title: Update: cohort mortality study of workers highly exposed to polychlorinated biphenyls (PCBs) during the manufacture of electrical capacitors, 1940-1998.
abstract: BACKGROUND
  The National Institute for Occupational Safety and Health previously reported mortality for a cohort of workers considered highly exposed to polychlorinated biphenyls (PCBs) between 1939 and 1977 at two electrical capacitor manufacturing plants. The current study updated vital status, examined liver and rectal cancer mortality previously reported in excess in this cohort and evaluated mortality from non-Hodgkin's lymphoma (NHL) and cancers of the stomach, intestine, breast, prostate, skin (melanoma) and brain reported to be in excess in other cohort and case-control studies of PCB-exposed persons.
  
  
  METHODS
  Mortality was updated through 1998 for 2572 workers. Age-, gender-, race- and calendar year-adjusted standardized mortality ratios (SMRs) and 95% confidence intervals (CI) were calculated using U.S., state and county referent rates. SMRs using U.S. referent rates are reported. Duration of employment was used as a surrogate for exposure.
  
  
  RESULTS
  Consistent with the previous follow-up, mortality from biliary passage, liver and gall bladder cancer was significantly elevated (11 deaths, SMR 2.11, CI 1.05 - 3.77), but mortality from rectal cancer was not (6 deaths, SMR 1.47, CI 0.54 - 3.21). Among women, mortality from intestinal cancer (24 deaths, SMR 1.89, CI 1.21 - 2.82) and from "other diseases of the nervous system and sense organs", which include Parkinson's disease and amyotrophic lateral sclerosis, (15 deaths, SMR 2.07, CI 1.16 - 3.42) were elevated. There were four ALS deaths, all women (SMR 4.35, CI 1.19-11.14). Mortality was elevated for myeloma (7 deaths, SMR 2.11, CI 0.84 - 4.34), particularly among workers employed 10 years or more (5 deaths, SMR 2.80, CI 0.91 - 6.54). No linear associations between mortality and duration of employment were observed for the cancers of interest.
  
  
  CONCLUSIONS
  This update found that the earlier reported excess in this cohort for biliary, liver and gall bladder cancer persisted with longer follow-up. Excess mortality for intestinal cancer among women was elevated across categories of duration of employment; myeloma mortality was highest among those working 10 years or more. The small numbers of deaths from liver and intestinal cancers, myeloma and nervous system diseases coupled with the lack of an exposure-response relationship with duration of employment preclude drawing definitive conclusions regarding PCB exposure and these causes of death.
authors.affiliation: Centers for Disease Control and Prevention, National Institute for Occupational Safety and Health, Division of Surveillance, Hazard Evaluation and Field Studies, Industrywide Studies Branch, Cincinnati, Ohio 45226, USA. mmprince12@earthlink.net
authors.forename: Mary M
authors.initials: MM
authors.lastname: Prince
authors.forename: Misty J
authors.initials: MJ
authors.lastname: Hein
authors.forename: Avima M
authors.initials: AM
authors.lastname: Ruder
authors.forename: Martha A
authors.initials: MA
authors.lastname: Waters
authors.forename: Patricia A
authors.initials: PA
authors.lastname: Laber
authors.forename: Elizabeth A
authors.initials: EA
authors.lastname: Whelan
mesh_terms: D000368:Aged; D015331:Cohort Studies; D004560:Electricity; D004785:Environmental Pollutants / Q000009:adverse effects*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007587:Job Description; D008297:Male; D008420:Manufactured Materials; D008875:Middle Aged; D009369:Neoplasms / Q000209:etiology* / Q000401:mortality*; D016273:Occupational Exposure / Q000009:adverse effects*; D011078:Polychlorinated Biphenyls / Q000009:adverse effects*
chemical_list: D004785:Environmental Pollutants; D011078:Polychlorinated Biphenyls