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Underlying and multiple cause mortality in a cohort of workers exposed to aromatic amines
Author(s) -
Axtell Catherine D.,
Ward Elizabeth M.,
McCabe George P.,
Schulte Paul A.,
Stern Frank B.,
Glickman Lawrence T.
Publication year - 1998
Publication title -
american journal of industrial medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.7
H-Index - 104
eISSN - 1097-0274
pISSN - 0271-3586
DOI - 10.1002/(sici)1097-0274(199811)34:5<506::aid-ajim12>3.0.co;2-5
Subject(s) - medicine , national death index , bladder cancer , standardized mortality ratio , cohort , cause of death , cohort study , confidence interval , mortality rate , epidemiology , incidence (geometry) , cancer , demography , hazard ratio , disease , physics , sociology , optics
Background The National Institute for Occupational Safety and Health (NIOSH) has previously conducted studies of bladder cancer incidence and mortality at a synthetic dye plant that manufactured beta‐naphthylamine from 1940 through 1979. This report extends the period of mortality follow‐up 13 years and analyzes both underlying and nonunderlying causes of death. Methods The vital status of each cohort member, as of December 31, 1992, was determined by using the National Death Index and information from the Internal Revenue Service and the U.S. Postal Service. The NIOSH life table analysis system (LTAS) was used to generate person‐years‐at‐risk and the expected numbers of death for 92 categories of death, using several referent rates (U.S. underlying, Georgia underlying, U.S. multiple cause). Results There were three bladder cancer deaths listed as underlying cause, yielding a standardized mortality ratio (SMR) based on U.S. rates of 2.4 (95% confidence interval (CI) = 0.5, 7.0) and a total of eight bladder cancers listed anywhere on the death certificates (SMR based on multiple cause referent rates = 5.6; 95% CI = 2.4, 11.1). Mortality from esophageal cancer, which had been significantly elevated in the previous study, was no longer significantly elevated (SMR = 2.0; 95% CI = 0.8,4.1). Mortality from all causes was significantly higher than expected (SMR = 1.5; 95% CI = 1.3, 1.6). Conclusions The elevated bladder cancer risk in this cohort was detected by the multiple cause, but not the underlying cause, analysis. Elevated mortality from other causes of death, especially among short‐term workers, may be related to regional and lifestyle factors. Am. J. Ind. Med. 34:506–511, 1998. © 1998 Wiley‐Liss, Inc.