Mortality and cancer morbidity among cement production workers: a meta-analysis.
OBJECTIVE
To analyze overall and cause-specific mortality, especially from cancer, among cement production workers.


BACKGROUND
Results from some epidemiological studies suggested an increased risk of overall mortality and of stomach cancer associated with employment in the cement production, but the presence of a hazard and, if present, the magnitude of a risk have not been precisely quantified. We conducted a systematic review and meta-analysis of data on mortality from all causes, cardiovascular or respiratory diseases, and cancer among cement workers.


METHODS
The literature search in PubMed and Scopus up to February 2016 and with appropriate keywords on mortality among cement workers revealed 188 articles which were screened. A total of 117 articles were reviewed in full text and 12 articles, referring to 11 study populations, were found to be relevant and of sufficient quality for further analysis. Meta-analyses were performed using a random-effects model.


RESULTS
Eight cohort studies, one proportionate mortality study, and two case-control studies were identified. The summary RRs were 0.89 [95 % confidence interval (CI) 0.76-1.01] for all-cause mortality, 0.94 (95 %, CI 0.80-1.08) for cancer mortality, 1.07 (95 % CI 0.79-1.35) for lung cancer mortality, and 0.93 (95 % CI 0.70-1.17) for stomach cancer mortality, respectively. Significant heterogeneity in results was observed among studies.


CONCLUSIONS
The present meta-analysis does not provide evidence of increased risk of overall mortality, as well as cancer, cardiovascular or respiratory mortality in relation to employment in cement production.
Department of Public Health Sciences and Pediatrics, Turin University, Turin, Italy.
Francesca
F
Donato
Department of Public Health Sciences and Pediatrics, Turin University, Turin, Italy.
Giacomo
G
Garzaro
Department of Public Health Sciences and Pediatrics, Turin University, Turin, Italy.
Enrico
E
Pira
Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, One Gustave L. Levy Place, Box 1130, New York, NY, 10029, USA. paolo.boffetta@mssm.edu.
Paolo
http://orcid.org/0000-0002-3811-2791
P
Boffetta
D000328:Adult; D002318:Cardiovascular Diseases / Q000209:etiology / Q000401:mortality; D016022:Case-Control Studies; D002423:Cause of Death; D015331:Cohort Studies; D060389:Construction Industry; D003252:Construction Materials / Q000633:toxicity*; D005260:Female; D006801:Humans; D008175:Lung Neoplasms / Q000209:etiology / Q000401:mortality; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000209:etiology / Q000401:mortality*; D009784:Occupational Diseases / Q000209:etiology / Q000401:mortality*; D016273:Occupational Exposure / Q000009:adverse effects*; D012140:Respiratory Tract Diseases / Q000209:etiology / Q000401:mortality; D013274:Stomach Neoplasms / Q000209:etiology / Q000401:mortality
Cancer; Cement dust; Cement production; Epidemiology; Mortality