Abstract
BackgroundThe evidence regarding the association between lung cancer and occupational exposure to cement is controversial. This study investigated causes of deaths from cancer of respiratory tract among cement workers.MethodsThe deaths of the Greek Cement Workers Compensation Scheme were analyzed covering the period 1969-1998. All respiratory, lung, laryngeal and urinary bladder cancer proportionate mortality were calculated for cement production, maintenance, and office workers in the cement industry. Mortality from urinary bladder cancer was used as an indirect indicator of the confounding effect of smoking.ResultsMortality from all respiratory cancer was significantly increased in cement production workers (PMR = 1.91; 95% CI 1.54 to 2.33). The proportionate mortality from lung cancer was significantly elevated (PMR = 2.05; 95% CI 1.65 to 2.52). A statistically significant increase in proportionate mortality due to respiratory (PMR = 1.7; 95% CI 1.2 to 2.34). and lung cancer (PMR = 1.67;95% CI = 1.15-2.34) among maintenance workers has been observed. The PMR among the three groups of workers (production, maintenance, office) did differ significantly for lung cancer (p = 0.001), while the PMR for urinary bladder cancer found to be similar among the three groups of cement workers.ConclusionCement production, and maintenance workers presented increased lung and respiratory cancer proportionate mortality, and this finding probably cannot be explained by the confounding effect of smoking alone. Further research including use of prospective cohort studies is needed in order to establish a causal association between occupational exposure to cement and risk of lung cancer.
Highlights
The evidence regarding the association between lung cancer and occupational exposure to cement is controversial
Cement production workers have been considered as the "high exposure group", maintenance workers were considered as the "medium exposure group", and office workers have been considered as the "low exposure group"
Mortality from respiratory cancer was significantly increased in cement production workers In particular, 91 deaths related to cancer of respiratory tract were recorded (85 deaths from lung and 6 from larynx cancer); Proportionate Mortality Ratio (PMR) = 1.91; 95% Confidence Intervals (CI) 1.54 to 2.33)
Summary
The evidence regarding the association between lung cancer and occupational exposure to cement is controversial. This study investigated causes of deaths from cancer of respiratory tract among cement workers. There is contradictory evidence of an association between exposure to cement dust and lung function impairment [3,4]. This is the case for the association between exposure to cement dust and respiratory tract malignancies, in particular lung and larynx cancer [5,6,7,8,9,10].
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