Respiratory tract mortality in cement workers: a proportionate mortality study.
BACKGROUND
The evidence regarding the association between lung cancer and occupational exposure to cement is controversial. This study investigated causes of deaths from cancer of respiratory tract among cement workers.


METHODS
The deaths of the Greek Cement Workers Compensation Scheme were analyzed covering the period 1969-1998. All respiratory, lung, laryngeal and urinary bladder cancer proportionate mortality were calculated for cement production, maintenance, and office workers in the cement industry. Mortality from urinary bladder cancer was used as an indirect indicator of the confounding effect of smoking.


RESULTS
Mortality from all respiratory cancer was significantly increased in cement production workers (PMR = 1.91; 95% CI 1.54 to 2.33). The proportionate mortality from lung cancer was significantly elevated (PMR = 2.05; 95% CI 1.65 to 2.52). A statistically significant increase in proportionate mortality due to respiratory (PMR = 1.7; 95% CI 1.2 to 2.34). and lung cancer (PMR = 1.67;95% CI = 1.15-2.34) among maintenance workers has been observed. The PMR among the three groups of workers (production, maintenance, office) did differ significantly for lung cancer (p = 0.001), while the PMR for urinary bladder cancer found to be similar among the three groups of cement workers.


CONCLUSIONS
Cement production, and maintenance workers presented increased lung and respiratory cancer proportionate mortality, and this finding probably cannot be explained by the confounding effect of smoking alone. Further research including use of prospective cohort studies is needed in order to establish a causal association between occupational exposure to cement and risk of lung cancer.
Department of Hygiene and Epidemiology, Medical Faculty, University of Thessaly, Larissa, Greece. gsrachmed@yahoo.com
George
G
Rachiotis
Spyros
S
Drivas
Konstantinos
K
Kostikas
Vasilios
V
Makropoulos
Christos
C
Hadjichristodoulou
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000395:Air Pollutants, Occupational / Q000009:adverse effects*; D015331:Cohort Studies; D060389:Construction Industry; D003252:Construction Materials / Q000009:adverse effects*; D006115:Greece / Q000453:epidemiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D009784:Occupational Diseases / Q000209:etiology / Q000401:mortality*; D016273:Occupational Exposure / Q000009:adverse effects*; D012042:Registries; D012142:Respiratory Tract Neoplasms / Q000209:etiology / Q000401:mortality*; D012907:Smoking / Q000009:adverse effects; D001749:Urinary Bladder Neoplasms / Q000209:etiology / Q000401:mortality
D000395:Air Pollutants, Occupational