinogenicity of bitumen fumes, as contrasted with tar-derived exposures. For the prospect of shedding more light on the bitumen-cancer controversy, the feasibility of a powerful multicenter cohort is currently being studied by the International Agency for Research on Cancer (IARC).
Each year over 500 U.S. workers are killed in falls and approximately 20% of these falls are from roofs. This study examines death certificate data from the National Institute for Occupational Safety and Health National Traumatic Occupational Fatalities database and found 288 fatal falls from roofs in 1984–1986, 138 (48%) of which were matched with reports of Occupational Safety and Health Administration investigations. Workers in the construction industry suffered 232 of the 288 fatal falls (80%). Workers in roofing trades (SIC 1761, 104 deaths) and structural steel erection (SIC 1791, 27 deaths) had the greatest frequency of injury. Poorly marked or unguarded roof openings were associated with 42 deaths. There were 24 fatal falls through skylights, and 27 fatal falls through other roof structures or materials unable to support a worker's weight. Of the 24 fatal falls through skylights, sufficient details were available to determine that 12 of the 24 involved falls through plastic or fiberglass skylights. Standards for strength requirements for skylights are advisable. Data sources used for this study lacked details concerning use of personal protective equipment such as safety belts and lanyards. However, the study provides general information on falls from roofs that may be useful in planning preventive measures.
Epidemiologic evidence on the relationship between polycyclic aromatic hydrocarbons (PAH) and cancer is reviewed. High occupational exposure to PAHs occurs in several industries and occupations. Covered here are aluminum production, coal gasification, coke production, iron and steel foundries, tar distillation, shale oil extraction, wood impregnation, roofing, road paving, carbon black production, carbon electrode production, chimney sweeping, and calcium carbide production. In addition, workers exposed to diesel engine exhaust in the transport industry and in related occupations are exposed to PAHs and nitro-PAHs. Heavy exposure to PAHs entails a substantial risk of lung, skin, and bladder cancer, which is not likely to be due to other carcinogenic exposures present in the same industries. The lung seems to be the major target organ of PAH carcinogenicity and increased risk is present in most of the industries and occupations listed above. An increased risk of skin cancer follows high dermal exposure. An increase in bladder cancer risk is found mainly in industries with high exposure to PAHs from coal tars and pitches. Increased risks have been reported for other organs, namely the larynx and the kidney; the available evidence, however, is inconclusive. The results of studies addressing environmental PAH exposure are consistent with these conclusions.
Causes of death among 2,190 deceased operating engineers identified from the 1967 International Union of Operating Engineers death benefit listing were analyzed to determine if there were conditions occurring with unusual frequency that might be indicative of hazardous conditions in the work environment. The most striking finding was a three-fold excess of fatal accidents occurring at places other than the home or resident institution. The increased risk was evident in each of four regions of the country and at all ages under 65. Significant excesses in deaths from lung cancer and intestinal cancer were seen also. Comparative mortality from lung cancer was directly related to age, with the greatest increase (two-fold) occurring after age 75. There was no evidence of a greater than expected frequency of deaths from non-malignant respiratory disease among operating engineers.
Lung cancer rates in Los Angeles County were reviewed for different occupations and industries. Employment groups found to be at excess risk who have not been previously implicated included roofers, dental lab technicians, decorators, nonautomotive mechanics, photoengravers, clothing ironers, electricians, bar and restaurant managers, janitors: and workers in the radio-TV brooad-casting, dairy, leather, food and drink, bakery, and auto repair industries. Mo lung cancer in Los Angeles County had exposure to asbestos, polycyclic aromatic hydrocarbon compounds (PAH), or both.
This article discusses various causes of skin cancer in industry: ultraviolet radiation, polycyclic aromatic hydrocarbons, ionizing radiation, arsenic and certain miscellaneous causes (trauma, burns, chronic irritation). Some of the most important preventive measures are outlined.
The objective of the current study was to estimate the risk of lung cancer attributable to occupational factors and not due to tobacco. At 24 hospitals in nine metropolitan areas in the United States, 1793 male lung cancer cases were matched for race, age, hospital, year of interview, and cigarette smoking (never smoker, ex-smoker, smoker (1-19 and > or = 20 cigarettes per day)) to two types of controls (cancer and non-cancer hospital patients). Information on usual occupation, exposure to specific potential carcinogens, and cigarette smoking was obtained by interview. Risk of lung cancer was increased significantly for electricians; sheetmetal workers and tinsmiths; bookbinders and related printing trade workers; cranemen, derrickmen, and hoistmen; moulders, heat treaters, annealers and other heated metal workers; and construction labourers. All of these occupations are potentially exposed to known carcinogens. Odds ratios (ORs) were increased for exposure to coal dust (adjusted OR = 1.5; 95% confidence interval (95% CI) 1.1-2.1). After stratification, this association was statistically significant only after 10 or more years of exposure. Lung cancer was also related to exposure to asbestos (adjusted OR = 1.8; 95% CI 1.5-2.2). The ORs increased with increasing duration of exposure to asbestos for all smoking categories except for current smokers of 1-19 cigarettes per day. The statistical power to detect ORs among occupations that were previously reported to be at increased risk of lung cancer but that failed to show an OR of at least 1.5 in the current study was small. The cumulative population attributable risk (PAR) of lung cancer due to occupation was 9.2%. It is concluded that occupational factors play an important part in the development of lung cancer independently of cigarette smoking. Because occupations at high risk of lung cancer were under-represented, the cumulative PAR of the present study is likely to be an underestimate of the true contribution of occupation to risk of lung cancer.
The authors have created US mortality rates (age, sex, race, and calendar-time specific) and proportions, using multiple cause-of-death
data, for the years 1960–1989. Multiple cause-of-death data include the usual underlying cause of death from the death certificate
as well as contributory causes and other significant conditions. US multiple-cause rates and proportions enable the user to
calculate the expected occurrences of disease on the death certificates of a cohort under study. There is an average of 2.66
causes and/or contributory conditions listed on US death certificates, increasing over time from 2.54 in the 1960s to 2.76
in the 1980s. The ratio of multiple-cause listings to underlying cause listings varies by disease, from low ratios for cancers
to high ratios for diseases such as diabetes, arthritis, prostate disease, hypertension, pneumoconiosis, and renal disease.
Use of these data is illustrated with two cohorts. Multiple-cause analysis (but not underlying cause analysis) revealed twofold
significant excesses of renal disease and arthritis among granite cutters. For workers exposed to dioxin, neither multiple-cause
nor underlying cause analysis indicated any excess of diabetes, an outcome of a priori interest. Good candidates for multiple-cause
analysis are diseases that are of long duration, not necessarily fatal, yet serious enough to be listed on the death certificate.
A job exposure matrix has been developed based on potential exposure data collected during the 1972-1974 National Occupational Hazard Survey (NOHS). The survey sample was representative of all U.S. non-agricultural businesses covered under the Occupational Safety and Health Act of 1970 and employing eight or more employees. Potential worker exposure to all chemical, physical, or biological agents was recorded during the field survey if certain minimum guidelines for exposure were met. The job exposure matrix (JEM) itself is a computerized database that assists the user in determining potential chemical or physical exposures in occupational settings. We describe the structure and possible uses of the job exposure matrix. In one example, potential occupational exposures to elemental lead were grouped by industry and occupation. In a second example, the matrix was used to determine exposure classifications in a hypothetical case-control study. Present availability as well as future enhancements of the job exposure matrix are described.
This study was conducted to investigate the adverse health effects of exposure to bitumen fumes. A cohort of 679 mastic asphalt workers was followed from 1959 to 10 June 1986, during this period 169 deaths occurred. The overall standardized mortality ratio (SMR) was 163 (95% confidence interval (95% CI) 141-190), the SMR was 225 (95% CI 172-288) for cancer and 223 (95% CI 130-358) for external causes. Among persons aged 40 to 89 years, significant increases were seen for lung cancer (SMR 290, 95% CI 188-429), nonpulmonary cancer (SMR 200, 95% CI 141-276), and liver cirrhosis (SMR 467, 95% CI 188-962). Bronchitis, emphysema, and asthma also occurred in excess (SMR 207, 95% CI 95-393). In conclusion, the inhalation of bitumen fumes may have contributed to the elevated mortality from cancer and respiratory diseases among mastic asphalt workers.
In the 1970s, the National Institute for Occupational Safety and Health developed a Life Table Analysis System to analyze occupational cohort studies. We have updated the original system by adding two new features: direct standardization with a test for linear trend, and analyses by lagged exposure (either duration of exposure or cumulative exposure). We have also updated US reference rates through 1989. The updated systems and documentation (version F) are available upon request. In collaboration with the National Cancer Institute, we have also developed multiple cause-of-death rate files, which consider contributory as well as underlying cause. These files (also available upon request) will enable investigators to derive the expected prevalence of diseases at death, which can then be compared with the observed prevalence in an exposed cohort. Work is currently underway to produce a personal computer version of the Life Table Analysis System.
This article will outline a pragmatic approach directed to incorporating key elements of a scientific review of the literature and derive a proposal for an occupational exposure standard for coal tar, coal tar pitch, creosote, petroleum pitch, bitumen and asphalt, six substances which contain polynuclear aromatic hydrocarbons. Five approaches to the standard setting process are reviewed and their strengths and weaknesses discussed. Unfortunately there does not exist an acceptable epidemiological data set, other than the coke oven emission studies, on which to base a valid and reliable risk assessment model. Based on comparative potency experiments of complex mixtures, consideration of the state-of-the-art sampling and analytical methods, prevention of acute human health effects, and current existing standards for these substances throughout the world, a set of recommended exposure standards are derived for health policy makers.
A case-control study of lung cancer was conducted to evaluate the relationship between lung cancer histologic types and occupation, adjusted for smoking. A total of 4,431 white male cases and 11,326 cancer controls, diagnosed between 1980 and 1985, were identified through the Missouri Cancer Registry. For all histologic types combined, excess risk was observed among many a priori suspected high-risk occupations. Lung cancer was elevated among men employed as insulators (odds ratio [OR] = 6.0; 95% confidence interval [CI] = 0.7, 137.8), carpenters (OR = 1.3; 95% CI = 1.0, 1.7), painters, plasterers, and wallpaper hangers (OR = 2.0; 95% CI = 1.2,3.3), structural metal workers (OR = 1.9; 95% CI = 0.6,6.0), mechanics and repairers (OR = 1.3; 95% CI = 1.0,1.7), motor vehicle drivers (OR = 1.5; 95% CI = 1.2,1.8), police and firefighters (OR = 1.6; 95% CI = 1.1,2.3), and food service personnel (OR = 1.8; 95% CI = 1.0,3.5). A deficit of lung cancer was observed among farmers (OR = 0.9; 95% CI = 0.7,1.0). Adenocarcinoma of the lung was elevated among carpenters (OR = 1.6; 95% CI = 1.0,2.5) and cabinet and furniture makers (OR = 2.0; 95% CI = 0.4,8.1), which is interesting because of the previous reports of excess adenocarcinoma of the nasal cavity associated with wood dust exposure. Adenocarcinomas were also elevated among plumbers (OR = 2.0; 95% CI = 1.0,3.8) and printers (OR = 1.8; 95% CI = 0.7,4.2). Electricians were at slightly increased risk for adenocarcinoma (OR = 1.5; 95% CI = 0.7,2.8) and "other" or mixed cell types of lung cancer (OR = 1.5; 95% CI = 0.8,2.9) but at decreased risk for small cell (OR = 0.8; 95% CI = 0.3,2.0) and squamous cell (OR = 0.8; 95% CI = 0.4,1.6) tumors. Among welders, adenocarcinoma (OR = 1.7; 95% CI = 0.7,3.8) and squamous cell (OR = 1.7; 95% CI = 0.9,3.3) cancers were elevated, but small cell and "other" lung cancers were not. Despite the limitations of the Cancer Registry data, some interesting associations were observed that merit further study, particularly the association between lung adenocarcinoma and occupational exposure to wood and wood dust.
A historical cohort study was conducted to study the possible risk of cancer associated with exposure to asphalt. Altogether 1320 unskilled workers employed in the asphalt industry were followed up over a ten year period and compared with 43,024 unskilled men in terms of cause specific mortality. Both groups were identified from census records and followed up by an automatic record link that had been established previously between the census register, National Register, and Death Certificate Register. The cancer mortality was significantly increased in asphalt workers aged 45 or more, when five years' latency from enrolment into the study was allowed for (SMR for cancer: 159, 95% confidence interval: 106-228). Non-significant increases were seen for respiratory, bladder, and digestive cancers but a significant increase was seen for brain cancer (SMR = 500, 95% CI: 103-1461). Components of asphalt fumes may have been important to the observed association between risk of cancer and employment in the asphalt industry.
Occupational data from 5 case-control studies in the United States involving 2,973 male cases and 3,210 controls were analyzed to estimate the percentage of lung cancer attributable to well-known and suspected lung carcinogens. The studies were conducted in areas heterogeneous in terms of industrial activities. The percentage of lung cancers attributable to occupations entailing potential exposure to well-recognized carcinogens ranged, by study area, from 3 to 17%. The further inclusion of occupational groups with suspect carcinogenic exposures changed these estimates very little. Exclusion of data derived from next-of-kin interviews influenced the estimates of attributable risks, but not in a systematic fashion. The estimates also varied according to ethnic group, smoking status and birth cohort, with higher values in non-whites, non-smokers and among members of more recent birth cohorts. Possible errors in exposure classification, which may make these estimates conservative, are discussed.
The association of occupation with lung cancer risk was examined in a case-control study conducted in six areas of New Jersey. The study included 763 white males with incident histologically confirmed primary cancer of the trachea, bronchus, and lung and 900 general population white male controls selected from driver's license and death certificate files. Altogether, 27 employment categories had a smoking-adjusted odds ratio (OR) of 1.3 or greater; five of these with significantly high OR contributed to an occupational population attributable risk of 13%. Masons and tilesetters; janitors and cleaners; printing workers; and trucking service, warehousing, and storage workers had significantly high risks overall and for longer durations of employment. Shipbuilding workers had significantly high risk overall and for short duration of employment. Although the excess risk for all shipbuilding workers was primarily among those with reported exposure to asbestos, the risk was also high among welders, burners, sheet metal workers, and boilermakers with no reported asbestos exposure.
Construction, one of the larger industries in the United States, employs 7.6 million workers, many in skilled trades occupations. Previously published data about potential worksite exposures and mortality of construction site workers are limited. We analyzed occupation and industry codes on death certificates from 19 U.S. states to evaluate mortality risks among men and women usually employed in construction occupations. Proportionate mortality ratios (PMRs) for cancer and several other chronic diseases were significantly elevated among 61,682 white male construction workers who died between 1984 and 1986. Men younger than age 65, who were probably still employed immediately prior to death, had significantly elevated PMRs for cancer, asbestos-related diseases, mental disorders, alcohol-related disease, digestive diseases, falls, poisonings, traumatic fatalities that are usually work-related, and homicides. Elevated PMRs for many of the same causes were observed to a lesser degree for black men and white women whose usual industry was construction. In addition, women experienced excess cancer of the connective tissue and suicide mortality. Various skilled construction trades had elevated PMRs for specific sites, such as bone cancer and melanoma in brickmasons, stomach cancer in roofers and brickmasons, kidney and bone cancer in concrete/terrazzo finishers, nasal cancer in plumbers, pulmonary tuberculosis in laborers, scrotal cancer and aplastic anemia in electricians, acute myeloid leukemia in boilermakers, rectal cancer and multiple sclerosis in electrical power installers, and lung cancer in structural metal workers. Using a standard population of blue collar workers did not result in fewer elevated PMRs for construction workers. Despite lifestyle differences and other limitations of the study, the large numbers of excess deaths observed in this study indicate the need for preventive action for construction workers.
We analyzed data from 1987 to 1990 National Health Interview Surveys and compared them with 1978 to 1980 National Health Interview Surveys data to determine changes in cigarette smoking prevalence by occupation. During this period, cigarette smoking prevalence declined from 31.7% to 24.2% among white-collar workers, from 43.7% to 39.2% among blue-collar workers, and from 37.2% to 34.5% among service workers. For occupational groups, the largest significant declines in smoking prevalence occurred among male sales workers (10.5 percentage points), female and male managers and administrators (9.9 and 8.7 percentage points), female professional and technical workers (8.0 percentage points), and male transportation equipment operatives (7.5 percentage points). Analyses of 1987 to 1990 detailed occupation codes revealed that roofers (57.8%) and crane and tower operators (57.6%) had the highest prevalences of cigarette smoking, whereas physicians (5.4%) and clergy (6.5%) had the lowest smoking prevalences. Since 1978 to 1980, the differences in smoking prevalence by occupation have widened, providing further evidence that smoking has moved from a relatively common behavior practiced by most segment of society to one that has become more concentrated among selected subpopulations. Health professionals need to play an important role in encouraging smoking cessation among workers and in advising management and labor about the benefits of strong work-site smoking policies.
Work in the construction industry involves about a threefold increased risk of fatal injury compared with all industries combined. The purpose of this study was to identify potential risk factors for fatal injury in the construction industry in New Jersey. Multiple data sources including death certificates, medical examiner reports, Occupational Safety and Health fatality files, and Workers' Compensation reports were used to identify 200 construction-related fatalities in New Jersey during the years 1983 to 1989. All deaths were in men. The death rate was 14.5 per 100,000 employed person-years over the study period. Death rates tended to diminish with increasing age after 34 until age 65 when the death rate was the highest (27.7). Death rates were higher for Hispanics (34.8) and African-Americans (24) than whites (10.6). Ironworkers and roofers had highest rates (109.0 and 56.2, respectively) among specific occupational groups within the construction industry. The leading cause of death was falls (46%). These data suggest that intervention efforts directed toward workers at heights is needed. Further research is warranted to elucidate the factors contributing to the elevated fatality rate of workers over age 65, and to Hispanic and African-American workers.
Alcohol and tobacco habits have been identified as strong risk factors for esophageal cancer. Increased risks of esophageal cancer have also been reported to be associated with occupational exposure to asbestos and various metals, among vulcanization workers, asphalt workers, and workers in the petrochemical industry. Mortality and cancer incidence were investigated in a series of studies of workers exposed to combustion by-products, i.e., chimney sweeps, waste incinerator workers, gas workers, and bus garage workers exposed to diesel exhausts. The SMRs for esophageal cancer ranged from 150-386 in these cohorts, and a combined SMR of 289 (95% C.I. 174-452) was obtained. Available data on smoking habits and indirect indicators of alcohol consumption show that the excess cannot be attributed solely to these factors. It seems likely that occupational exposure to combustion products is associated with an increased risk of esophageal cancer.
To evaluate the utility of expanding the number and precision of injury categories used in previous occupational mortality studies, this study reanalyzed data from four previous studies of unionized construction workers (construction laborers, ironworkers, sheet metal workers, and operating engineers), by expanding the number of injury categories from 6 to 33.
Proportionate mortality ratios (PMRs) were computed using the distribution of deaths from the National Occupational Mortality Surveillance System, a mortality surveillance system from 28 states, as a comparison. A blue collar comparison group was also used in additional analyses to adjust for socioeconomic and other factors.
This reanalysis identified significantly elevated PMRs in at least one of the four worker groups for falls, motor vehicle crashes, machinery incidents, electrocutions, being struck by falling objects, being struck by flying objects, explosions, suffocation, and water transport incidents. Limiting the comparison population to deaths among blue collar workers did not change the results substantially.
This study demonstrates that increasing the precision of categories of death from injury routinely used in mortality studies will provide improved information to guide prevention. Am. J. Ind. Med. 37:364-373, 2000. Published 2000 Wiley-Liss, Inc.
Hazard Review Health effects caused by occupational exposure to asphalt Code of Federal Regulations, Title 29, Part 1910, Section 1000 Safety analysis of high risk categories within the roo®ng industry
- Niosh T Pizatella
NIOSH. 2000. Hazard Review. Health effects caused by occupational exposure to asphalt. In press. OSHA. 1985. Code of Federal Regulations, Title 29, Part 1910, Section 1000, Subpart Z, Table Z1-A under Coal Tar Pitch Volatiles. Parsons T, Pizatella T, Collins J. 1986. Safety analysis of high risk categories within the roo®ng industry. Professional Safety, 31:13±16.
Proportionate mortality ratio analysis systemÐversion V. Draft documentation. Cincinnati, OH: National Institute for Occupational Safety and Health. Emmett E. 1986. Occupational skin cancer Mortality and cancer incidence in Swedish road paving asphalt workers and roofers
- R Dubrow
- S Spaeth
- Adams C S Burnett
- Robinson M Petersen
- ±49 G Engholm
- A England
- Linder
Dubrow R, Spaeth S, Burnett C, Adams S, Petersen M, Robinson C. 1993. Proportionate mortality ratio analysis systemÐversion V. Draft documentation. Cincinnati, OH: National Institute for Occupational Safety and Health. Emmett E. 1986. Occupational skin cancer. J Occup Med 17: 44±49. Engholm G, England A, Linder B. 1991. Mortality and cancer incidence in Swedish road paving asphalt workers and roofers. Health Environ 1:62±68. EPA. 1984. Health effects assessment for coal tars. U.S. Environmental Protection Agency EPA/540/1-84/024.
A pragmatic approach to standard setting: the example of coal tar products and asphalt Asbestos disease in commercial roofers: radiologic signs Causes of death among construction machinery operators
- Haines A Verma
Chong J, Haines A, Verma D. 1989. A pragmatic approach to standard setting: the example of coal tar products and asphalt. Ann Occup Hyg 33:197. Christiani D, Greene R. 1990. Asbestos disease in commercial roofers: radiologic signs. Proceedings from the VIIth International Pneumoco-nioses Conference, Part II. NIOSH, U.S. DHHS, Pub No. 90±108, p 1414±1417. Decou¯e P, Lloyd W, Salvin, L. 1977. Causes of death among construction machinery operators. J Occup Med 19(2):123±128.
Mortality by occupation, industry, and cause of death: 24 reporting states DHHS (NIOSH) Pub. No. 97-114. California Department of Health
- C Burnett
- Rosenberg J H Maurer
- Dosemeci
Burnett C, Maurer J, Rosenberg H, Dosemeci M. 1997. Mortality by occupation, industry, and cause of death: 24 reporting states, 1984± 1988. DHHS (NIOSH) Pub. No. 97-114. California Department of Health. 1987. California Occupational Mortality (COMS) 1979±1981.
Roofers and Roadbuilders
- J Brubacher
Brubacher J. 1997. Roofers and Roadbuilders. In: Michael I Greenberg, editor. Occupational, industrial, and environmental toxicology.
Occupational mortality in Washington State
- S Milham
Milham S. 1983. Occupational mortality in Washington State 1950±
1979. NIOSH Publications No. 83-116. October, 1983.
IARC Monographs on the evaluation of carcinogenic risk of chemicals to humans. Overall evaluation of carcinogenicity: an updating of IARC monographs Vol 1-42
IARC. 1987. IARC Monographs on the evaluation of carcinogenic risk
of chemicals to humans. Overall evaluation of carcinogenicity: an
updating of IARC monographs Vol 1-42, Suppl. 7, International
Agency for Research on Cancer, Lyon.
California occupational mortality, 1979±1981. California Department of Health Services
- J A Singleton
- J J Beaumont
Singleton JA, Beaumont JJ: 1989. California occupational mortality,
1979±1981. California Department of Health Services.
Occupational data sets appropriate for proportionate mortality ratio analysis
- J Beaumont
- A H Okun
Beaumont J, Okun AH. 1981. Occupational data sets appropriate for
proportionate mortality ratio analysis. Banbury Report 9: Quanti®ca-tion of Occupational Cancer, pp. 391±411.
Mortality by occupation, industry, and cause of death: 24 reporting states
- C Burnett
- J Maurer
- H Rosenberg
- M Dosemeci
Burnett C, Maurer J, Rosenberg H, Dosemeci M. 1997. Mortality by
occupation, industry, and cause of death: 24 reporting states, 1984±
1988. DHHS (NIOSH) Pub. No. 97-114.
Mortality and cancer incidence in Swedish road paving asphalt workers and roofers
- G Engholm
- A England
- B Linder
Engholm G, England A, Linder B. 1991. Mortality and cancer
incidence in Swedish road paving asphalt workers and roofers. Health
Environ 1:62±68.
A review of proportionate mortality design in occupational epidemiology. Paper presented at the
- St
- R Claire
- W Butler
St. Claire R, Butler W. 1981. A review of proportionate mortality
design in occupational epidemiology. Paper presented at the American
Public Health Association annual meeting, Los Angeles, November 5,
1981.
California Department of Health
California Department of Health. 1987. California Occupational
Mortality (COMS) 1979±1981.
Asbestos disease in commercial roofers: radiologic signs
- D Christiani
- R Greene
Christiani D, Greene R. 1990. Asbestos disease in commercial roofers:
radiologic signs. Proceedings from the VIIth International Pneumoconioses Conference, Part II. NIOSH, U.S. DHHS, Pub No. 90±108, p
1414±1417.