D B Richardson1, E Rage2, P A Demers3, M T Do3, N DeBono3, N Fenske4, V Deffner4, M Kreuzer4, J Samet5, C Wiggins6,7, M K Schubauer-Berigan8,9, K Kelly-Reif8, L Tomasek10, L B Zablotska11, D Laurier2. 1. University of North Carolina, Chapel Hill, NC, USA. 2. Institute for Radiological Protection and Nuclear Safety (IRSN), PSE-SANTE, SESANE, Fontenay-aux-Roses, France. 3. Occupational Cancer Research Centre, Toronto, Canada. 4. Federal Office for Radiation Protection, Neuherberg, Germany. 5. Colorado School of Public Health, Aurora, CO, USA. 6. University of New Mexico, Albuquerque, NM, USA. 7. New Mexico Tumor Registry, Albuquerque, NM, USA. 8. National Institute for Occupational Safety and Health, Cincinnati, OH, USA. 9. International Agency for Research on Cancer, Lyon, France. 10. Radiation Protection Institute, Prague, Czech Republic. 11. University of California, San Francisco, San Francisco, CA, USA.
Abstract
BACKGROUND: The Pooled Uranium Miners Analysis (PUMA) study draws together information from cohorts of uranium miners from Canada, the Czech Republic, France, Germany and the USA. METHODS: Vital status and cause of death were ascertained and compared with expectations based upon national mortality rates by computing standardized mortality ratios (SMRs) overall and by categories of time since first hire, calendar period of first employment and duration of employment as a miner. RESULTS: There were 51 787 deaths observed among 118 329 male miners [SMR = 1.05; 95% confidence interval (CI): 1.04, 1.06]. The SMR was elevated for all cancers (n = 16 633, SMR = 1.23; 95% CI: 1.21, 1.25), due primarily to excess mortality from cancers of the lung (n = 7756, SMR = 1.90; 95% CI: 1.86, 1.94), liver and gallbladder (n = 549, SMR = 1.15; 95% CI: 1.06, 1.25), larynx (n = 229, SMR = 1.10; 95% CI: 0.97, 1.26), stomach (n = 1058, SMR = 1.08; 95% CI: 1.02, 1.15) and pleura (n = 39, SMR = 1.06; 95% CI: 0.75, 1.44). Lung-cancer SMRs increased with duration of employment, decreased with calendar period and persisted with time since first hire. Among non-malignant causes, the SMR was elevated for external causes (n = 3362, SMR = 1.41; 95% CI: 1.36, 1.46) and respiratory diseases (n = 4508, SMR = 1.32; 95% CI: 1.28, 1.36), most notably silicosis (n = 814, SMR = 13.56; 95% CI: 12.64, 14.52), but not chronic obstructive pulmonary disease (n = 1729, SMR = 0.98; 95% CI: 0.93, 1.02). CONCLUSIONS: Whereas there are important obstacles to the ability to detect adverse effects of occupational exposures via SMR analyses, PUMA provides evidence of excess mortality among uranium miners due to a range of categories of cause of death. The persistent elevation of SMRs with time since first hire as a uranium miner underscores the importance of long-term follow-up of these workers.
BACKGROUND: The Pooled UraniumMiners Analysis (PUMA) study draws together information from cohorts of uraniumminers from Canada, the Czech Republic, France, Germany and the USA. METHODS: Vital status and cause of death were ascertained and compared with expectations based upon national mortality rates by computing standardized mortality ratios (SMRs) overall and by categories of time since first hire, calendar period of first employment and duration of employment as a miner. RESULTS: There were 51 787 deaths observed among 118 329 male miners [SMR = 1.05; 95% confidence interval (CI): 1.04, 1.06]. The SMR was elevated for all cancers (n = 16 633, SMR = 1.23; 95% CI: 1.21, 1.25), due primarily to excess mortality from cancers of the lung (n = 7756, SMR = 1.90; 95% CI: 1.86, 1.94), liver and gallbladder (n = 549, SMR = 1.15; 95% CI: 1.06, 1.25), larynx (n = 229, SMR = 1.10; 95% CI: 0.97, 1.26), stomach (n = 1058, SMR = 1.08; 95% CI: 1.02, 1.15) and pleura (n = 39, SMR = 1.06; 95% CI: 0.75, 1.44). Lung-cancer SMRs increased with duration of employment, decreased with calendar period and persisted with time since first hire. Among non-malignant causes, the SMR was elevated for external causes (n = 3362, SMR = 1.41; 95% CI: 1.36, 1.46) and respiratory diseases (n = 4508, SMR = 1.32; 95% CI: 1.28, 1.36), most notably silicosis (n = 814, SMR = 13.56; 95% CI: 12.64, 14.52), but not chronic obstructive pulmonary disease (n = 1729, SMR = 0.98; 95% CI: 0.93, 1.02). CONCLUSIONS: Whereas there are important obstacles to the ability to detect adverse effects of occupational exposures via SMR analyses, PUMA provides evidence of excess mortality among uraniumminers due to a range of categories of cause of death. The persistent elevation of SMRs with time since first hire as a uranium miner underscores the importance of long-term follow-up of these workers.
Authors: David B Richardson; Estelle Rage; Paul A Demers; Minh T Do; Nora Fenske; Veronika Deffner; Michaela Kreuzer; Jonathan Samet; Stephen J Bertke; Kaitlin Kelly-Reif; Mary K Schubauer-Berigan; Ladislav Tomasek; Lydia B Zablotska; Charles Wiggins; Dominique Laurier Journal: Environ Health Perspect Date: 2022-05-23 Impact factor: 11.035
Authors: Kaitlin Kelly-Reif; Stephen J Bertke; Jonathan Samet; Akshay Sood; Mary K Schubauer-Berigan Journal: Occup Environ Med Date: 2022-05-02 Impact factor: 4.948