title: Mortality of a cohort of workers in Great Britain with blood lead measurements.
abstract: OBJECTIVE
  We examined the mortality of a historic cohort of workers in Great Britain with measured blood lead levels (BLLs).
  
  
  METHODS
  SMRs were calculated with the population of Great Britain as the external comparator. Trends in mortality with mean and maximum BLLs and assessed lead exposure were examined using Cox regression.
  
  
  RESULTS
  Mean follow-up length among the 9122 study participants was 29.2 years and 3466 deaths occurred. For all causes and all malignant neoplasms, the SMRs were statistically significantly raised. For disease groups of a priori interest, the SMR was significantly raised for lung cancer but not for stomach, brain, kidney, bladder or oesophageal cancers. The SMR was not increased for non-malignant kidney disease but was borderline significantly increased for circulatory diseases, for ischaemic heart disease (IHD) and cerebrovascular disease (CVD). No significant trends with exposure were observed for the cancers of interest, but for circulatory diseases and IHD, there was a statistically significant trend for increasing HR with mean and maximum BLLs.
  
  
  CONCLUSIONS
  This study found an excess of lung cancer, although the risk was not clearly associated with increasing BLLs. It also found marginally significant excesses of IHD and CVD, the former being related to mean and maximum BLLs. The finding for IHD may have been due to lead, but could also have been due to other dust exposure associated with lead exposure and possibly tobacco smoking. Further work is required to clarify this and the carcinogenicity of lead.
authors: Institute of Occupational Medicine, Edinburgh, UK.
authors: Damien M
authors: DM
authors: McElvenny
authors: Institute of Occupational Medicine, Edinburgh, UK.
authors: Brian G
authors: BG
authors: Miller
authors: Institute of Occupational Medicine, Edinburgh, UK.
authors: Laura A
authors: LA
authors: MacCalman
authors: Institute of Occupational Medicine, Edinburgh, UK.
authors: Anne
authors: A
authors: Sleeuwenhoek
authors: Institute of Occupational Medicine, Edinburgh, UK.
authors: Martie
authors: M
authors: van Tongeren
authors: Health and Safety Executive, Bootle, Merseyside, UK.
authors: Kevin
authors: K
authors: Shepherd
authors: Health and Safety Executive, Bootle, Merseyside, UK.
authors: Andrew J
authors: AJ
authors: Darnton
authors: Institute of Occupational Medicine, Edinburgh, UK Heriot Watt University, Edinburgh, UK.
authors: John W
authors: JW
authors: Cherrie
mesh_terms: D000328:Adult; D002318:Cardiovascular Diseases / Q000097:blood / Q000401:mortality*; D002423:Cause of Death; D015331:Cohort Studies; D006801:Humans; D007854:Lead / Q000009:adverse effects* / Q000097:blood; D008175:Lung Neoplasms / Q000097:blood / Q000401:mortality*; D008297:Male; D008875:Middle Aged; D009784:Occupational Diseases / Q000097:blood / Q000401:mortality*; D016273:Occupational Exposure / Q000009:adverse effects*; D016016:Proportional Hazards Models; D012307:Risk Factors; D006113:United Kingdom / Q000453:epidemiology
chemical_list: D007854:Lead
keywords: Cancers; Cohort analysis; Ischaemic heart disease; Mortality determinants