title: Mortality of lead smelter workers: A follow-up study with exposure assessment.
abstract: Lead exposure has been linked to impaired renal function and kidney failure. High lead exposures have been associated with increased mortality from certain cancers, hypertension, cardiovascular disease, and amyotrophic lateral sclerosis (ALS).
  
  
  
  We extended vital status follow-up on a cohort of 1,990 lead smelter workers by 25 years and computed standardized mortality ratios and rate ratios (RR) stratified by cumulative lead exposure.
  
  
  
  The update added 13,823 person-years at risk and 721 deaths. Increased risk of mortality was observed for the a priori outcomes of lung cancer, cardiovascular disease (including cerebrovascular disease), chronic kidney disease, and ALS. However, of these outcomes, only cardiovascular, cerebrovascular, and chronic kidney diseases were associated with a positive exposure-response in RR analyses.
  
  
  
  This study reaffirms the association of lead exposure with cardiovascular and kidney diseases; however, increased mortality observed for certain cancers is not likely to be due to lead exposure. Am. J. Ind. Med. 59:979-986, 2016. Published 2016. This article is a U.S. Government work and is in the public domain in the USA.
authors.affiliation: Division of Surveillance, Hazard Evaluations, and Field Studies, Industrywide Studies Branch, National Institute for Occupational Safety and Health, Cincinnati, Ohio. inh4@cdc.gov.
authors.forename: Stephen J
authors.initials: SJ
authors.lastname: Bertke
authors.affiliation: Division of Surveillance, Hazard Evaluations, and Field Studies, Industrywide Studies Branch, National Institute for Occupational Safety and Health, Cincinnati, Ohio.
authors.forename: Everett J
authors.initials: EJ
authors.lastname: Lehman
authors.affiliation: Division of Surveillance, Hazard Evaluations, and Field Studies, Industrywide Studies Branch, National Institute for Occupational Safety and Health, Cincinnati, Ohio.
authors.forename: Steven J
authors.initials: SJ
authors.lastname: Wurzelbacher
authors.affiliation: Division of Surveillance, Hazard Evaluations, and Field Studies, Industrywide Studies Branch, National Institute for Occupational Safety and Health, Cincinnati, Ohio.
authors.forename: Misty J
authors.initials: MJ
authors.lastname: Hein
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002318:Cardiovascular Diseases / Q000139:chemically induced / Q000401:mortality; D002423:Cause of Death; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007674:Kidney Diseases / Q000139:chemically induced / Q000401:mortality; D007854:Lead; D007855:Lead Poisoning / Q000150:complications / Q000401:mortality*; D008175:Lung Neoplasms / Q000401:mortality; D008297:Male; D008669:Metallurgy; D008875:Middle Aged; D009784:Occupational Diseases / Q000139:chemically induced / Q000401:mortality*; D016273:Occupational Exposure / Q000009:adverse effects / Q000706:statistics & numerical data*; D014481:United States / Q000453:epidemiology
chemical_list: D007854:Lead
keywords: lead exposure; mortality cohort study