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

AX6-196
Table AX6-7.4 (cont’d). Other Studies of Lead Exposure and Cancer
Reference, Study
Location, and Period Study Description Pb Measurement Findings and Interpretation
United States (cont’d)
Cocco et al. (1999)
U.S.
1984-1996
Case-control design.
Cases: all 41,957 stomach cancer deaths
occurring among persons aged 35 or
older during 1984-1996, from U.S.
24-state death certificate registry.
Controls: 2 gender-, race-, age-, and
region-matched controls per case
selected from deaths due to
nonmalignant causes.
Subjects were subdivided into 4 groups
by gender and race (white or African-
American) for all analyses.
A job-exposure matrix was
applied to death certificatelisted
occupations to categorize
persons as having low, medium,
or high probability and intensity
of exposure.
OR (95% CI)
Adjusted for age, ethnicity, marital status, urban residence, and
socioeconomic status.
Elevated ORs:
White female, high probability of exposure 1.53 (1.10, 2.12)
Black male, high probability of exposure 1.15 (1.01, 1.32)
Black female, high probability of exposure 1.76 (0.74, 4.16)
Highly exposed group included 1,503 white and 453 black men and
65 white and 10 black women; no pattern of increase across exposure
levels.
Intensity of exposure showed no association with stomach cancer
except for black women:
Low 1.82 (1.04, 3.18)
Moderate 1.39
High 1.25
No control for other occupational exposures. Exposure estimate
based on occupation listed on death certificate and hence subject to
misclassification due to missing longest-held job.