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

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AX6-203<br />

Table AX6-7.4 (cont’d). Other Studies <strong>of</strong> <strong>Lead</strong> Exposure and Cancer<br />

Reference, Study<br />

Location, and Period Study Description Pb Measurement Findings and Interpretation<br />

Europe (cont’d)<br />

Wingren and<br />

Englander (1990)<br />

Sweden<br />

1964-1985<br />

(same population as in<br />

case-control analyses<br />

<strong>of</strong> Wingren and<br />

Axelson 1985, 1987,<br />

1993)<br />

Dingwall-Fordyce<br />

and Lane (1963)<br />

U.K.<br />

1925-1962<br />

Malcolm and Barnett<br />

(1982) (follow-up <strong>of</strong><br />

Dingwall-Fordyce and<br />

Lane, 1963)<br />

U.K.<br />

1925-1976<br />

Cohort design.<br />

625 Swedish glass workers employed<br />

<strong>for</strong> at least 1 mo between 1964<br />

and 1985.<br />

Mortality was compared with national<br />

rates.<br />

Cohort design.<br />

425 male employees drawing pensions<br />

from U.K. battery plants.<br />

Standardized mortality <strong>for</strong> employees<br />

vs. national population counterparts.<br />

Cohort design.<br />

1,898 Pb-acid battery workers.<br />

Mortality was traced <strong>for</strong> the Pb-acid<br />

battery workers to determine cause <strong>of</strong><br />

death. The proportion <strong>of</strong> deaths due to<br />

cancer (all types and major<br />

subcategories) among the worker<br />

population was compared to that seen in<br />

corresponding members <strong>of</strong> the general<br />

population, yielding a PMR.<br />

Workers from areas with<br />

airborne Pb levels up to 0.110<br />

mg/m 3 were classified as<br />

exposed.<br />

Battery plant workers were<br />

assumed to be exposed, and<br />

their mortality compared to that<br />

<strong>of</strong> like age and gender in the<br />

U.K. population as a whole.<br />

Urinary Pb excretion was also<br />

used to categorize workers by<br />

estimated exposure (none, light,<br />

or heavy): 80 lightly and 187<br />

heavily (at least 100 µg/L)<br />

exposed.<br />

Job histories were reviewed to<br />

classify workers’ Pb exposure<br />

as high, medium, or none.<br />

SMR (95% CI)<br />

Pharyngeal: 9.9 (1.2, 36.1)<br />

Lung: 1.4 (0.5, 3.1)<br />

Colon: nonsignificant<br />

SMR (95% CI); number observed deaths<br />

All cancer: 1.2 (0.8, 1.7); 267<br />

No consistent increase in SMRs across categories <strong>of</strong> increasing Pb<br />

exposure.<br />

Limitations: No cancer site-specific analyses. No control <strong>for</strong><br />

potential confounders including smoking and exposure to arsenic or<br />

other metals.<br />

Proportionate mortality ratio (PMR)<br />

All cancers:<br />

1.15 (136 deaths), p > 0.05<br />

By exposure:<br />

None 1.02<br />

Medium 1.06<br />

High 1.30<br />

No significant excesses <strong>for</strong> individual cancer sites except <strong>for</strong><br />

digestive cancer PMR <strong>of</strong> 1.67, p < 0.01, among nonexposed workers.<br />

The difference in exposure <strong>for</strong> the high and medium exposure groups<br />

narrowed greatly over the follow-up, thus complicating interpretation<br />

<strong>of</strong> dose-response patterns. No control <strong>for</strong> smoking or occupational<br />

exposure to other carcinogens.

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