Abstract
In support of a nested case-control study at a U.S. naval shipyard, the results of the reconstruction of historical exposures were summarized, and an analysis was undertaken to determine the impact of historical exposures to potential chemical confounders. The nested case-control study (N = 4388) primarily assessed the relationship between lung cancer and external ionizing radiation. Chemical confounders considered important were asbestos and welding fume (as iron oxide fume), and the chromium and nickel content of welding fume. Exposures to the potential confounders were estimated by an expert panel based on a set of quantitatively defined categories of exposure. Distributions of the estimated exposures and trends in exposures over time were examined for the study population. Scatter plots and Spearman rank correlation coefficients were used to assess the degree of association between the estimates of exposure to asbestos, welding fume, and ionizing radiation. Correlation coefficients were calculated separately for 0-, 15-, 20-, and 25-year time-lagged cumulative exposures, total radiation dose (which included medical X-ray dose) and occupational radiation dose. Exposed workers’ estimated cumulative exposures to asbestos ranged from 0.01 fiber-days/cm 3 to just under 20,000 fiber-days/cm 3 , with a median of 29.0 fiber-days/cm 3 . Estimated cumulative exposures to welding fume ranged from 0.16 mg-days/m 3 to just over 30,000 mg-days/m 3 , with a median of 603 mg-days/m 3 . Spearman correlation coefficients between cumulative radiation dose and cumulative asbestos exposures ranged from 0.09 (occupational dose) to 0.47 (total radiation dose), and those between radiation and welding fume from 0.14 to 0.47. The estimates of relative risk for ionizing radiation and lung cancer were unchanged when lowest and highest estimates of asbestos and welding fume were considered. These results suggest a fairly large proportion of study population workers were exposed to asbestos and welding fume, that the absolute level of confounding exposure did not affect the risk estimates, and that weak relationships existed between monitored lifetime cumulative occupational radiation dose and asbestos or welding fume.
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