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PubMed1998

Evaluation of workers exposed to dust containing hard metals and aluminum oxide.

BACKGROUND: Fourteen worker exposed to hard metals and aluminum oxide were evaluated. METHODS: Six heavily exposed workers underwent bronchoscopy and bronchoalveolar lavage, and five workers underwent transbronchial biopsy. RESULTS: Microchemical analysis of transbronchial biopsies showed a high lung burden of exogenous particles, especially metal related to their hard metals exposure. Lung tissue and cellular changes, which were associated with exposure to hard metal and aluminum oxide, corresponded well with the microanalytic test results. CONCLUSIONS: Three workers had at biopsy diffuse interstitial inflammatory changes: two of them were asymptomatic with normal chest X-ray films, and one had clinically evident disease with severe giant cell inflammation. Two other workers showed focal inflammation. The worker showing clinical disease and one asymptomatic worker with interstitial inflammatory changes had evaluated bronchoalveolar lavage fluid-eosinophilia counts. These two were father (with clinical disease) and son (asymptomatic).

Adult↗
PubMed1998

An evaluation of the prevalence of latex sensitivity among atopic and non-atopic intensive care workers.

BACKGROUND: Exposure to latex is known to cause an array of symptoms, including pruritus, dermatitis, erythema, and urticaria. Workers at elevated risk for latex exposure include health care personnel whose repeated patient contact or surgical work require extensive use of latex gloves. This study evaluated the prevalence of latex allergies in atopic and non-atopic intensive care workers and sought to determine the impact of risk factors such as frequency of glove use and hand washing on latex sensitization. METHODS: We evaluated the prevalence of latex sensitivity in 122 intensive care unit (ICU) workers using a questionnaire and skin prick test. Atopy and latex sensitivity were determined by skin prick test using a battery of common inhalant allergens and an extract prepared from the gloves used in the ICU. Frequency of glove use and hand washing were determined by questionnaire. RESULTS AND CONCLUSIONS: Forty ICU workers (32.8%) were considered atopic by having at least one positive response to the inhalant allergens. Atopic ICU workers were more likely to have positive latex skin test than non-atopic ICU workers (atopic vs. non-atopic workers: p < 0.001, odds ratio = 14.2). Frequency of current glove use or hand washing frequency were not significant predictors of a positive response to latex; however, a positive history of atopic eczema and family history of allergies, as determined by questionnaire were significant predictors of a positive response to latex antigens.

Adult↗
PubMed1998

Aromatic and polycyclic hydrocarbons in air and their urinary metabolites in coke plant workers.

This study describes the exposure of coke plant workers to hydrocarbons. Aromatic hydrocarbons (AHs) and polycyclic aromatic hydrocarbons (PAHs) in the breathing zone air and their oxygenated metabolites in the urine of coke plant workers are qualitatively and quantitatively determined. Concentrations of benzene, toluene, naphthalene, m + p-xylene, o-xylene and 14 different PAHs were measured at the different workplaces by personal air sampling. O-cresol, 1- and 2-naphthol, methylhippuric acid, and 1-hydroxypyrene were determined in hydrolyzed urine of workers collected after the work shift. The gas chromatography-mass spectrometry (GC/MS) method was applied to identify AHs in air and in urine samples. Time-weighted values of exposure to aromatic hydrocarbons at a coke plant were: benzene (0.06-9.82 mg/m3), toluene (0.05-4.71 mg/m3), naphthalene (0.01-3.28 mg/m3), o-xylene (0.01-1.76 mg/m3) and m + p-xylene (0.01-2.62 mg/m3). At the coke batteries, the total concentration of PAHs ranged from 7.27 to 21.92 micrograms/m3. At the sorting department, the total concentration of PAHs were about half this value. Concentration of the urinary metabolites (naphthols and methylhippuric acid) detected in workers at the tar distillation department are three times higher than those for the coke batteries and sorting department workers. A correlation between inhaled toluene, naphthalene, xylene, and urinary excretion of metabolites has been found. Time-weighted average concentrations of AHs in the breathing zone air show that exposure levels of the workers are rather low in comparison to exposure limits. The 1-hydroxypyrene concentration is below 24.75 mumol/mol creatinine. The GC/MS analysis reveals the presence of AHs, mainly benzene and naphthalene homologues. It has been found that coke plant workers are simultaneously exposed to the mixture of aromatic and polycyclic hydrocarbons present in the breathing zone air of a coke plant. Exposure levels are significantly influenced by job categories. Compounds identified in the urine appear to be the products of the hydroxylation of AHs present in the air as well as unmetabolized hydrocarbons.

Adult↗
PubMed1998

Effect of dietary calcium on blood lead concentrations in occupationally exposed and nonexposed workers.

Workers exposed to lead may benefit from a calcium-rich diet, since calcium competes with lead for intestinal absorption. We studied the effect of dietary calcium on blood lead levels. We assessed blood lead levels, dietary intake of calcium, smoking and alcohol consumption, and anthropometric and demographic data in 56 workers exposed to lead and 90 workers without such exposure. Mean intake of dietary calcium was 775 +/- 370 mg/day in the nonexposed workers and 858 +/- 423 mg/day in the exposed workers. Occupational lead exposure explained nearly 90% of the variance in blood lead levels of the entire cohort. Smoking and alcohol intake also showed significant associations with blood lead levels, but their combined effect was less than 2%. When the exposed and nonexposed workers were considered separately, no association was found between blood lead levels and calcium intake. The amount of calcium in the diet does not influence blood lead levels. Further studies are warranted to determine whether dietary calcium influences blood lead levels in exposed and nonexposed workers in other settings and in subjects with lower intakes of calcium.

Adult↗
PubMed1998

Sensitization to green coffee beans and work-related allergic symptoms in coffee workers.

BACKGROUND: Occupational respiratory allergy to green coffee beans (GCB) and to castor beans (CB) was studied in 112 workers in a modern coffee manufacturing plant of Trieste (Italy), where the process is completely automatic, the environmental conditions are good and where exposure to CB can be considered absent because since 1970, only new sacks have been used for coffee transportation. METHODS: All subjects were interviewed by a trained doctor using a questionnaire to investigate allergic symptoms and predisposing factors. Sensitization to GCB and to common allergens (pollens, molds, house dust mites) were evaluated by the skin-prick test. The serum of subjects with a positive skin-prick test to CGB or who had symptoms at work was tested for specific IgE (RAST) for GCB and CB. Lung function was evaluated by a Ponigraph spirometer. RESULTS: Sensitization to GCB was found in 25.8% of green coffee workers (31 cases), in 2.7% of roasted coffee workers (37 cases) and in 4.5% of the clerks (44 cases), p < 0.01. The evaluation of IgE specific for CB gave positive results only in 3 of 10 subjects sensitized to GCB. A total of 20% of GCB workers (6 cases) complained of work-related respiratory symptoms (asthma and/or rhinitis) compared with only one subject in the roasted coffee group and one in the control group (p < 0.01). Asthma was reported by 2/31 of the green coffee workers and by 1/44 of roasted coffee workers. CONCLUSIONS: There was a significant correlation between sensitization to GCB and work related symptoms (p < 0.01), common allergic symptoms (p < 0.05) and atopy by prick test (< 0.01). These results point to the need to evaluate atopic status in workers and identify the most susceptible subjects, with the aim of informing them of their at-risk status and monitoring their progress. This makes it possible to diagnose sooner those symptoms possibly indicative of a work-related disease, because even in presence of good environmental conditions and even when symptoms are mild, it is almost always the atopic subjects who are affected.

Adult↗
PubMed1999

Pulmonary dysfunction in silica-exposed workers: a relationship to radiographic signs of silicosis and emphysema.

BACKGROUND: It has been established that occupational exposure to silica dust may cause significant impairment of pulmonary function. To compare the contribution of silicosis and emphysema to pulmonary dysfunction, radiographic signs of silicosis and emphysema in silica exposed workers were analyzed. METHODS: Two hundred and twenty workers exposed to silica working in a Chinese refractory plant were selected as study subjects. Their findings of silicosis and emphysematous changes on radiograph were classified and evaluated. A questionnaire on respiratory symptoms, smoking, and occupational history was administered. All the workers performed measurements of spirometry and CO single-breath diffusing capacity. RESULTS: Radiographic hyperinflation was detected in 9% of the workers without silicosis and in 33% of the workers with silicosis. Silicosis was significantly associated with hyperinflation after adjusting for exposure duration, age, and smoking. Respiratory symptoms were more frequent in the more severe cases of silicosis. Regression analysis showed that silicosis was significantly associated with decreases in the parameters of pulmonary function, but the significance disappeared when the hyperinflation term was added to the models. Radiographic hyperinflation was strongly associated with decreases in FEV1 and FEV1/FVC while relevant factors were controlled. Comparison between workers with and without hyperinflation showed that the former had significantly lower pulmonary function values. CONCLUSIONS: The results suggest that emphysema associated with silicosis is likely to be responsible for pulmonary obstruction and decreased diffusing capacity occurring in silica-exposed workers.

Adult↗
PubMed2000

Mesothelioma and lung tumors attributable to asbestos among petroleum workers.

BACKGROUND: Asbestos exposure has been definitively found to be associated with both mesothelioma and lung cancer. Nevertheless, in the overall population of oil refinery workers potentially exposed to asbestos, many studies clearly show a definitely increased risk of mesothelioma, but no proven excess of lung cancer after comparison to the general population. Through the presentation of new data and the re-appraisal of two recent and independent epidemiological studies conducted in Liguria, Italy, and Ontario, Canada, we attempt to shed light on this apparently paradoxical finding. METHODS: Lung cancer mortality was studied among maintenance workers exposed to asbestos, and among two other subgroups of refinery employees: blue collar and white collar workers. The comparison with blue collar workers was performed in order to take into account the role of healthy worker effect, smoking habit, and the socioeconomic level. The comparison with white collar workers was performed to control for other occupational lung carcinogens. RESULTS AND CONCLUSIONS: Results reveal a consistency between the two studies and show that 96-100% of the mesotheliomas and 42-49% of the lung tumors arising among maintenance workers were attributable to asbestos exposure. Our new analysis, estimating two cases of asbestos-related lung cancer for each case of mesothelioma, confirms published findings on the magnitude of asbestos-related tumors in oil refineries.

Asbestos↗
PubMed2001

Prevention of lead poisoning in construction workers: a new public health approach.

BACKGROUND: In 1990, Yale University, the Connecticut Departments of Health Services and of Transportation, the Connecticut Construction Industries Association, and the state's construction trade unions created the Connecticut Road Industry Surveillance Project (CRISP). METHODS: Data from 90 bridge projects from 1991 to 1995 and approximately 2,000 workers were evaluated. The distribution of peak lead concentrations in the blood for CRISP workers classified into five groups were compared to that from workers outside of Connecticut. RESULTS: This demonstration project was instrumental in lowering bridge worker blood lead levels. After 1992, only the painting contract employees experienced peak blood lead levels with < or = 2% exceeding 50 microg/dl. Compared to similar workers in other states, Connecticut workers had significantly lower peak blood lead levels. CONCLUSIONS: Two thousand workers and over 120 contractors benefited directly from CRISP. Two key features of the CRISP model differed from the 1993 OSHA standard: a contract-specified lead health protection program and a centralized system of medical monitoring. These differences may account for the improved protection observed between the CRISP and non-Connecticut cohorts.

Adult↗
PubMed2003

Cancer morbidity in Swedish asphalt workers.

BACKGROUND: Some studies have indicated an increased risk of lung cancer among asphalt workers. This study investigates the risk of lung cancer in Swedish asphalt workers. METHODS: A cohort of 6,150 asphalt workers, mainly employed in road construction, was compared to the general population, and to a reference group of construction workers not exposed to asphalt fumes. The exposure to polyaromatic hydrocarbons (PAH) at paving in Sweden during the 1980s and 1990s were estimated to be in the order of one or a few micrograms per cubic meter, but must have been higher in earlier years. RESULTS: Thirty-two lung cancer cases were observed among asphalt workers. The relative risk (SIR) and 95% confidence intervals were 0.98 (0.67-1.39). The corresponding relative risk, as compared to a group of construction workers and adjusted for smoking habits, was 1.03 (0.70-1.45). We found no increased risk for other cancers investigated or death in other lung diseases. CONCLUSIONS: Asphalt workers do not have any increased lung cancer risk from exposure to fumes and gases from asphalt at the exposure levels that occurred in Sweden during the 1960s and 1970s.

Cause of Death↗
PubMed2003

Cancer incidence among male Norwegian asphalt workers.

BACKGROUND: The main objective of the present study was to investigate whether exposure to bitumen fumes could enhance the risk of cancer in asphalt workers. METHODS: A historical prospective cohort study was performed including 8,763 male asphalt workers from all main asphalt companies in Norway. Name, date of birth, and unique personal identification number, address, job type, and start and stop of employment in specific jobs was obtained for the workers. Information was complied from payroll and personnel records in the companies. The cohort was then linked to the Cancer Registry of Norway, which has complete records of individual cases of cancer in the Norwegian population since 1953. Follow-up was from 1 January 1970 to 31 December 1997. The 5-year age and period adjusted general male population in Norway served as reference population. RESULTS: Lung cancer was found elevated with standardized incidence ratio (SIR) = 1.3 (95% confidence intervals (CI) = 1.1, 1.7) in the overall analysis. Lung cancer was found more elevated in workers first exposed in the 1950s and 1960s and in mastic asphalt workers (SIR = 4.2, 95% CI = 1.2, 10, based on four cases) and pavers (SIR = 1.4, 95% CI = 1.0, 1.9). There was a deficiency in the incidence of malignant melanoma with 13 cases versus 26 expected. CONCLUSIONS: Risk of lung cancer was found enhanced among the asphalt workers. Some of the enhanced risk could probably be explained by the smoking habits of the workers. Exposure to coal tar may also have contributed to the enhanced risk.

Cohort Studies↗
PubMed2003

Cancer mortality among European asphalt workers: an international epidemiological study. II. Exposure to bitumen fume and other agents.

BACKGROUND: An increased risk of lung cancers among asphalt workers has been suggested in epidemiological studies based on large scale statistical analyses. METHODS: In a multi-country study of 29,820 male workers employed in road paving, asphalt mixing and roofing, 32,245 ground and building construction workers and 17,757 other workers from Denmark, Finland, France, Germany, Israel, the Netherlands, Norway, and Sweden, with mortality that was documented from 1953-2000. Exposures to bitumen fume, coal tar, 4-6 ring polycyclic aromatic hydrocarbons, organic vapor, diesel exhaust, asbestos, and silica dust were assessed via a job-exposure matrix. Standardized mortality ratios (SMRs) and 95% confidence intervals (CIs) based on national mortality rates, as well as relative risks (RRs) based on Poisson regression models were calculated. RESULTS: The SMR of lung cancer among workers exposed to bitumen fume (1.08, 95% CI 0.99-1.18) was comparable to that of non-exposed workers (SMR 1.05, 95% CI 0.92-1.19). In a sub-cohort of bitumen-exposed workers without exposure to coal tar, the SMR of lung cancer was 1.23 (95% CI 1.02-1.48). The analysis based on the semi-quantitative, matrix-based exposures in the whole cohort did not suggest an increased lung cancer risk following exposure to bitumen fume. However, in an analysis restricted to road pavers, based on quantitative estimate of bitumen fume exposure, a dose-response was suggested for average level of exposure, applying a 15-year lag, which was marginally reduced after adjustment for co-exposure to coal tar. The results for cancer of the head and neck were similar to those of lung cancer, although they were based on a smaller number of deaths. There was no clear suggestion of an association with bitumen fume for any other neoplasm. CONCLUSIONS: The results of the analysis by bitumen fume exposure do not allow us to conclude on the presence or absence of a causal link between exposure to bitumen fume and risk of cancer of the lung and the head and neck.

Adult↗
PubMed2001

Subclinical immunologic and physiologic responses in hexamethylene diisocyanate-exposed auto body shop workers.

BACKGROUND: Diisocyanates are potent sensitizing agents and currently the most commonly identified cause of occupational asthma in industrialized countries. However, diisocyanate asthma is difficult to diagnose and exposure and host risk factors are unclear. Auto body shops, one of the most common hexamethylene diisocyanate (HDI) exposure settings, are particularly difficult to study due to their small size and episodic exposures. Surveillance studies of such workers are limited. OBJECTIVES: We have initiated a cross-sectional field epidemiologic study, Survey of Painters and Repairers of Auto bodies by Yale (SPRAY), to characterize the effects of diisocyanate exposures on actively employed auto body shop workers. Methods and Results We present here questionnaire, physiologic, immunologic, and exposure data on 75 subjects enrolled in the study. No overt cases of clinically apparent diisocyanate asthma were identified based on spirometry, methacholine challenge, peak flows, and symptoms. HDI-specific lymphocyte proliferation was present in 30% of HDI-exposed workers and HDI-specific IgG in 34% of HDI-exposed workers, but they were not associated. HDI-specific IgE was detected in two workers. HDI-specific lymphocyte proliferation, increased methacholine responsiveness, and symptoms of chest tightness and shortness of breath were more common in the most heavily HDI-exposed workers, the painters. More long-term follow-up of this cohort should clarify the significance of these HDI-specific immunologic responses, physiologic changes, and symptoms. CONCLUSIONS: These findings demonstrate the presence of HDI-specific immune responses in a large proportion of healthy HDI-exposed workers.

Adolescent↗
PubMed1985

Surveillance of workers exposed to mercury vapour:validation of a previously proposed biological threshold limit value for mercury concentration in urine.

A cross-sectional epidemiological study was carried out among subjects exposed to mercury (Hg) vapour, ie, a group of 131 male workers (mean age: 30.9 yr; average duration of exposure, 4.8 yr) and a group of 54 female workers (mean age, 29.9 yr; average duration of exposure 7 yr). The results were compared with those obtained in well-matched control groups comprising 114 and 48 male and female workers, respectively. The intensity of current Hg vapour exposure was rather moderate as reflected by the levels of mercury in urine (HgU) (mean and 95th percentile: males 52 and 147 micrograms/g creatinine; females 37 and 63 micrograms/g creatinine) and of mercury in blood (mean and 95th percentile: males 1.4 and 3.7 micrograms/dl; females 0.9 and 1.4 microgram/dl). Several symptoms mainly related to the central nervous system (memory disturbances, depressive feelings, fatigue, irritability) were more prevalent in the Hg-exposed subjects. They were, however, not related to exposure parameters. In both male and female Hg-exposed workers no significant disturbances were found in short-term memory (audioverbal), simple reaction time (visual), critical flicker fusion, and colour discrimination ability. Only slight renal tubular effects were detected in Hg-exposed males and females, ie, an increased urinary beta-galactosidase activity and an increased urinary excretion of retinol-binding protein. The prevalence of these preclinical renal effects was more related to the current exposure intensity (HgU) than to the duration of exposure and was detected mainly when HgU exceeds 50 micrograms/g creatinine. Changes in hand tremor spectrum recorded with an accelerometer were found in the Hg-exposed males only. The prevalence of abnormal values for some hand tremor parameters (total velocity and total displacement in the 2-50-Hz band) was mainly increased in male workers exposed for more than 10 yr. Unlike the renal tubular effects, the preclinical signs of tremor were more related to the integrated exposure than to the current exposure. Since the female workers, who have been exposed to Hg vapour levels usually insufficient to increase their HgU levels above 50 micrograms/g creatinine, did not exhibit any change in hand tremor pattern, the results of the present study tend to validate our previously proposed biological threshold limit value of a HgU of 50 micrograms/g creatinine for workers chronically exposed to mercury vapour.

Belgium↗
PubMed1986

The role of atopy in potroom workers' asthma.

A study was performed to clarify a possible role of atopy in the occurrence of acute bronchoconstrictive impairment observed in some workers in a plant using the Alu-Swiss process for the electrolytic extraction of aluminum. Of 227 workers examined the percentage of those with a history of atopy and positive skin tests for common allergens was within the expected range. Six had positive patch test with 2% NaF. Among seven workers with paroxysmal wheezing and dyspnea, of whom three were only light smokers, three had positive skin test with common allergens but only one of them had an increased IgE value. The same worker also had positive patch test for 2% NaF. The average age of workers with paroxysmal wheezing and dyspnea was 32.6 years, and only two had symptoms defined as chronic bronchitis. Although their forced expiratory volumes, with two exceptions, measured at the beginning of work shift were within normal limits, in most of those workers bronchial hyperreactivity was also objectively assessed using nonspecific bronchoprovocative tests with histamine (or metacholine). The results support our previous findings that acute respiratory impairment in some workers is most probably based on bronchial hyperreactivity and not on an allergic mechanism.

Adult↗
PubMed1988

Usage of personal protective devices among Egyptian industrial workers.

A systematic random sample of 405 workers from metal, asbestos cement pipes, textile, and viscose rayon industries were interviewed using a prepared and tested questionnaire. Personal Protective Devices (PPDs), namely goggles, gloves, respirators, and ear defenders, had been distributed to all workers on the payroll and were used by 31.4%. Usage of PPDs was associated with the educational level, duration of occupation, awareness of the work hazards, and knowledge about the purpose of PPDs. Marked association was found between nonusage of PPDs and discomfort, interference with job performance, and the psychological feeling of lowering the person's prestige by the wearing of PPDs. Nonusage was also associated with lack of maintenance of the device and absence of supervision of its usage. Users were more numerous among married workers and workers with urban residence than among unmarried workers and those with rural residence, respectively. No association could be found between the rate of usage and the worker's age except for ear plugs, for which nonusage was proportional to the worker's age. The most important factors were those related to the role of the safety staff and the discomfort of the devices. Recommendations for occupational health authorities on the basis of the above evaluation are suggested.

Cooperative Behavior↗
PubMed1988

Neurotoxic effects of organic solvents in exposed workers: two controlled follow-up studies after 5.5 and 10.6 years.

The findings of acute and/or chronic central and peripheral neurotoxic effects of organic solvents in workers from a previous controlled cross-sectional study (65 exposed and 33 unexposed) were re-assessed to ascertain whether the neurotoxic symptoms and signs had become chronic. These follow-ups were performed 5.5 years later by occupational medical and clinical neurological examination (59 exposed and 30 unexposed) and again 10.6 years later by a mailed questionnaire (53 exposed and 30 unexposed). Both follow-ups revealed more acute neurotoxic symptoms in the exposed workers than in the unexposed workers, but fewer than previously, and indeed, the current exposure to solvents had been reduced. However, at both follow-ups, the exposed workers showed significantly more symptoms of chronic encephalopathy, in particular, memory and concentration impairment. These latter symptoms had also significantly worsened in the workers who were still being exposed, while they were presently unchanged in the previously exposed workers who had been free of exposure for 6.6 years at the latter follow-up. On the other hand, symptoms of chronic encephalopathy had not appeared in the unexposed group. Among workers, both still and previously exposed, there were also social consequences in the form of occupational disqualification. According to the findings, long-term occupational exposure to organic solvents in concentrations that are not unusual at workplaces may lead to development of chronic neurotoxic symptoms.

Adult↗
PubMed1989

Reactions of asbestos-exposed workers to notification and screening.

In the wake of efforts to pass legislation mandating notification of workers at high risk of developing occupational disease, considerable controversy exists regarding the potential costs and benefits of such notification efforts. It has been suggested that individual notification would cause undue psychological distress, especially when primary prevention efforts are no longer possible. In this study, we assessed reactions of asbestos-exposed workers to a letter notifying them of their risk for asbestos-related illnesses and the availability of a medical screening program. Two hundred forty-seven workers who attended the screening program and 53 who chose not to attend completed a questionnaire that tapped reactions to notification. Workers reported neither undue psychological distress nor avoidance behavior in response to notification, and many respondents reported engaging in active and appropriate coping behaviors. Workers who first learned of their risk through the notification letter (33.7%) were no more likely to report distress or denial than were workers who had learned previously through other sources. Individuals who chose not to attend the screening program were less likely than attenders to report experiencing distress upon learning of their risk status, more likely to engage in minimization of risk, and less likely to have taken direct action. Our results suggest that the psychological costs of notifying workers of increased risk for asbestos-related illness appear to be outweighed by the benefits of notification and screening.

Asbestos↗
PubMed1991

Mortality patterns among petroleum refinery and chemical plant workers.

A historical cohort study was conducted to evaluate the mortality experience of 6,831 employees of the Shell Oil Company, Deer Park, Texas, petroleum refinery and chemical plant with emphasis on cancer mortality. Subjects were all workers with potential plant exposure who were employed for at least 3 months during 1948-72. Vital status was determined as of 12/31/83 for 98% of the cohort and death certificates were obtained for 95.4% of 1,180 observed deaths. The statistical analyses excluded 159 female study members. For all causes of death combined, all cancers combined, and for most of the nonmalignant disease categories examined, there were deficits in mortality among refinery workers, chemical plant workers, and workers with experience in both areas. These deficits were generally most pronounced for chemical plant workers. An analysis of specific cancer sites revealed patterns of increased risk suggestive of a possible relationship between occupational exposures in the refinery and lympho-reticulosarcoma. Patterns of increased risk were also observed among chemical plant workers for a category of lymphopoietic tissue cancers, including multiple myeloma, myelofibrosis, polycythemia vera, and certain non-Hodgkin's lymphomas. Some very limited evidence of a possible workplace association was also found among refinery workers for leukemia and cancers of the central nervous system and biliary passages/liver. No evidence was found of an increased risk for cancer of the respiratory system or stomach or for malignant melanoma. A work history review of all suspect cancer excesses failed to identify any common work areas, job assignments, or exposure potentials, although the lack of detailed data on specific chemical exposures precluded accurate assessments of exposure-response.

Actuarial Analysis↗