title: Cancer mortality in a cohort of male German iron foundry workers.
abstract: BACKGROUND
  Observations of an increased incidence of cancers of the upper aero-digestive tract (pharynx, esophagus, larynx, lung) among workers of local German foundries gave rise to concern about a potentially elevated occupational risk of those cancer sites. The purpose of the study was to examine whether occupational exposure in iron foundries increases the risk of cancer.
  
  
  METHODS
  A historical cohort study of 17,708 male German production workers in 37 iron foundries who were first employed in 1950-1985 with a minimum employment period of 1 year was initiated. Employment and occupational histories were collected. Mortality was compared with that of the German general population during 1950-1993 using a new method for computing the SMR when not all causes of death are available (called SMR*).
  
  
  RESULTS
  Mortality from all causes was elevated to SMR = 115.4 (95% confidence interval (CI) = 111.9-119.1), as was for total cancer (SMR* = 123.8, CI = 102.1-152.6), especially cancers of the lung (SMR* = 163.9, CI = 123.9-223.0) and liver (SMR* = 322.5, CI = 149.5-844.8), and diseases of the respiratory system (SMR* = 147.6, CI = 100.4-221.5). Non-significant elevations of mortality were also found for cancers of the mouth and pharynx (SMR* = 153.5, CI = 82.3-359.8) and larynx (SMR* = 173.1, CI = 85.5-550.5). Mortality from various causes of death was higher among workers with shorter exposure periods than among long-term employees. The elevated mortality persisted for years and decades after termination of employment.
  
  
  CONCLUSIONS
  The results provide further evidence for an increased risk of lung cancer and possibly other cancers of the upper aero-digestive tract among foundry workers. Special attention should be paid to the strongly increased mortality from liver cancer and the mortality pattern among employees having terminated work.
authors.affiliation: German Cancer Research Center (DKFZ), Division of Clinical Epidemiology, Heidelberg, Germany.
authors.forename: Karl-Heinrich
authors.initials: KH
authors.lastname: Adzersen
authors.forename: Nikolaus
authors.initials: N
authors.lastname: Becker
authors.forename: Karen
authors.initials: K
authors.lastname: Steindorf
authors.forename: Rainer
authors.initials: R
authors.lastname: Frentzel-Beyme
mesh_terms: D000328:Adult; D001650:Bile Duct Neoplasms / Q000139:chemically induced / Q000401:mortality; D001653:Bile Ducts, Intrahepatic / Q000473:pathology; D015331:Cohort Studies; D003627:Data Interpretation, Statistical; D005500:Follow-Up Studies; D005858:Germany / Q000453:epidemiology; D006801:Humans; D007501:Iron / Q000009:adverse effects*; D008113:Liver Neoplasms / Q000139:chemically induced / Q000401:mortality*; D008171:Lung Diseases / Q000139:chemically induced / Q000401:mortality; D008297:Male; D008669:Metallurgy / Q000706:statistics & numerical data*; D016273:Occupational Exposure / Q000009:adverse effects*; D012142:Respiratory Tract Neoplasms / Q000139:chemically induced / Q000401:mortality*; D012307:Risk Factors; D013997:Time Factors
chemical_list: D007501:Iron