Abstract

OBJECTIVES--To explore a suspected hazard of lung cancer in butchers and cooks. METHODS--4018 male butchers and 2062 male cooks were identified from the 1961 census of England and Wales. 4857 (79.9%) of these men were traced through the National Health Service Central Register, and 3518 deaths were recorded during follow up to the end of 1992. Mortality from lung cancer and other causes was compared with that of the general population by the person-years method. RESULTS--Mortality from all causes was significantly below that of the national population in both butchers (standardized mortality ratio (SMR) 0.94, 95% confidence interval (95% CI) 0.90-0.98) and cooks (SMR 0.89, 95% CI 0.84-0.95). When allowance was made for a latency of 20 years from entry to follow up, the deficit in butchers was reduced, but that in cooks persisted, and was largely explained by a shortfall of deaths from cancer and circulatory disease. Mortality from lung cancer was close to expectation in the butchers (SMR 1.01, 95% CI 0.90-1.13) and below expectation in the cooks (SMR 0.93, 95% CI 0.75-1.13). Cooks had increased mortality from cancers of the oral cavity (SMR 5.57) and pharynx (SMR 2.66). CONCLUSIONS--The findings provide no support for an occupational hazard of lung cancer in either butchers or cooks. The possibility of excess risk in sub-groups of these occupations cannot be discounted. The high rates of oral and pharyngeal cancer in cooks are probably a consequence of high alcohol consumption.