title: Pharmaceutical production workers and the risks of mortality from respiratory system cancer and lymphatic and hematopoietic tissue cancers.
abstract: OBJECTIVE
  To evaluate further elevated mortality risks from respiratory system cancer (RSC) and lymphatic and hematopoietic tissue cancers (LHTC) in a cohort of 1466 male workers employed full-time in pharmaceutical production.
  
  
  METHODS
  We computed standardized mortality ratios, and in nested case-control studies of RSC and LHTC, evaluated mortality risks by plant exposures with adjustment for potential confounding factors.
  
  
  RESULTS
  Subjects with potential plant exposure had no elevated RSC risk and a statistically significant LHTC excess. The case-control study found many RSC risks reduced with adjustment for smoking, and LHTC risks increased with increasing levels of average exposure to dimethyl-formamide.
  
  
  CONCLUSIONS
  RSC mortality risks decreased, and we found limited evidence that positive confounding by smoking may explain some remaining excess risks. For LHTC, increased mortality risks and exposure-response patterns in the case-control study may indicate a possible workplace association.
authors.affiliation: Center for Occupational Biostatistics and Epidemiology, University of Pittsburgh, PA 15261, USA. ayouk@pitt.edu
authors.forename: Ada O
authors.initials: AO
authors.lastname: Youk
authors.forename: Jeanine M
authors.initials: JM
authors.lastname: Buchanich
authors.forename: Gary M
authors.initials: GM
authors.lastname: Marsh
authors.forename: Michael
authors.initials: M
authors.lastname: Cunningham
authors.forename: Nurtan A
authors.initials: NA
authors.lastname: Esmen
mesh_terms: D000328:Adult; D000368:Aged; D016022:Case-Control Studies; D004345:Drug Industry; D019337:Hematologic Neoplasms / Q000139:chemically induced / Q000401:mortality*; D006801:Humans; D008175:Lung Neoplasms / Q000139:chemically induced / Q000401:mortality*; D008223:Lymphoma / Q000139:chemically induced / Q000401:mortality*; D008297:Male; D008875:Middle Aged; D016273:Occupational Exposure; D012137:Respiratory System / Q000473:pathology*; D018570:Risk Assessment