Objectives Previous studies at a New York State chemical manufacturing plant reported elevated risks of cardiovascular disease among workers. We updated the mortality experience of 1874 workers employed between 1949 and 2006 through December 31, 2007. We investigated exposures to carbon disulfide and shift work and their association with coronary artery disease.

Method Jobs with carbon disulfide and shift work exposure (≥1 day) were identified among departments and job titles in specific years. Standardised mortality ratios (SMR) compared mortality to the US population, adjusted for gender, race, age, and calendar year. Internal comparisons used directly standardised rate ratios (SRR).

Results Overall, excess deaths were observed for coroanary artery disease (SMR=1.24, 95% CI 1.04–1.48). Most workers exposed to carbon disulfide perfortmed shift work; we evaluated coronary artery disease mortality in groups defined by duration of exposure to these agents. Compared to the US population, statistically significant increases in mortality were observed among workers with both exposures for 90 days or more (SMR=1.36, 95% CI 1.03–1.76), and among workers with fewer than 90 days of both exposures (SMR=1.31, 95% CI 0.65–2.34). Using cutpoints of 4 years (median exposure duration among long-term cases), the results were no longer statistically significant. In internal comparisons, long-term workers exposed to carbon disulfide and shift work for 4 years or more had a near 3-fold increase in coronary artery disease mortality, compared to workers exposed less than 4 years.

Conclusions Excess coronary artery disease mortality confirms earlier results, but further investigation is needed to understand risk factors.