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Published on: September 4, 2016
Mortality Among Hardmetal Production Workers: German Historical Cohort Study
Peter Morfeld1, Juliane Valérie Groß, Thomas C Erren
1Institute for Occupational Epidemiology and Risk Assessment of Evonik Industries AG, Essen, Germany (IERA) (Drs Morfeld, Noll, Yong); Institute and Policlinic for Occupational Medicine, Environmental Medicine and Prevention Research of Cologne University Hospital, Cologne, Germany (IPOEP) (Drs Morfeld, Groß, Erren, Yong); Division of Environmental and Occupational Health Sciences, School of Public Health, University of Illinois at Chicago, Chicago, Illinois (Drs Kennedy, Esmen); Center for Occupational Biostatistics and Epidemiology, Department of Biostatistics, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, Pennsylvania (Drs Zimmerman, Buchanich, Marsh).
Objective:
The aim of this study was to investigate a cohort in German hardmetal industry, especially relationship between exposures to cobalt, with and without tungsten, and risks of total and cause-specific mortality.
Methods:
The cohort comprises blue-collar workers at three German plants who were employed in hardmetal processing. Individual cumulative exposures and long-term average concentrations were estimated for cobalt, nickel, tungsten, respirable, and inhalable dust. Standardized mortality ratios (SMRs) were calculated for external comparisons. Time-dependent multivariable Cox models were performed for internal analyses.
Results:
Elevated SMRs were found for all-cause, heart diseases, and nonmalignant respiratory diseases mortality, but not for lung cancer. Internal analyses did not show increased risks for any endpoints, and no exposure-response relationship was indicated.
Conclusions:
This study does not provide evidence for elevated lung cancer risks. Methodologic limitations, incomplete ascertainment of death causes in particular, impede conclusions about exposure effects.
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