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

AX6-189
Table AX6-7.2 (cont’d). Key Occupational Studies of Lead Exposure and Cancer
Reference, Study
Location, and Period
Europe (cont’d)
Study Description Pb Measurement Findings and Interpretation
Anttila et al. (1996)
Finland
1973-1988
(Nested analysis based
on Antilla et al., 1995
cohort)
Gerhardsson et al.
(1995)
Sweden
1969-1989
Case-control design.
(See Anttila et al., 1995 for basic
information on the source population.)
Cases: 26 Finnish men with CNS
cancer.
Controls: 200 Finnish men without
CNS cancer.
Nested case-control analysis.
Cohort design.
684 male Swedish secondary Pb smelter
workers with Pb exposure.
Cancer incidence among workers was
traced through 1989.
Incidence was compared with county
rates.
Peak blood Pb levels used to
categorize exposure as 0.1-0.7,
0.8-1.3, and 1.4-4.3 µg/L.
Cumulative exposure estimated by
using mean annual blood Pb level to
categorize exposure as 0, 1-6, 7-14,
or 15-49 µg/L.
Interviews were used to obtain
occupational history and other riskfactor
data from patients or next
of kin.
Blood Pb level: any worker with a
detectable blood Pb level was
classified as exposed.
Number of cases or deaths
CNS cancer incidence (26 cases): Rose with increasing peak lifetime
blood Pb measurements; not significant.
Glioma mortality (16 deaths): Rose consistently and significantly
with peak and mean blood Pb level, duration of exposure, and
cumulative exposure.
Mortality by cumulative exposure, controlled for cadmium, gasoline,
and yr monitoring began:
Low (13 subjects) 2.0 (2)
Medium (14 subjects) 6.2 (2)
High (16 subjects) 12.0 (5)
One death among 26 subjects with no exposure: test for trend
significant at p = 0.02.
Controlled for smoking as well as exposure to cadmium and gasoline.
Complete follow-up with minimal disease misclassification.
SIR (95% CI); number of cases
All malignancies:
1.27 (0.91, 1.74); 40
Respiratory:
1.32 (0.49, 2.88); 6
All gastrointestinal:
Cohort 1.84 (0.92, 3.29); 11
Highest quartile 2.34 (1.07, 4.45); 9
Stomach:
1.88 (0.39, 5.50); 3
Colon:
1.46 (0.30, 4.28); 3
SIRs for all other sites except brain were nonsignificantly elevated;
too few cases.
No control for smoking. Small numbers, so meaningful doseresponse
analyses not possible for most cancer sites.