title: Mortality of workers employed in shoe manufacturing: an update.
abstract: BACKGROUND
  In the late 1970s, the National Institute for Occupational Safety and Health identified two shoe manufacturing facilities where workers experienced relatively "pure" exposures to toluene. A mortality study was conducted through December 31, 1982. An original study did not detect elevated leukemia mortality but did detect increased lung cancer mortality. The present study is an update of the mortality of the original cohort.
  
  
  METHODS
  The study cohort consisted of workers employed 1 month or more between 1940 and 1979 at two Ohio shoe manufacturing plants. Vital status was ascertained through December 31, 1999.
  
  
  RESULTS
  Seven thousand eight hundred twenty eight workers, contributing 300,777 person years, were available for analysis. An excess of lung cancer deaths persisted with additional years of follow-up (SMR = 1.36, 95% confidence interval (CI) = 1.19-1.54). Trend tests did not indicate a positive trend between lung cancer risk and duration of employment. Mortality from leukemia was not significantly elevated in the updated analysis.
  
  
  CONCLUSIONS
  Results indicate a possible association between lung cancer mortality and exposure to chronic, low-levels of organic solvents. Although the strength of this conclusion was weakened by the lack of increasing lung cancer risk in relation to duration of employment, other studies have supported this association.
authors.affiliation: The Centers for Disease Control and Prevention, The National Institute for Occupational Safety and Health, Division of Surveillance, Hazard Evaluations, and Field Studies, Industrywide Studies Branch, Cincinnati, Ohio 45226, USA. ELehman@cdc.gov
authors.forename: Everett J
authors.initials: EJ
authors.lastname: Lehman
authors.forename: Misty J
authors.initials: MJ
authors.lastname: Hein
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000395:Air Pollutants, Occupational / Q000009:adverse effects*; D002648:Child; D003704:Dementia / Q000453:epidemiology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007221:Industry; D007938:Leukemia / Q000401:mortality; D015993:Life Tables; D008175:Lung Neoplasms / Q000401:mortality*; D008297:Male; D008875:Middle Aged; D009026:Mortality / Q000639:trends; D016273:Occupational Exposure; D012775:Shoes; D012997:Solvents / Q000009:adverse effects*; D014050:Toluene / Q000009:adverse effects*; D014481:United States / Q000453:epidemiology
chemical_list: D000395:Air Pollutants, Occupational; D012997:Solvents; D014050:Toluene