title: A study update of mortality in workers at a phosphate fertilizer production facility.
abstract: OBJECTIVE
  To evaluate the mortality experience among 3,199 workers employed 1951-1976 at a phosphate fertilizer production plant in central Florida with follow-up through 2011.
  
  
  METHODS
  Cause-specific standardized mortality ratios (SMRs) for the full cohort were calculated with the U.S. population as referent. Lung cancer and leukemia risks were further analyzed using conditional logistic regression.
  
  
  RESULTS
  The mortality due to all-causes (SMR = 1.07, 95% confidence interval [CI] 1.02-1.13, observed deaths [n] = 1,473), all-cancers (SMR = 1.16, 95%CI 1.06-1.28, n = 431), and a priori outcomes of interests including lung cancer (SMR = 1.32, 95%CI = 1.13-1.53, n = 168) and leukemia (SMR = 1.74, 95%CI = 1.11-2.62, n = 23) were statistically significantly elevated. Regression modeling on employment duration or estimated radiation scores did not show exposure-response relation with lung cancer or leukemia mortality.
  
  
  CONCLUSIONS
  SMR results showed increased lung cancer and leukemia mortality in a full cohort of the phosphate fertilizer production facility. There was, however, no exposure-response relation observed among cases and matched controls.
authors.affiliation: Division of Surveillance, Hazard Evaluations, and Field Studies, National Institute for Occupational Safety and Health, CDC, Cincinnati, Ohio.
authors.forename: James H
authors.initials: JH
authors.lastname: Yiin
authors.affiliation: Division of Surveillance, Hazard Evaluations, and Field Studies, National Institute for Occupational Safety and Health, CDC, Cincinnati, Ohio.
authors.forename: Robert D
authors.initials: RD
authors.lastname: Daniels
authors.affiliation: Division of Surveillance, Hazard Evaluations, and Field Studies, National Institute for Occupational Safety and Health, CDC, Cincinnati, Ohio.
authors.forename: Travis L
authors.initials: TL
authors.lastname: Kubale
authors.affiliation: Division of Surveillance, Hazard Evaluations, and Field Studies, National Institute for Occupational Safety and Health, CDC, Cincinnati, Ohio.
authors.forename: Kevin L
authors.initials: KL
authors.lastname: Dunn
authors.affiliation: Division of Epidemiology and Biostatistics, School of Public Health, University of Illinois at Chicago, Chicago, Illinois.
authors.forename: Leslie T
authors.initials: LT
authors.lastname: Stayner
mesh_terms: D000328:Adult; D016022:Case-Control Studies; D002423:Cause of Death / Q000639:trends; D015331:Cohort Studies; D005260:Female; D005308:Fertilizers / Q000032:analysis / Q000633:toxicity*; D005431:Florida / Q000453:epidemiology; D006801:Humans; D007938:Leukemia / Q000139:chemically induced / Q000401:mortality*; D008175:Lung Neoplasms / Q000139:chemically induced / Q000401:mortality*; D008297:Male; D066192:Manufacturing Industry / Q000706:statistics & numerical data*; D008875:Middle Aged; D009784:Occupational Diseases / Q000139:chemically induced / Q000401:mortality*; D016273:Occupational Exposure / Q000032:analysis; D010710:Phosphates / Q000032:analysis / Q000633:toxicity*; D012307:Risk Factors; D014481:United States / Q000453:epidemiology
chemical_list: D005308:Fertilizers; D010710:Phosphates
keywords: exposure-response; leukemia; lung cancer; occupational epidemiology; phosphate fertilizer production; standardized mortality ratios