title: Historical cohort study of US man-made vitreous fiber production workers: I. 1992 fiberglass cohort follow-up: initial findings.
abstract: This 1986 to 1992 update and expansion of an earlier historical cohort study examined the 1946 to 1992 mortality experience of 32,110 workers employed for 1 year or more during 1945 to 1978 at any of 10 US fiberglass (FG) manufacturing plants. Included are (1) a new historical exposure reconstruction for respirable glass fibers and several co-exposures (arsenic, asbestos, asphalt, epoxy, formaldehyde, polycyclic aromatic hydrocarbons, phenolics, silica, styrene, and urea); and (2) a nested, matched case-control study of 631 respiratory system cancer (RSC) deaths in male workers during 1970 to 1992 with interview data on tobacco smoking history. Our findings to date from external comparisons based on standardized mortality ratios (SMRs) in the cohort study provide no evidence of excess mortality risk from all causes combined, all cancers combined, and non-malignant respiratory disease. Also, excluding RSC, we observed no evidence of excess mortality risk from any of the other cause-of-death categories considered. For RSC among the total cohort, we observed a 6% excess (P = 0.05) based on 874 deaths. Among long-term workers (5 or more years of employment) we observed a not statistically significant 3% excess based on 496 deaths. Among the total cohort, we observed increases in RSC SMRs with calendar time and time since first employment, but these were less pronounced among long-term workers. RSC SMRs were not related to duration of employment among the total cohort or long-term workers. In an externally controlled analysis of male workers at risk between 1970 and 1992, we observed no association between RSC SMRs and increasing exposure to respirable FG. Our findings to date from internal comparisons based on rate ratios in the case-control study of RSC were limited to analyses of categorized study variables with and without adjustment for smoking. On the basis of these analyses, the duration of exposure and cumulative exposure to respirable FG at the levels encountered at the study plants did not appear to be associated with an increased risk of RSC. RSC risk also did not seem to increase with time since first employment. There is some evidence of elevated RSC risk associated with non-baseline levels of average intensity of exposure to respirable glass, but when adjusted for smoking this was not statistically significant, and there was no apparent trend with increasing exposure. This same pattern of findings was observed for duration of exposure, cumulative exposure, and average intensity of exposure to formaldehyde. None of the other individual co-exposures encountered in the study plants appeared to be associated with an increased risk of RSC. The primary focus of ongoing analyses is to determine the extent to which our present findings are robust to alternative characterizations of exposure.
authors.affiliation: Department of Biostatistics, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA 15261, USA. gmarsh@pitt.edu
authors.forename: G M
authors.initials: GM
authors.lastname: Marsh
authors.forename: A O
authors.initials: AO
authors.lastname: Youk
authors.forename: R A
authors.initials: RA
authors.lastname: Stone
authors.forename: J M
authors.initials: JM
authors.lastname: Buchanich
authors.forename: M J
authors.initials: MJ
authors.lastname: Gula
authors.forename: T J
authors.initials: TJ
authors.lastname: Smith
authors.forename: M M
authors.initials: MM
authors.lastname: Quinn
mesh_terms: D000328:Adult; D016022:Case-Control Studies; D002423:Cause of Death; D015331:Cohort Studies; D005260:Female; D005500:Follow-Up Studies; D005898:Glass; D006801:Humans; D008171:Lung Diseases / Q000139:chemically induced* / Q000401:mortality*; D008175:Lung Neoplasms / Q000139:chemically induced* / Q000401:mortality*; D008297:Male; D009784:Occupational Diseases / Q000139:chemically induced / Q000401:mortality; D016273:Occupational Exposure / Q000009:adverse effects*; D011237:Predictive Value of Tests; D012306:Risk; D012907:Smoking / Q000009:adverse effects; D016019:Survival Analysis; D017741:Survivors; D013997:Time Factors; D014481:United States / Q000453:epidemiology
chemical_list: C009753:fiberglass