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Mortality among sheet metal workers participating in a respiratory screening program.
Laura Welch1, John Dement, Gavin West
1The Center for Construction Research and Training (CPWR).
American Journal of Industrial Medicine
|February 26, 2015
Summary
Sheet metal workers exposed to asbestos showed increased risks of mesothelioma and lung cancer. Even low-level exposures, indicated by chest X-ray profusion scores, were linked to higher lung cancer and COPD risks.
Area of Science:
- Occupational Health
- Environmental Epidemiology
- Respiratory Medicine
Background:
- The Sheet Metal Occupational Health Institute Trust (SMOHIT) initiated a health hazard screening program in 1985.
- The program focused on the U.S. and Canadian sheet metal industries.
Purpose of the Study:
- To investigate mortality causes in sheet metal workers.
- To identify predictors of lung cancer, mesothelioma, and chronic obstructive pulmonary disease (COPD) in this cohort.
Main Methods:
- A cohort of 17,345 individuals with over 20 years in the trade was followed from 1986 to 2010.
- Standardized Mortality Ratios (SMRs) and Cox proportional hazards models were employed.
- Analysis investigated causes of death, including lung cancer, mesothelioma, and COPD.
Main Results:
- Excess mortality was significantly observed for mesothelioma and asbestosis.
- Lung cancer risk increased with higher chest X-ray profusion scores, even after controlling for smoking.
- Reduced FEV1/FVC (<80%) was associated with lung cancer risk when profusion scores were low (<1/0).
- COPD risk correlated with increasing chest X-ray profusion scores.
Conclusions:
- Asbestos-related diseases are evident in workers with predominantly indirect exposures.
- Low International Labour Organization (ILO) scores on chest X-rays indicate an increased lung cancer risk.
