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Studies of respiratory morbidity in rubber workers. Part III. Respiratory morbidity in processing workers.

Respiratory questionnaires and pulmonary function tests were administered to sixty-five men exposed to dust in the processing are from three rubber tire manufacturing plants. Similar tests were done on 189 "control" workers. Compared with the controls, the processing workers had a higher prevalence of chronic productive cough. Overall, the processing group showed a decrease in the ratio of FEV to FVC. The processing workers with more than ten years of exposure showed a significant decrease in the ratio of FEV1.0/FVC, the FEV1.0, the residual FEV1.0, and the flow rates at 50% and 25% of the forced vital capacity. None of the pulmonary function effects could be solely explained on the basis of smoking, age, ethnic, or socioeconomic factors: all were related to the length of exposure. Based on these results we conclude that exposure in the processing area produces pulmonary disease.

Adult↗

Respiratory disease mortality among uranium miners.

A mortality analysis of a group of white and Indian uranium miners was done by a life-table method. A significant excess of respiratory cancer among both whites and Indians was found. Nonmalignant respiratory disease deaths among the whites are approaching cancer in importance as a cause of death, probably as a result of diffuse parenchymal radiation damage. Exposure-response curves for nonsmokers are linear for both respiratory cancer and "other respiratory disease." Cigaret smoking elevates and distorts that curve. Light cigaret smokers appear to be most vulnerable to lung parenchymal damage. The predominant histologic cancer among nonsmokers is small-cell undifferntiated, just as it is among cigaret smokers.

Adult↗

Cohort study of mortality of vermiculite miners exposed to tremolite.

A cohort of 406 men employed before 1963 for at least one year in a vermiculite mine in Montana was followed up until July 1983. The vermiculite ore as fed to the mill contained 4-6% of amphibole fibre in the tremolite series. Vital status was established in all but one of the 406 and death certificates were obtained and coded for 163 of the 165 men who died. Compared with white men in the United States, the cohort experienced excess mortality from all causes (SMR 1.17), respiratory cancer (SMR 2.45), non-malignant respiratory disease (SMR 2.55), and accidents (SMR 2.14). Four deaths were from malignant mesothelioma (proportional mortality 2.4%). Compared with Montana death rates, the SMR for respiratory cancer was somewhat higher (3.03). Man-year analyses of respiratory cancer and estimated cumulative exposure gave a relation that did not depart significantly from linearity. The results of this and case-referent analyses indicate an increased risk of mortality from respiratory cancer in this cohort of about 1% for each fibre year of exposure. In relation to estimated exposure the mortality experienced by the cohort from both lung cancer and mesothelial tumours was higher than in chrysotile mining.

Aluminum Silicates↗

Respiratory disease mortality patterns among South African iron moulders.

To assess the influence of foundry exposure on malignant and non-malignant respiratory disease, the proportional mortality ratio (PMR) was used to compare the cause of death distributions of the 578 dead members of the Iron Moulders Society of South Africa, recipients of the union's death benefit fund between 1961 and 1983. Comparisons were made with the age and period specific white male deaths. For the 419 members where job information was available, the influence of occupation (journeyman, production moulder) was assessed using different techniques--the relative proportional mortality ratio (RPMR), the mortality odds ratio (MOR), and the proportional cancer mortality ratio (PCMR) for comparison. Excess PMRs were found for cancer of the trachea, bronchus, and lung (1.71, p = 0.03; Poisson one sided test) for those over 65 and for non-malignant respiratory disease (1.58, p = 0.01) and for injuries and poisonings (2.61, p less than 0.0001) in those under 65. Reduced PMRs were found for all cancers (0.75, p = 0.03) and all circulatory disease (0.91, p = 0.12) in those under 65. When comparing job types, raised risks were obtained for journeymen using all methods (RPMR, MOR, PCMR) but the small cell sizes rendered the results non-significant. The raised PMRs due to respiratory disease are unlikely to be due to smoking because of a poor association with other causes of death related to smoking. A more likely explanation is that these excess rates for malignant and non-malignant respiratory disease are due to exposure to the foundry environment. Of additional concern are the high PMRs due to injuries and poisonings, which could be related to the high accident rates in the iron and steel industry.

Cohort Studies↗

Man-made mineral fibers and health. Answered and unanswered questions.

An overall assessment of the epidemiologic evidence from 23 published studies on workers' health in the industry producing man made mineral fibers (MMMF) (21 studies) and in the user industry (2 studies) is presented. Three major studies recently published, one cross-sectional and two of the historical cohort type, conducted in the producer industry, have been singled out for closer examination and discussion. The combined evidence from the epidemiologic studies indicates that causal associations between MMMF occupational exposure, as it occurred in past decades, and lung cancer and chronic respiratory diseases cannot be excluded, neither does it offer clear support for such associations. Experimental data indicate clearly that a fibrogenic effect can be obtained by the intratracheal administration of MMMF and a carcinogenic effect by the intratracheal, intrapleural, and intraperitoneal administration of MMMF, while no appreciably fibrogenic nor carcinogenic effects have been detected in inhalation experiments. While it can be stated that no long-term pathological effects have been observed in MMMF workers in the first 20 years or so after first employment, the key scientific issue of whether MMMF are fibrogenic and/or carcinogenic in man when inhaled remains still open.

Air Pollutants, Occupational↗