Cohort mortality study of workers at seven beryllium processing plants: update and associations with cumulative and maximum exposure.
OBJECTIVE
To extend follow-up of cause-specific mortality in workers at seven beryllium processing plants and to estimate associations between mortality risk and beryllium exposure.


METHODS
9199 workers were followed for mortality from 1940 through 2005. Standardised mortality ratios (SMRs) were estimated based on US population comparisons for lung, nervous system and urinary tract cancers, chronic obstructive pulmonary disease (COPD), chronic kidney disease, and categories containing chronic beryllium disease (CBD) and cor pulmonale. Associations with maximum and cumulative exposure were calculated for a subset of the workers.


RESULTS
Overall mortality in the cohort compared with the US population was elevated for lung cancer (SMR 1.17; 95% CI 1.08 to 1.28), COPD (SMR 1.23; 95% CI 1.13 to 1.32), and the categories containing CBD (SMR 7.80; 95% CI 6.26 to 9.60) and cor pulmonale (SMR 1.17; 95% CI 1.08 to 1.26). Mortality rates for most diseases of interest increased with time-since-hire. For the category including CBD, rates were substantially elevated compared to the US population across all exposure groups. Workers whose maximum beryllium exposure was ≥ 10 μg/m(3) had higher rates of lung cancer, urinary tract cancer, COPD and the category containing cor pulmonale than workers with lower exposure. Significant positive trends with cumulative exposure were observed for nervous system cancers (p = 0.0006) and, when short-term workers were excluded, lung cancer (p = 0.01), urinary tract cancer (p = 0.003) and COPD (p < 0.0001).


CONCLUSIONS
These findings reaffirm that lung cancer and CBD, and suggest that COPD and nervous system and urinary tract cancers, are related to beryllium exposure. Cigarette smoking and exposure to other lung carcinogens are unlikely to explain these elevations.
Division of Surveillance, Hazard Evaluations, and Field Studies, National Institute for Occupational Safety and Health, Cincinnati, Ohio 45226, USA. zcg3@cdc.gov
Mary K
MK
Schubauer-Berigan
James R
JR
Couch
Martin R
MR
Petersen
Tania
T
Carreón
Yan
Y
Jin
James A
JA
Deddens
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001607:Berylliosis / Q000401:mortality; D001608:Beryllium / Q000633:toxicity*; D004305:Dose-Response Relationship, Drug; D004784:Environmental Monitoring / Q000379:methods; D004812:Epidemiologic Methods; D062665:Epidemiological Monitoring; D006801:Humans; D008175:Lung Neoplasms / Q000139:chemically induced / Q000401:mortality; D008297:Male; D008875:Middle Aged; D009423:Nervous System Neoplasms / Q000139:chemically induced / Q000401:mortality; D009784:Occupational Diseases / Q000139:chemically induced* / Q000401:mortality; D016273:Occupational Exposure / Q000009:adverse effects / Q000032:analysis; D029424:Pulmonary Disease, Chronic Obstructive / Q000139:chemically induced / Q000401:mortality; D012907:Smoking / Q000009:adverse effects; D013997:Time Factors; D014481:United States / Q000453:epidemiology; D014571:Urologic Neoplasms / Q000139:chemically induced / Q000401:mortality
D001608:Beryllium