Air Quality Criteria for Lead Volume II of II - (NEPIS)(EPA) - US ...

AX6-188
Table AX6-7.2 (cont’d). Key Occupational Studies of Lead Exposure and Cancer
Reference, Study
Location, and Period Study Description Pb Measurement Findings and Interpretation
Europe (cont’d)
Anttila et al. (1995)
Finland
1973-1988
Cohort plus case-referent design.
20,700 workers with at least one blood
Pb measurement between 1973 and
1983.
Workers were linked to the Finnish
Cancer Registry for follow-up through
1988. For deceased workers, cause of
death was identified from death
certificate.
Mortality and incidence were compared
with gender-, 5-yr age, and 4-yr
calendar-yr matched national rates.
Exposure was categorized according
to the highest peak blood level
measured:
Low: 0-0.9 µmol/L
(0-18.6 µg/dL)
Moderate: 1-1.9 µmol/L
(20.7-39.4 µg/dL)
High: 2-7.8 µmol/L
(41.4-161.6 µg/dL)
Mean blood Pb 26 µg/dL.
Total cohort:
No elevation in total or site-specific cancer mortality.
Moderately exposed:
Total respiratory and lung cancer:
SIR = 1.4 (95% CI: 1.0, 1.9) for both
Total digestive, stomach, bladder, and nervous system:
nonsignificant elevations.
Highly exposed:
No increase in risks.
All cancer:
RR = 1.4 (95% CI: 1.1, 1.8)
Lung or tracheal:
RR = 2.0 (95% CI: 1.2, 3.2)
No increase in high-exposure group.
No RRs reported for other cancers.
Case-referent substudies:
Lung cancer ORs increased with increasing cumulative
exposure to Pb.
Highly exposed: squamous-cell lung cancer OR of 4.1
(95% CI: 1.1, 15) after adjustment for smoking.
Short follow-up period limits statistical power, offset to a
large degree by the substantial sample size. No control for
exposure to other potential carcinogens.