Underlying and multiple cause mortality in a cohort of workers exposed to aromatic amines.
Axtell CD; Ward EM; McCabe GP; Schulte PA; Stern FB; Glickman LT
Am J Ind Med 1998 Nov; 34(5):506-511
Background: the National Institute for Occupational Safety and Health (NIOSH) has previously conducted studies of bladder cancer incidence and mortality at a synthetic dye plant that manufactured beta-naphthylamine front 1940 through 1979. This report extends the period of mortality follow-up 13 years and analysis both underlying and nonunderlying causes of death. Methods The vital status of each cohort member; as of December 31, 1992, was determined by using the national Death Index and information from the Internal Revenue Service and the U.S. Postal Service. The NIOSH life table analysis system (LTAS) was used to generate person-years-at-risk and the expected numbers of death for 92 categories of death, using several referent rates (U.S. underlying, Georgia underlying, U.S. multiple cause). Results: there were three bladder cancer deaths listed as underlying cause, yielding a standardized mortality ratio (SMR) based on U.S. rates of 2.4 (95% confidence interval (CI) = 0.5, 7.0) and a total of eight bladder cancers listed anywhere on the death certificates (SMR based on multiple cause referent rates = 5.6; 95% CI = 2.4, 11.1). Mortality from esophageal cancer which had been significantly, elevated in the previous study, was no longer significantly elevated (SMR = 2.0; 95% CI = 0.8, 4.1). Mortality from all causes was significantly higher than expected (SMR = 1.5; 95% CI = 1.3, 1.6). Conclusions: the elevated bladder cancer risk in this cohort was detected by the multiple cause, bur not the underlying cause, analysis. Elevated mortality from other causes of death, especially among short-term workers, may be related to regional and lifestyle factors.
Toxic-materials; Toxins; Bladder-disease; Bladder-disorders; Risk-analysis; Risk-factors; Throat; Throat-disorders; Statistical-analysis; Work-environment; Worker-health
CD Axtell, University of New Mexico, Center for Health Promotion & Disease Prevention, 2701 Frontier NE,Surge Bldg,Room 251, Albuquerque, NM 87131
American Journal of Industrial Medicine