The Diesel Exhaust in Miners Study: a cohort mortality study with emphasis on lung cancer

Details

• Personal Author:
  Attfield MD ; Blair, Austin ; Coble JB ; Lubin JH ; Schleiff, Patricia L. ; Silverman DT ; Stewart PA ; Vermeulen R
• Description:
  Background: Current information points to an association between diesel exhaust exposure and lung cancer and other mortality outcomes, but uncertainties remain. Methods: We undertook a cohort mortality study of 12,315 workers exposed to diesel exhaust at eight US non-metal mining facilities. Historical measurements and surrogate exposure data, along with study industrial hygiene measurements, were used to derive retrospective quantitative estimates of respirable elemental carbon (REC) exposure for each worker. Standardized mortality ratios and internally adjusted Cox proportional hazard models were used to evaluate REC exposure-associated risk. Analyses were both unlagged and lagged to exclude recent exposure such as that occurring in the 15 years directly before the date of death. Results: Standardized mortality ratios for lung cancer (1.26, 95% confidence interval [CI] = 1.09 to 1.44), esophageal cancer (1.83, 95% CI = 1.16 to 2.75), and pneumoconiosis (12.20, 95% CI = 6.82 to 20.12) were elevated in the complete cohort compared with state-based mortality rates, but all-cause, bladder cancer, heart disease, and chronic obstructive pulmonary disease mortality were not. Differences in risk by worker location (ever-underground vs surface only) initially obscured a positive diesel exhaust exposure-response relationship with lung cancer in the complete cohort, although it became apparent after adjustment for worker location. The hazard ratios (HRs) for lung cancer mortality increased with increasing 15-year lagged cumulative REC exposure for ever-underground workers with 5 or more years of tenure to a maximum in the 640 to less than 1280 microg/m3-y category compared with the reference category (0 to < 20 microg/m3-y; 30 deaths compared with eight deaths of the total of 93; HR = 5.01, 95% CI = 1.97 to 12.76) but declined at higher exposures. Average REC intensity hazard ratios rose to a plateau around 32 microg/m3. Elevated hazard ratios and evidence of exposure-response were also seen for surface workers. The association between diesel exhaust exposure and lung cancer risk remained after inclusion of other work-related potentially confounding exposures in the models and were robust to alternative approaches to exposure derivation. Conclusions: The study findings provide further evidence that exposure to diesel exhaust increases risk of mortality from lung cancer and have important public health implications. [Description provided by NIOSH]
• Subjects:
  Dust Environmental Monitoring Lung Lung Diseases Manufacturing And Industrial Facilities Mining Mortality Neoplasms Occupational Health Respiratory System Respiratory Tract Diseases Risk Assessment Safety Vehicle Emissions

  More +
• Keywords:
  Analytical-processes Cancer Cancer-rates Diesel-emissions Diesel-engines Diesel-exhausts Dose-response Equipment-operators Exposure-assessment Industrial-hygiene Lung-cancer Machine-operation Machine-operators Mathematical-models Miners Mining-equipment Mining-industry Mortality-data Pneumoconiosis Quantitative-analysis Respirable-dust Respiratory-system-disorders Risk-analysis Statistical-analysis Surveillance Underground-miners

  More +
• ISSN:
  0027-8874
• Document Type:
  Text
• Genre:
  Journal Article
• Place as Subject:
  Maryland ; OSHA Region 3 ; Virginia ; West Virginia
• CIO:
  National Institute for Occupational Safety and Health (NIOSH)
• Division:
  DRDS - Division of Respiratory Disease Studies
• Topic:
  Workplace Safety & Health
• Location:
  North America
• Volume:
  104
• Issue:
  11
• NIOSHTIC Number:
  nn:20040457
• Citation:
  J Natl Cancer Inst 2012 Jun; 104(11):869-883
• Contact Point Address:
  Patricia L. Schleiff, MS, Division of Respiratory Disease Studies, National Institute for Occupational Safety and Health, 1095 Willowdale Rd, Morgantown, WV 26501
• Email:
  pls1@cdc.gov
• CAS Registry Number:
  Carbon (CAS RN 7440-44-0)
• Federal Fiscal Year:
  2012
• NORA Priority Area:
  Mining
• Peer Reviewed:
  True
• Source Full Name:
  Journal of the National Cancer Institute
• Collection(s):
  National Institute for Occupational Safety and Health
• Main Document Checksum:
  urn:sha-512:7644ed9804e1372e44a047598a7e79023b7d5bb5770efed879a6dbf7d2c88b0a99b8a1efa9c55186e537342d813017e00891b61a84a49326b02e4acd5b10b515
• Download URL:
  https://stacks.cdc.gov/view/cdc/193307/cdc_193307_DS1.pdf
• File Type:
  [PDF - 324.23 KB ]