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Biomedical subjects

E Delzell

Publications and source records attributed to E Delzell.

At least 55 records · Page 3Linked to original sources
PubMed1993

Mortality patterns among men in the motor vehicle manufacturing industry.

This retrospective follow-up study evaluates the mortality experience of 123,232 male hourly workers employed at a motor vehicle manufacturing company in 1973. Company computerized personnel records were used to identify subjects and to obtain their employment history. Follow-up through December 31, 1985 was conducted using company, state, and national data sources. The mortality rates of the cohort were compared with the rates of the United States (U.S.) general population of white or black men, adjusting for age and calendar time, and using the standardized mortality ratio (SMR) as the measure of association. The overall mortality rate of cohort members is lower than the U.S. rate by 11% among whites (11,060 observed/12,427 expected deaths; SMR = 89) and by 24% among blacks (3,744/4,926 deaths; SMR = 76). These low mortality rates reflect deficits of diseases other than cancer. Cancer SMRs are 99 for whites and 90 for blacks. There are slight excesses of stomach cancer (SMR = 113) and of lung cancer (SMR = 108) among whites and of cancer of the large intestine and rectum (SMR = 114) and of the lymphopoietic tissue (SMR = 111) among blacks. Both whites and blacks have a large deficit of buccal cancer and pharynx cancer, and blacks also have a deficit of esophagus cancer. The cohort's overall deficit of deaths is due largely to the favorable mortality experience of active workers. In contrast, white subjects who have left active employment have an 11% mortality excess, and inactive black subjects have a mortality rate that is similar to the general population rate. The increased mortality among inactive whites is not limited to any one particular disease category. This pattern may reflect illness-related employment termination and generalized confounding by socioeconomic status, although the study does not rule out a relationship between workplace exposures and specific diseases.

Adult↗
PubMed1993

Retrospective follow-up study of foundry and engine plant workers.

A retrospective follow-up study of 21,013 workers employed at a foundry and two engine manufacturing plants was conducted to determine if these workers had an unusual mortality experience. A total of 2,235 deaths occurred during the follow-up period of 1970-1987. Mortality from all causes was lower than expected. Men experienced a 6-13% excess of lung cancer deaths, depending on the choice of the comparison group. The data displayed evidence of a positive trend between lung cancer mortality and increasing duration of employment (p = 0.008). White men experienced a statistically significant excess of deaths from stomach cancer (standardized mortality ratio [SMR] = 158; 95% confidence interval [CI] = 101-234). Black men had increased mortality from pancreatic cancer, especially among engine plant workers (SMR = 303; CI = 121-624), and an excess of prostate cancer, concentrated among foundry workers (SMR = 234; CI = 112-430).

Adult↗
PubMed1993

Inter-rater agreement in the assessment of solvent exposure at a car assembly plant.

This study investigated the feasibility and the reproducibility of a retrospective assessment of solvent exposure in the painting operations of a car assembly plant. Five industrial hygienists (the raters) reviewed summary documents on plant operations and solvent exposure levels, developed from plant records and interviews. The raters independently reviewed 695 department-job-year combinations compiled from 29 work histories and used semi-quantitative scores to rate solvent exposure. Inter-rater agreement was evaluated by computing the percent concordance index and the intraclass correlation coefficient (rI). There was discordance among raters, a large proportion of which pertained to low exposure levels (1-5 ppm). The computation of the rI is sensitive to the distribution of exposure levels. A low rI can be observed for a rare exposure even if the percent concordance is high. Inter-rater agreement was good for cumulative exposure scores computed for frequent exposures: coatings (rI = 0.67), aromatic hydrocarbons (rI = 0.66), and petroleum distillates (rI = 0.62).

Automobiles↗
PubMed1993

Exposure to butadiene and lymphatic and hematopoietic cancer.

Several follow-up studies have assessed lymphatic and hematopoietic cancer (LHC) among workers with potential exposure to 1,3-butadiene. These investigations of the styrene-butadiene rubber and butadiene manufacturing industries include 17,448 subjects with an average of 22 years of follow-up. When the results of the studies are combined, the total number of observed leukemia deaths is 36, compared with 34.2 expected. The standardized mortality ratio is 1.05, with a 95% confidence interval of 0.74-1.46. These null data are compatible with, at most, a weak positive association of butadiene with leukemia. There is little evidence of an association with other forms of LHC among styrene-butadiene rubber workers (55 observed/50.1 expected deaths). Only one study has evaluated directly the relation between estimates of butadiene exposure and leukemia, and this investigation reports a positive association. The result, however, cannot be interpreted as causal, because there is no satisfactory explanation for the marked discrepancy between this case-control study and a null follow-up study based on the same subjects. Overall, the epidemiologic evidence does not provide persuasive evidence that butadiene exposure causes LHC.

Butadienes↗
PubMed1992

A follow-up study of agricultural chemical production workers.

This retrospective follow-up study evaluated the mortality experience of 4,323 men employed at a plant in Alabama (AL) that manufactures agricultural and other chemicals. On average, there were 18 years of follow-up per subject during the study period of 1951 to 1987. The observed numbers of deaths among cohort members were compared with the numbers expected on the basis of United States (US) and AL general population mortality rates. The all causes standardized mortality ratio (SMR), computed using US rates as the referent, was 97 (233 observed/240 expected deaths) for whites and 68 (47/69) for blacks. White subjects had more than expected deaths from buccal cavity and pharynx (BCP) cancer [SMR = 388; 95% confidence interval (CI) = 125-905] and from esophageal cancer (SMR = 417; 112-1,067). Their lung cancer mortality rate was 50% higher than the rate of US white men and 14% higher than the rate of AL white men. Each of these three cancers has strong nonoccupational determinants, the roles of which were not assessed and which may have been responsible in whole or in part for the observed increases. The excesses of lung and esophageal cancer were concentrated among short-term employees, an observation which also argues against a causal link with occupational factors. Black men experienced no increased mortality from BCP, esophageal or lung cancer, but results for blacks were imprecise. For white and black subjects combined, there were 3 observed versus 0.62 expected deaths due to soft tissue sarcoma (p = 0.05). The job histories of subjects with this type of cancer did not suggest any shared occupational exposure.

Black or African American↗
PubMed1992

A case-control study of lung cancer at a dye and resin manufacturing plant.

This case-control study evaluated the relationship between lung cancer and occupational factors among employees at a dye and resin manufacturing plant. The study included 51 lung cancer cases and 102 controls who were members of a cohort of workers investigated in a previous retrospective follow-up study. Information on area of employment and on potential exposure to certain chemicals was obtained from plant personnel and medical records and from interviews with long-term employees. Information on potential confounders, including cigarette smoking, was obtained by interviewing study subjects or their next-of-kin. The odds ratio (OR) for heavy smokers compared with light or nonsmokers was 5.9 (95% confidence interval (CI) = 2.4-15). An elevated OR for lung cancer was observed for subjects who worked in the anthraquinone dye and epichlorohydrin manufacturing area of the plant (OR = 2.4; 95% CI = 1.1-5.2) and for employees who were seen at the plant infirmary for acute exposure to chlorine (OR, adjusted for smoking = 27; 95% CI = 3.5-205). Pipefitters employed at the plant for five or more years also had an elevated OR (3.3; 95% CI = 0.8-14).

Adult↗
PubMed1991

Validity of a mortality study based on a corporate health surveillance system.

We evaluated the Shell Health Surveillance System (HSS) by conducting two mortality studies at an oil refinery. Study A used the HSS to measure the mortality of active and retired workers during 1973 to 1982. Study B used additional information sources and followed up terminated employees. For subjects included in both studies, results were very similar. However, the mortality experience of terminees before 1973 (included only in study B) was different from that of study A subjects, reflecting differences in length of employment and time since hire. HSS-based studies provide valid measures of long-term effects of past exposures among retirees and of short-term effects of recent exposures among active employees. However, they cannot detect short-term effects of past exposures, and they have limited power for evaluating dose-response relationships.

Cause of Death↗
PubMed1989

A follow-up study of workers at a dye and resin manufacturing plant.

A total of 2642 men employed at a dye and resin manufacturing plant in New Jersey were observed from the opening of the plant in 1952 through 1985, and their mortality rates were compared with the rates of United States white men. The workers' mortality experience was related to former employment at the Cincinnati Chemical Works, which had produced or used benzidine and beta-naphthylamine. The 2553 men who had never worked at the Cincinnati Chemical Works had fewer than expected deaths from all causes combined (317 observed/402 expected) and equal numbers of observed and expected cancer deaths (89/89). The 89 former Cincinnati Chemical Works employees had an excess of cancer (17/8.6, P = .02), which was due to increased mortality from bladder (3/0.25, P = .004), kidney (2/0.21, P = .04), and CNS (2/0.22, P = .04) cancer. There also were several increases in cancers among men employed in certain work areas at the New Jersey plant. These included elevated mortality from lung (18/9.2, P = .01) and liver (3/0.46, P = .02) cancer among maintenance workers, from stomach (3/0.40, P = .02) and CNS (3/0.44, P = .02) cancer among azo dye workers, and from lung cancer (4/0.91, P = .03) among epichlorohydrin workers. The lung cancer excess among maintenance workers increased with length of employment, suggesting an association with an unidentified occupational exposure. Other associations were based on small numbers of deaths, and their interpretation is not clear.

Adult↗
PubMed1989

Mortality from leukemia and other diseases among workers at a petroleum refinery.

This study evaluates the mortality experience of 9484 white men who worked at a petroleum refinery. We compared the numbers of deaths among these men during the period 1940 through 1984 with the numbers expected on the basis of the mortality rates of US white men. Overall, there were 2874 observed compared with 3568 expected deaths (standardized mortality ratio, 77). Mortality rates for most major cause of death categories and most cancers were also lower than expected. However, there was a statistically significant 50% excess of leukemia deaths (44 observed/29.6 expected). Lymphocytic leukemia was increased both among men hired before 1940 and among men hired in 1940 or later. In contrast, myelocytic leukemia was increased only among men hired in 1940 or later. The restriction of the myelocytic leukemia excess to men hired in 1940 or later may be related to process changes which occurred at the refinery after 1940 and which resulted in an increased percentage of benzene in certain refinery streams. The presence of an excess of lymphocytic leukemia, but not myelocytic leukemia, among men hired before 1940 suggests that some factor other than benzene was responsible for the former condition.

Cohort Studies↗
PubMed1988

A death-certificate case-control study of non-Hodgkin's lymphoma and occupation in men in North Carolina.

A death certificate-based case-control study was performed to investigate associations between occupation and non-Hodgkin's lymphoma (NHL) in North Carolina. Cases consisted of 501 men who died of NHL (International Classification of Diseases codes 200 and 202) during the years 1968-1970, 1975-1977, and 1980-1982. Controls were selected from other noncancer deaths, and were frequency matched for age, year of death, and race. Occupation and industry were obtained from the death certificates and coded without knowledge of case-control status. An increased risk for men in professional, technical, and managerial occupations, compared with all others, was detected among whites (OR = 2.69, 1.95-3.72). Black men classified as having "low exposures" by an occupational exposure linkage system had an odds ratio of 1.74 (0.84-3.60). Because of this finding, the occupations were ranked by social class and a statistically significant linear relationship was noted in whites, with risk increasing from lower social class to upper social class. An increased risk was also detected among whites in the rubber, plastics, and synthetics industries (p = .03), and among blacks employed in machine trades occupations (OR = 3.63, 1.32-9.97) and structural work occupations (OR = 2.38, 0.93-6.05). An increased risk was also detected for black painters (p = .02), but not for whites. There was no association found between NHL and employment in the following areas: textile industry; farming; laborers; or occupations with exposures to asbestos or benzene. The association with farming was further examined in counties with high use of pesticides and herbicides, and no increased risk of NHL was detected. Cases were more likely to live in the western part of the state than the eastern. However, NHL mortality rates provided by the North Carolina State Center for Health Statistics did not confirm the relationship.

Adult↗
PubMed1988

Benzene and leukemia. A review of the literature and a risk assessment.

Benzene is widely recognized as a leukemogen, and the Occupational Safety and Health Administration is currently attempting to limit exposure to it more strictly. The proposed new regulation is a limit of an eight-hour time-weighted average of 1 ppm in place of the current limit of 10 ppm. The fundamental rationale for the change is a perception that the current standard is associated with an inordinate excess of leukemia. The epidemiologic literature on benzene and leukemia supports the inference that benzene causes acute myelocytic leukemia. However, the available data are too sparse, or suffer other limitations, to substantiate the idea that this causal association applies at low levels (i.e., 1-10 ppm) of benzene. Nonetheless, under the assumption that causation does apply at such low levels, a number of authors, including ourselves, have performed risk assessments using similar data but different methodologies. The assessments that we consider acceptable suggest that, among 1,000 men exposed to benzene at 10 ppm for a working lifetime of 30 years, there would occur about 50 excess deaths due to leukemia in addition to the baseline expectation of seven deaths. However, this estimate is speculative and whether or not enough confidence can be placed in it to justify a lower occupational benzene standard remains a decision for policy makers.

Benzene↗
PubMed1987

Case-control study of hepatocellular carcinoma, occupation, and chemical exposures.

The relation of hepatocellular carcinoma (HCC) to occupation and chemical exposures was evaluated in a case-control study. The study included 80 cases and 146 matched hospital controls on whom a work history was obtained. No persuasively positive association between HCC and any particular occupation, industry, or chemical exposure was found. However, the relative rate (RR) of HCC for persons employed in highway construction compared with those never so employed is 5.0 with 95% confidence limits (CL), 1.0 to 26. The RR for farming occupations, 1.4 (95% CL, 0.7 to 2.9), is also slightly elevated. The RR for persons exposed to pesticides compared with those not exposed is 2.4 (95% CL, 0.9 to 6.5). Asphalt exposures are associated with a RR of 3.2 (95% CL, 0.9, 11). These findings are compared to the results of other epidemiologic studies.

Adult↗
PubMed1986

A case-control study of hepatocellular carcinoma and the hepatitis B virus, cigarette smoking, and alcohol consumption.

A case-control study was undertaken to evaluate the roles of the hepatitis B virus (HBV), cigarette smoking, and alcohol use in the etiology of hepatocellular carcinoma (HCC). A major purpose of the study was to evaluate the effect of cigarette smoking on HCC among hepatitis B surface antigen (HBsAg)-negative persons, since it had been suggested that the relative effect of cigarette smoking on HCC was higher among HBsAg-negative persons than among HBsAg-positive persons. Eighty-six cases and 161 hospital controls were included in the study. This study confirmed the strong relationship between the HBV and HCC. Twelve of 67 cases and none of 63 controls were chronically infected with HBV as evidenced by serum HBsAg. The study also found a moderately strong relationship between alcohol use and HCC. The results of the present study do not support the hypothesis that cigarette smoking is a risk factor for HCC. Among all subjects, the relative rate of HCC for cigarette smokers compared with nonsmokers after adjustment for alcohol consumption was 1.0 with 95% confidence limits, 0.5 to 1.8. Among HBsAg-negative subjects, the relative rate was 1.1 with 95% confidence limits, 0.5 to 2.4. There was also no consistent dose-response relationship between quantity smoked and HCC in this study.

Adult↗
PubMed1985

Multiple myeloma and family history of cancer. A case-control study.

A hospital-based case-control study was done to examine the hypothesis that persons with a family history of multiple myeloma (MM) or other cancers are at increased risk of multiple myeloma. Study members were 439 cases of multiple myeloma and 1317 matched controls seen at the Duke University Medical Center. Only 3 cases and 4 controls reported multiple myeloma in their families. The relative risk (RR) was 2.3, but the 95% confidence interval (CI) was 0.5-10.1, allowing no firm conclusion about the risk associated with familial MM. A family history of cancer of any type resulted in a relative risk of MM of 1.4 (CI: 1.1-1.8). This association was strongest (RR = 2.5, CI: 1.1-5.3) among young study members (age less than or equal to 49). A family history of hematologic malignancy (ICD 200-208) resulted in a RR of 2.4 (95% CI: 1.4-4.0). The data also suggested that a family history of lung cancer, breast cancer, and genitourinary cancer may be associated with increased risk of myeloma in older persons.

Epidemiologic Methods↗
PubMed1985

Mortality among rubber workers: X. Reclaim workers.

This study evaluated the mortality experience of 1,352 white and 438 nonwhite men who worked in the rubber-reclaiming division of a large rubber manufacturing company. In comparisons of mortality of white reclaim workers with that of nonreclaim workers rate ratios were 2.7 for esophageal cancer (six observed deaths among reclaim workers), 2.1 for bladder cancer (seven observed deaths), and 4.5 for multiple myeloma (six observed deaths). The excess of bladder cancer among white reclaim workers may be associated with their employment in other high-risk areas of the plant, whereas no such explanation was found for the excesses of esophageal cancer and multiple myeloma. Overall, the lung cancer mortality rate of white reclaim workers was similar to the rate of US white males and other white rubber workers. There was a 50% excess of lung cancer deaths among nonwhite reclaim workers compared with other nonwhite rubber workers. However, this observation is based on small numbers, and no firm conclusions can be reached about the risk of lung cancer associated with reclaim operations in this group of rubber workers.

Esophageal Neoplasms↗
PubMed1985

Mortality among rubber workers: IX. Curing workers.

This research examined mortality among 1,152 white male production workers employed in the tire-curing department of a large rubber manufacturing plant. To determine whether these men had any cause-specific mortality excesses, their experience was compared with that of both the U.S. white male general population and a group of production workers at the same plant who had not worked in the curing division. Both types of comparisons indicated that the curing workers experienced excess mortality from lung cancer. There were 45 deaths from lung cancer among curing workers compared to 24.6 expected based on the age- and calendar period-specific rates of other rubber workers. In addition, the mortality rate ratio for pneumonia was 2.2 for curing relative to noncuring workers. These findings are consistent with the results of other studies and suggest that occupational exposures may have contributed to the development of pulmonary disease among curing workers.

Age Factors↗