Abstract
We aimed at investigating mortality among beryllium‐exposed workers, according to solubility of beryllium and beryllium compounds. We conducted an historical cohort study of 16,115 workers employed during 1925–2008 in 15 facilities, including eight entailing exposure to insoluble beryllium and seven entailing exposure to soluble/mixed beryllium compounds, who were followed up for mortality until 2011. Data were analyzed using indirect standardization and Cox regression modeling. Lung cancer standardized mortality ratio (SMR, national reference rates) was 1.02 (95% confidence interval [CI]: 0.94–1.10) in the whole cohort, 0.88 (95% CI: 0.75–1.03) in the insoluble beryllium subcohort, and 1.09 (95% CI: 0.99–1.09) in the soluble/mixed beryllium subcohort. For lung cancer, there was an association with period of hire in soluble/mixed beryllium plants but not in insoluble plants, and, conversely, employment in soluble/mixed plants was associated with increased mortality only among workers hired before 1955. There was no trend with duration of employment. Mortality from chronic beryllium disease increased, in particular, among workers hired before 1955 in soluble/mixed beryllium facilities. There was no increase in lung cancer mortality in the entire cohort and lung cancer mortality was not increased among beryllium workers hired in 1955 or later in soluble/mixed beryllium facilities, or at any time among those employed in insoluble beryllium facilities.
Highlights
An increased mortality from lung cancer was originally reported in workers from two beryllium plants in the United States (Lorain and Reading), who were first employed before 1955 and who were exposed to high levels of beryllium, including soluble beryllium compounds [1, 2]
A statistically significant interaction was detected between period of hire and type of facility for overall and lung cancer mortality, and interaction terms were added to the regression models: the results for these two variables represent the product of the hazard ratios (HRs) of the main effect and that of the term of interaction with the other variable, and are interpretable as results of stratified analyses (Table 3, model II)
The results show no increase in mortality from any neoplastic or non-n eoplastic cause except other non-malignant respiratory diseases (ONMRD)
Summary
An increased mortality from lung cancer was originally reported in workers from two beryllium plants in the United States (Lorain and Reading), who were first employed before 1955 and who were exposed to high levels of beryllium, including soluble beryllium compounds [1, 2]. These and an additional five plants were included in a study of 9225 workers employed 1940 through 1969 and followed through 1988 [3]. Several indices of beryllium exposure were analyzed in Reading and two other plants with exposure estimates, using different statistical models [6, 7]; average and maximum exposure were reportedly associated with lung cancer risk
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