Mortality among sheet metal workers participating in a medical screening program.
Dement-J; Welch-L; Haile-E; Myers-D
Am J Ind Med 2009 Aug; 52(8):603-613
BACKGROUND: The Sheet Metal Occupational Health Institute Trust (SMOHIT) was formed in 1985 to examine the health hazards of the sheet metal industry in the U.S. and Canada through an asbestos disease screening program. A study of mortality patterns among screening program participants was undertaken. METHODS: A cohort of 17,345 individuals with 20 or more years in the trade and who participated in the asbestos disease screening program were followed for vital status and causes of death between 1986 and 2004. Data from the screening program included chest X-ray results by International Labour Office (ILO) criteria and smoking history. Standardized mortality ratios (SMRs) by cause were generated using U.S. death rates and Cox proportional hazards models were used to investigate lung cancer risk relative to chest X-ray changes while controlling for smoking. RESULTS: A significantly reduced SMR of 0.83 (95% CI = 0.80-0.85) was observed for all causes combined. Statistically significant excess mortality was observed for pleural cancers, mesothelioma, and asbestosis in the SMR analyses. Both lung cancer and COPD SMRs increased consistently and strongly with increasing ILO profusion score. In Cox models, which controlled for smoking, increased lung cancer risk was observed among workers with ILO scores of 0/1 (RR = 1.17, 95% CI = 0.89-1.54), with a strong trend for increasing lung cancer risk with increasing ILO profusion score >0/0. CONCLUSIONS: Sheet metal workers are at increased risk for asbestos-related diseases. This study contributes to the literature demonstrating asbestos-related diseases among workers with largely indirect exposures and supports an increased lung cancer risk among workers with low ILO profusion scores.
Accident-prevention; Accidents; Construction; Construction-equipment; Construction-industry; Construction-industry; Construction-materials; Construction-workers; Epidemiology; Exposure-assessment; Exposure-levels; Exposure-methods; Injuries; Injury-prevention; Lung-cancer; Lung-irritants; Mortality-data; Mortality-rates; Occupational-hazards; Pulmonary-cancer; Pulmonary-system; Pulmonary-system-disorders; Risk-analysis; Risk-factors Roofing-and-sheet-metal-work; Statistical-analysis; Work-analysis; Work-environment; Work-operations; Workplace-studies; Work-practices;
Author Keywords: sheet metal worker; construction; trades; mortality; cancer; lung cancer
John Dement, Division of Occupational & Environmental Medicine, Department of Community & Family Medicine, Duke University Medical Center, 2200 West Main Street, Suite 400, Durham, NC 27710
Cooperative Agreement; Construction
American Journal of Industrial Medicine
CPWR-The Center for Construction Research and Training, Silver Spring, Maryland