Abstract

OBJECTIVES: To study mortality patterns in the largest existing cohort of painters. METHODS: 15 years of follow up were added to a study of 42,170 painters and 14,316 non-painters based on union records. There were 23,458 deaths, compared with 5313 in the earlier follow up. RESULTS: Comparisons with the United States population showed significantly increased rates in painters for lung cancer (standardised mortality ratio (SMR) 1.23, 95% confidence interval (95% CI) 1.17 to 1.29), bladder cancer (SMR 1.23, 95% CI 1.05 to 1.43), liver cancer (SMR 1.25, 95% CI 1.03 to 1.50), and stomach cancer (SMR 1.39, 95% CI 1.20 to 1.59). However, in direct comparisons with non-painters only the excesses for lung cancer (SRR 1.23, 95% CI 1.11 to 1.35, increasing to 1.32, 95% CI 16 to 1.93 with 20 years latency) and bladder cancer (SRR 1.77, 95% CI 1.13 to 2.77) were confirmed. Some confounding by smoking may affect these two outcomes, particularly with external referents. Cirrhosis of the liver was increased for both painters and non-painters (SMRs 1.21, 95% CI 1.07 to 1.35, and 1.26, 95% CI 1.03 to 1.51, respectively), possibly indicating high alcohol consumption. Suicide (SMR 1.21, 95% CI 1.05 to 1.38) and homicide (SMR 1.36, 95% CI 1.04 to 1.75) were increased for painters but not for non-painters; neuropsychiatric diseases have been associated with painters in earlier studies. CONCLUSIONS: The results suggest modest occupational risks for lung and bladder cancer; these results are consistent with existing publications. The International Agency for Research on Cancer has classified painting as an occupation definitely associated with cancer.