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Mortality Among Sheet Metal Workers Participating in a Respiratory Screening Program



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  • Personal Author:
  • Description:
    Background: The Sheet Metal Occupational Health Institute Trust (SMOHIT) was formed in 1985 to examine the health hazards of the sheet metal industry in the U.S. and Canada through an asbestos disease screening program. This investigation updates findings concerning mortality patterns among screening program participants was undertaken and further investigates predictors of increased mortality due to lung cancer, mesothelioma, and COPD. Methods: A cohort of 17,345 individuals with 20 or more years in the trade and who participated in the asbestos disease screening program were followed for vital status and causes of death between 1986 and 2010. Data from the screening program included chest x-ray results by ILO criteria, spirometry, and smoking history. Standardized Mortality Ratios (SMR) by cause were generated using U.S. death rates and Cox proportional hazards models were used to investigate predictors of death due to lung cancer, mesothelioma, and COPD Results: A significantly reduced SMR of 0.83 (95% CI=0.81-0.85) was observed for all causes combined. Statistically significant excess mortality was observed for pleural cancers, mesothelioma, and asbestosis in the SMR analyses. In Cox models, which controlled for smoking, increased lung cancer risk was observed among workers with ILO scores of 0/1 (RR=1.10, 95% CI=0.86-1.39), with a strong trend for increasing lung cancer risk with increasing ILO profusion score greater than 0/0. Among workers with an ILO profusion score < 1/0, an FEV1 /FVC ratio less than 80% was associated with an increased risk for lung cancer. COPD mortality was predicted by increased interstitial markings on the chest x-ray, FVC below 70% of predicted, FEV1 below 70% of predicted, and an FEV1 /FVC ratio below 70%. The risk of death from cancers of the pleura and mesothelioma also were significantly increased among workers without radiological evidence of asbestosis or pleural abnormalities. Conclusions: Sheet metal workers are at increased risk for asbestos-related diseases. This study contributes to the literature demonstrating asbestos-related diseases among workers with largely indirect exposures and supports an increased lung cancer risk among workers with low ILO profusion scores. [Description provided by NIOSH]
  • Subjects:
  • Keywords:
  • Publisher:
    CPWR-The Center for Construction Research and Training
  • Document Type:
    Text
  • Funding:
    Cooperative Agreement
  • Genre:
    Report
  • Place as Subject:
  • CIO:
    National Institute for Occupational Safety and Health (NIOSH)
  • Topic:
    Workplace Safety & Health
  • Location:
    North America
  • Pages in Document:
    1-23
  • NIOSHTIC Number:
    nn:20057851
  • Citation:
    Silver Spring, MD: CPWR-The Center for Construction Research and Training, 2014 Apr; :1-23
  • Contact Point Address:
    John M. Dement, Ph.D., CIH, Professor, Division of Occupational & Environmental Medicine, Department of Community & Family Medicine, Duke University Medical Center, 2200 West Main Street, Suite 400, Durham, NC 27710
  • Email:
    John.Dement@Duke.edu
  • CAS Registry Number:
    Asbestos (CAS RN 1332-21-4)
  • Federal Fiscal Year:
    2014
  • NORA Priority Area:
    Construction
  • Performing Organization:
    CPWR - The Center for Construction Research and Training, Silver Spring, Maryland
  • Peer Reviewed:
    False
  • Start Date:
    20090901
  • Source Full Name:
    Mortality among sheet metal workers participating in a respiratory screening program
  • End Date:
    20240831
  • Collection(s):
  • Main Document Checksum:
    urn:sha-512:f34bc157f3691754522992920a98725d0d94787b612fa90351dba28ec0e7b16411c33e39294fe5801fffa1b7b683f3fb3005a8b475b74d04e1c61e5a7431addd
  • Download URL:
  • File Type:
    Filetype[PDF - 263.74 KB ]
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