Mortality surveillance and occupational hazards: the Solutia mortality experience 1980–94

• Published in: Occupational and environmental medicine (London, England) England), 2000-10, Vol.57 (10), p.710-717, Article 710
• Main Authors: Collins, James J, Riordan, Susan G
• Format: Article
• Language: English
• Subjects: Biological and medical sciences; bladder cancer; Cancer; Cardiovascular disease; Cause of Death; Causes of death; Chemical hazards; Chemical industry; Cohort Studies; Cross-Sectional Studies; Employment; Female; Forecasting; Health risks; Humans; Hydrocarbons; leukaemia; Lung neoplasms; Male; Medical sciences; Miscellaneous; Mortality; mortality surveillance; occupational cancer; Occupational Diseases - diagnosis; Occupational Diseases - mortality; Occupational exposure; Occupational Exposure - adverse effects; Occupational Exposure - analysis; Occupational hazards; Occupational health; Occupational medicine; Plant diseases; Population; Public health. Hygiene-occupational medicine; Race; Retirement; Risk Factors; Sarcoma; Sentinel Surveillance; Studies; Surveillance; Toxic substances; United States - epidemiology; Urinary bladder; Workers; working conditions
• ISSN: 1351-0711; 1470-7926
• DOI: 10.1136/oem.57.10.710

OBJECTIVES Several investigators argue that company wide mortalities for recent workers allow early identification of potential workplace hazards. Mortalities for recent workers were compared with published studies of workers with specific exposures in the same company to find whether mortality surveillance results could be used to identify previously unknown health effects from workplace hazards. METHODS Relative risks for causes of death in published substance specific studies at the plants were compared with the relative risks in the mortality surveillance of workers 20 or more years after first being employed. RESULTS As reported by other companies, low mortalities were found among workers in the mortality surveillance. The mortality surveillance reports often found no increased risk of disease at plants in which substance specific studies had found no effects. However, disease specific relative risks were not found by the mortality surveillance predictions of relative risks in the substance specific studies with increased risk. CONCLUSION Mortality surveillance is of limited use for identifying health effects from past workplace exposures to specific materials. The healthy worker and survivor effects, the failure to identify subsets of workers exposed to potentially toxic substances, the typically long induction period between exposure and disease, and the inability of recent mortality levels to reflect historical conditions all may make it difficult to use mortality surveillance to identify workplace hazards. Combining mortality surveillance with studies of workers with potentially toxic exposures helps identify occupational hazards.