A cohort mortality study of lead-exposed workers in the USA, Finland and the UK

• Published in: Occupational and environmental medicine (London, England) England), 2017-11, Vol.74 (11), p.785-791
• Main Authors: Steenland, Kyle, Barry, Vaughn, Anttila, Ahti, Sallmén, Markku, McElvenny, Damien, Todd, AC, Straif, Kurt
• Format: Article
• Language: English
• Subjects: Adults; Aged; Bladder; Bladder cancer; Blood levels; Blood pressure; Brain; Brain Neoplasms - blood; Brain Neoplasms - etiology; Brain Neoplasms - mortality; Cancer; Carcinogens; Cardiovascular diseases; Cause of Death; Chronic obstructive pulmonary disease; Cohort Studies; Coronary artery disease; Epidemiology; Exposure; Female; Finland; Health risk assessment; Heart; Heart diseases; Humans; Kidneys; Laryngeal Neoplasms - blood; Laryngeal Neoplasms - etiology; Laryngeal Neoplasms - mortality; Larynx; Lead; Lead - adverse effects; Lead - blood; Lead content; Lead poisoning; Lung cancer; Lung diseases; Lung Neoplasms - blood; Lung Neoplasms - etiology; Lung Neoplasms - mortality; Male; Middle Aged; Mortality; Obstructive lung disease; Occupational Diseases - blood; Occupational Diseases - etiology; Occupational Diseases - mortality; Occupational exposure; Occupational Exposure - adverse effects; Pulmonary Disease, Chronic Obstructive - blood; Pulmonary Disease, Chronic Obstructive - etiology; Pulmonary Disease, Chronic Obstructive - mortality; Regression analysis; Smoking; Smoking - blood; Studies; Trends; United Kingdom; United States; Urinary bladder; Urinary Bladder Neoplasms - blood; Urinary Bladder Neoplasms - etiology; Urinary Bladder Neoplasms - mortality; Workplace
• ISSN: 1351-0711; 1470-7926
• DOI: 10.1136/oemed-2017-104311

ObjectivesTo investigate further whether inorganic lead is a carcinogen among adults, or associated with increased blood pressure and kidney damage, via a large mortality study.MethodsWe conducted internal analyses via Cox regression of mortality in three cohorts of lead-exposed workers with blood lead (BL) data (USA, Finland, UK), including over 88 000 workers and over 14 000 deaths. Our exposure metric was maximum BL. We also conducted external analyses using country-specific background rates.ResultsThe combined cohort had a median BL of 26 µg/dL, a mean first-year BL test of 1990 and was 96% male. Fifty per cent had more than one BL test (mean 7). Significant (p40 µg/dL; for bladder, lung and larynx cancer; and for COPD. In a small subsample of the US cohort (n=115) who were interviewed, we found no association between smoking and BL.ConclusionsWe found strong positive mortality trends, with increasing BL level, for several outcomes in internal analysis. Many of these outcomes are associated with smoking, for which we had no data. A borderline trend was found for brain cancer, not associated with smoking.