Lung cancer mortality in a site producing hard metals
Pascal Wilda, Alain Perdrixb, Sylvie Romazinib, Jean-Jacques Moulina, François Pelletb
a Institut National de
Recherche et de Sécurité, Service Epidémiologie, BP 27, 54501 Vandoeuvre Cedex, France, b Institut Universitaire de Médecine du Travail
et de l'Environnement de Grenoble, Laboratoire de médecine du
travail et de Toxicologie
Correspondence to: Dr Pascal Wild wild{at}inrs.fr
Accepted 26 January
2000
OBJECTIVES
To
study the mortality from lung cancer from exposures to hard metal dust
at an industrial site producing hard metalspseudoalloys of cobalt and
tungsten carbideand other metallurgical products many of which
contain cobalt.
METHODSA historical
cohort was set up of all subjects who had worked for at least 3 months
on the site since its opening date in the late 1940s. A full job
history could be obtained for 95% of the subjects. The cohort was
followed up from January 1968 to December 1992. The exposure was
assessed by an industry specific job exposure matrix (JEM)
characterising exposure to hard metal dust from 1 to 9 and other
possibly carcinogenic exposures as present or absent. Smoking
information was obtained by interview of former workers. Standard
lifetable methods and Poisson regression were used for the statistical
analysis of the data.
RESULTSMortality from
all causes was close to the expected (standardised mortality ratio
(SMR) 1.02, 399 deaths) whereas mortality from lung cancer was
significantly increased among men (SMR 1.70; 46 deaths, 95% confidence
interval (95% CI) 1.24 to 2.26). By workshop, lung cancer mortality
was significantly higher than expected in hard metal production before
sintering (SMR 2.42; nine deaths; 95%CI 1.10 to 4.59) and among
maintenance workers (SMR 2.56; 11 deaths; 95%CI 1.28 to 4.59), whereas
after sintering the SMR was lower (SMR 1.28; five deaths; 95%CI 0.41 to 2.98). The SMR for all exposures to hard metal dust at a level >1
in the JEM was in significant excess (SMR 2.02; 26 deaths; 95%CI 1.32 to 2.96). The risks increased with exposure scores, duration of
exposure, and cumulative dose reaching significance for duration of
exposure to hard metal dust before sintering, after adjustment for
smoking and known or suspected carcinogens.
CONCLUSIONExcess
mortality from lung cancer was found among hard metal production
workers which cannot be attributed to smoking alone. This excess
occurred mostly in subjects exposed to unsintered hard metal dust.
Keywords: lung cancer; hard metals
© 2000 by Occupational and Environmental Medicine
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