An analysis of mortality was performed among 11,915 construction workers of the Laborers International Union of North America who died between January 1, 1985 and December 31, 1988 and had achieved at least 1 year of active service in the union. Death certificates of the decedents were obtained and analyzed. Proportionate mortality (PMR) and proportionate cancer mortality ratios (PCMRs) were computed using mortality rates for the general United States population as the reference. Mortality from all cancers, fatal transportation and nontransportation injuries, and falls were significantly increased, with respective PMRs of 1.13, 1.37, 1.61, and 1.34. The rise in total cancer mortality was due to increases in the number of deaths from stomach, rectal, lung, and thyroid cancer, with respective PMRs of 1.63, 1.35, 1.26, and 2.50. Mortality from causes associated with smoking, such as heart disease and lung diseases, excluding lung cancer, approached expected values. The PCMR analysis also indicated significant increases from stomach, lung, and thyroid cancer mortality. When examined by race and years of union membership, the PCMRs for stomach, lung, thyroid, and rectal cancer were still elevated. No statistically significant trends with years of union membership were detected. The risk of death from all cancers and lung, stomach, and thyroid cancer increased with age at death, after the age of 30. Twenty deaths attributed to mesothelioma, indicative of probable asbestos (1332214) exposure, were also noted. A PMR and PCMR could not be computed since expected rates of mesothelioma in the general population were unavailable. The authors conclude that the study confirms previous findings of increased risks of lung and stomach cancer and fatal injuries among construction laborers, and recommend conducting more detailed analyses of the types of injuries, developing a surveillance database, and initiating smoking cessation and other health promotion programs for construction laborers.
Frank Stern, NIOSH, 4676 Columbia Pwy, MS-R15, Cincinnati, OH 45226