TY - JOUR T1 - A cohort mortality study of lead-exposed workers in the USA, Finland and the UK JF - Occupational and Environmental Medicine JO - Occup Environ Med SP - 785 LP - 791 DO - 10.1136/oemed-2017-104311 VL - 74 IS - 11 AU - Kyle Steenland AU - Vaughn Barry AU - Ahti Anttila AU - Markku Sallmén AU - Damien McElvenny AU - AC Todd AU - Kurt Straif Y1 - 2017/11/01 UR - http://oem.bmj.com/content/74/11/785.abstract N2 - Objectives To investigate further whether inorganic lead is a carcinogen among adults, or associated with increased blood pressure and kidney damage, via a large mortality study.Methods We conducted internal analyses via Cox regression of mortality in three cohorts of lead-exposed workers with blood lead (BL) data (USA, Finland, UK), including over 88 000 workers and over 14 000 deaths. Our exposure metric was maximum BL. We also conducted external analyses using country-specific background rates.Results The combined cohort had a median BL of 26 µg/dL, a mean first-year BL test of 1990 and was 96% male. Fifty per cent had more than one BL test (mean 7). Significant (p<0.05) positive trends, using the log of each worker’s maximum BL, were found for lung cancer, chronic obstructive pulmonary disease (COPD), stroke and heart disease, while borderline significant trends (0.05≤p≤0.10) were found for bladder cancer, brain cancer and larynx cancer. Most results were consistent across all three cohorts. In external comparisons, we found significantly elevated SMRs for those with BLs>40 µg/dL; for bladder, lung and larynx cancer; and for COPD. In a small subsample of the US cohort (n=115) who were interviewed, we found no association between smoking and BL.Conclusions We found strong positive mortality trends, with increasing BL level, for several outcomes in internal analysis. Many of these outcomes are associated with smoking, for which we had no data. A borderline trend was found for brain cancer, not associated with smoking. ER -