Mortality Among Paris Public Transportation Workers: The EDGAR-Cohort, Preliminary Results

Abstract

P-738 Introduction: At the initiative of the occupational medicine service and the National Institute for Public Health Surveillance (InVS), a study was implemented to examine patterns of mortality related to employment in Paris transportation industry. The Paris public transportation company (Régie Autonome des Transports Parisiens, RATP) employs about 45,000 bus or train drivers, technical and maintenance employees, and commercial or administrative clerks. Some have been or may be occupationally exposed to various chemicals and toxicants including asbestos. Methods: The cohort was defined as all RATP agents who were active on January 1980 or hired later on, with at least one year of seniority. This cohort of 56,979 men and 11,802 women was followed up for mortality over the period 1980–1999. Standardized mortality ratios (SMRs) were calculated for the total cohort and for those deceased prematurely (before 65 years), using regional mortality rates as reference. Separate analyses were performed by time period, birth and hiring generation, time spent since hiring, and death and hiring ages. Results: 5130 deaths were identified over the follow up period and 19 people were lost to follow-up; 4949 causes of death were identified within the national death registry. Cancer was the leading cause of death among men (1873/4537 deaths, 41%) and women (174/412 deaths, 42%). Among men, SMRs were estimated at 0.88 for all deaths (95% confidence interval [0.86–0.91]) and 0.90 [0.87–0.93] for premature deaths. Among women, SMRs were 0.92 [0.83–1.01] for all deaths and 0.88 [0.78–0.99] for premature deaths. In men, SMRs increased according to the time spent since hiring: 0.77 [0.72–0.82] for those with 1 to 19 years since hiring and 0.92 [0.89–0.94] for those with 20 to 49 years. SMRs gradually increased over the study periods (1980–1984, 1985–1989, 1990–1994 and 1995–1999) and were respectively 0.78, 0.85, 0.91, 0.93 for men, and 0.65, 0.83, 0.86, 1.11 for women. Regarding cause specific analyses, excess of mortality were observed for ischaemic heart disease among men of all ages (SMR=1.10 [1.01–1.21]) and less than 65 years old (SMR=1.22 [1.10–1.36]). This excess was higher among men born between 1930 and 1939 (SMR=1.23 [1.07–1.42]). Discussion and conclusion: Mortality among men was lower than in the regional population, reflecting a healthy worker effect. On the other hand, a healthy worker effect was less important among women. Relationships between general/specific causes of death and job type and job exposure will be performed when individual work histories and a specific job-exposure-matrix will be completed. This database will provide the opportunity to identify excesses (even modest) in causes-specific mortality risk associated with particular job types, socio-economic factors and specific exposures.