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

AX6-202
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
Europe (cont’d)
Cocco et al. (1997)
Sardinia
1931-1992
Wingren and Axelson
(1987, 1993)
(update of Wingren
and Axelson, 1985,
same basic cohort as in
Wingren and
Englander (1990)
Sweden
1950-1982
Cohort design.
1,388 male production and maintenance
workers employed for at least 1 yr at a
Sardinian Pb and zinc smelter between
June of 1932 and July of 1971.
Mortality was followed up through 1992.
Mortality was compared with age- and
calendar-yr-specific regional rates.
Since regional rates were only available
for 1965 and later, analyses were limited
to this period.
Case-control design.
Source population: 5,498 men aged
45 or older in 11 Swedish parishes,
including 887 glass workers.
Cancer-specific nested case-control
analysis:
Cases: deaths due to stomach, colon,
and lung cancer from 1950-1982
Controls: deaths due to causes other
than cancer or cardiovascular disease
All workers were considered to
be exposed to Pb.
Glass workers were considered
exposed.
Glassblowers also singled out
as workers with higher
exposure potential.
Job history applied to job
matrix to categorize
occupations as low, moderate,
or high Pb exposure.
SMRs vs. regional rates (95% CI); number of deaths
Lung 0.82 (0.56, 1.16); 31
Stomach 0.97 (0.53, 1.62); 14
All cancers 0.93 (0.78, 1.10); 132
Kidney 1.75 (0.48, 4.49); 4
Bladder 1.45 (0.75, 2.53); 12
Brain 2.17 (0.57, 5.57); 4
Kidney cancer showed a significant trend toward increasing risk with
increasing duration of exposure
No significant trends were noted for lung or other cancers
Brain cancer excess was limited to workers employed for 10 yrs or
less.
No control for smoking or exposure to arsenic or other smelterrelated
exposures. No data on intensity of exposure.
Strong association of smelter work with pneumoconiosis and other
respiratory disease (SMR = 4.47, 95% CI: 3.37, 5.80); since this
outcome includes silicosis, which is thought to predispose individuals
to lung cancer, some lung cancer deaths may have been missed due to
misclassification of cause of death based on death certificates.
OR (90% CI); number of deaths
All glass workers:
Lung 1.7 (1.1, 2.5); 86
Stomach 1.5 (1.1, 2.0); 206
Colon 1.6 (1.0, 2.5); 79
Glassblowers:
Lung 2.3
Stomach 2.6
Colon 3.1
Glassblowers singled out from glass workers as a whole thus showed
higher estimated risk. ORs for high or moderate vs. low exposure
showed no consistent increase for lung or stomach cancer, however,
although they did show mild upward trend for colon cancer.
No control for smoking or other occupational exposures.