title: Mortality and cancer morbidity among cement workers.
abstract: OBJECTIVE
  To explore associations between exposure to cement dust and cause specific mortality and tumour morbidity, especially gastrointestinal tumours.
  
  
  METHODS
  A retrospective cohort study.
  
  
  METHODS
  2400 men, employed for at least 12 months in two Swedish cement factories.
  
  
  METHODS
  Cause specific morality from death certificates (1952-86). Cancer morbidity from tumour registry information (1958-86). Standardised mortality rates (SMRs; national reference rates) and standardised morbidity incidence rates (SIRs; regional reference rates) were calculated.
  
  
  RESULTS
  An increased risk of colorectal cancer was found > or = 15 years since the start of employment (SIR 1.6, 95% confidence interval (95% CI) 1.1-2.3), mainly due to an increased risk for tumours in the right part of the colon (SIR 2.7, 95% CI 1.4-4.8), but not in the left part (SIR 1.0, 95% CI 0.3-2.5). There was a numerical increase of rectal cancer (SIR 1.5, 95% CI 0.8-2.5). Exposure (duration of blue collar employment)-response relations were found for right sided colon cancer. After > or = 25 years of cement work, the risk was fourfold (SIR 4.3, 95% CI 1.7-8.9). There was no excess of stomach cancer or respiratory cancer. Neither total mortality nor cause specific mortality were significantly increased.
  
  
  CONCLUSIONS
  Diverging risk patterns for tumours with different localisations within the large bowel were found in the morbidity study. Long term exposure to cement dust was a risk factor for right sided colon cancer. The mortality study did not show this risk.
authors.affiliation: Department of Occupational and Environmental Medicine, University Hospital, Lund.
authors.forename: K
authors.initials: K
authors.lastname: Jakobsson
authors.forename: V
authors.initials: V
authors.lastname: Horstmann
authors.forename: H
authors.initials: H
authors.lastname: Welinder
mesh_terms: D002423:Cause of Death; D015331:Cohort Studies; D004391:Dust / Q000009:adverse effects; D005770:Gastrointestinal Neoplasms / Q000209:etiology / Q000401:mortality*; D006801:Humans; D008297:Male; D009017:Morbidity; D009784:Occupational Diseases / Q000209:etiology / Q000401:mortality*; D016273:Occupational Exposure / Q000009:adverse effects*; D012189:Retrospective Studies; D012307:Risk Factors; D012823:Silicate Cement / Q000009:adverse effects*; D013548:Sweden / Q000453:epidemiology; D013997:Time Factors
chemical_list: D004391:Dust; D012823:Silicate Cement