title: Mortality in a cohort of Russian fertilizer workers.
abstract: OBJECTIVE
  The study evaluated the mortality of workers exposed to precursors of N-nitroso compounds in a Russian fertilizer plant.
  
  
  METHODS
  Workers employed at least two years between 1945 and 1985 in production departments or other services were included in the cohort, which comprised 2039 men and 2957 women followed from 1965 to 1990. The standardized mortality ratios (SMR) were calculated using cause-specific death rates for the Moscow region as reference. An internal comparison was carried out using Poisson regression modeling. Exposure to arsenic, nitrogen oxides, and sulfur dioxide was estimated from an industrial hygiene survey.
  
  
  RESULTS
  The production and other workers had no excess of mortality from all causes or all neoplasms. However the male production workers had excess mortality from all cancers combined (SMR 143) and lung cancer (SMR 186) after a latency period of > or = 20 years. Men with the highest exposure to nitrogen oxides had a twofold increase in mortality from stomach cancer, with a marginally significant increasing trend between stomach cancer and cumulative exposure to nitrogen oxides for both genders. Excess mortality from all cancers and stomach cancer was found for the worker with the highest average exposure to arsenic, and excess lung cancer mortality could be attributed to exposure to arsenic.
  
  
  CONCLUSIONS
  The investigation showed a weak association between employment in a fertilizer production plant and increased mortality from cancer. The results somewhat support the hypothesis that occupational exposure to precursors of N-nitroso compounds increases the risk of stomach cancer mortality, as does exposure to arsenic.
authors.affiliation: Department of Epidemiology and Prevention, NN Blokhin Cancer Research Centre, Moscow, Russia.
authors.forename: M A
authors.initials: MA
authors.lastname: Bulbulyan
authors.forename: N J
authors.initials: NJ
authors.lastname: Jourenkova
authors.forename: P
authors.initials: P
authors.lastname: Boffetta
authors.forename: S V
authors.initials: SV
authors.lastname: Astashevsky
authors.forename: A F
authors.initials: AF
authors.lastname: Mukeria
authors.forename: D G
authors.initials: DG
authors.lastname: Zaridze
mesh_terms: D001151:Arsenic / Q000009:adverse effects; D005260:Female; D005308:Fertilizers / Q000009:adverse effects*; D006801:Humans; D008137:Longitudinal Studies; D008175:Lung Neoplasms / Q000453:epidemiology; D008297:Male; D017672:Nitrogen Compounds / Q000009:adverse effects*; D009589:Nitrogen Oxides / Q000009:adverse effects; D009784:Occupational Diseases / Q000401:mortality*; D016012:Poisson Distribution; D012044:Regression Analysis; D012426:Russia / Q000453:epidemiology; D013274:Stomach Neoplasms / Q000453:epidemiology; D013458:Sulfur Dioxide / Q000009:adverse effects
chemical_list: D005308:Fertilizers; D017672:Nitrogen Compounds; D009589:Nitrogen Oxides; D013458:Sulfur Dioxide; D001151:Arsenic