Emphysema Mortality Research Articles

Mortality in agricultural workers after compensation claims for respiratory disease, pesticide illness, and injury.

The long-term mortality experience of California agricultural workers who filed workers' compensation claims for respiratory diseases, pesticide illnesses, and injuries between 1946 and 1975 was observed until 1991 and compared to U.S. death rates. The respiratory disease claimants had an elevated relative risk of 3.27 (95% CI 2.09-4.86) for mortality from nonmalignant respiratory diseases (NMRD). Emphysema mortality was particularly high, with a relative risk of 5.94 (95% CI 2.56-11.70). NMRD mortality peaked 5 to 9 years after the claims were filed (relative risk 9.83, 95% CI 4.47-18.57) and was most strongly associated with exposure to wood, rice, coffee, and flour dusts. Among the pesticide illness claimants, mortality from heart disease was slightly elevated in the subcohort with systemic pesticide illness (SMR = 1.32, 95% CI 0.86-1.94). Among the injury claimants, risk was increased for motor vehicle deaths (relative risk 1.62, 95% CI 0.74-3.08). It was concluded that respiratory disease claimants in agriculture have a significantly elevated risk of mortality from respiratory diseases and that the risk is highest (10-fold) 5-9 years after claims are filed.

Longitudinal gompertzian analysis of emphysema mortality in the US, 1962–1987: The differing basis for evolving mortality patterns in men and women

Age-specific mortality rates for emphysema in the United States from 1962 through 1987 were subjected to longitudinal Gompertzian analysis, a method that can be used to identify and distinguish aggregate genetic, environmental, and competitive influences upon mortality. Annual crude emphysema mortality rates (per 100 000) among men increased from 11.7 in 1962 to 20.94 in 1968, and then fell to 7.74 in 1987. The basis for this rise and fall is shown to be the corresponding changes in environmental influences upon emphysema mortality in men. Between 1962 and 1987, the annual crude emphysema mortality rates among women increased from 1.71 to 4.25. The basis for the increase of emphysema mortality in women, on the other hand, is shown to be an enhancement of the competitiveness of emphysema as a cause of mortality in women, and not the result of worsening environmental influences. The capability to distinguish between environmental and competitive influences upon evolving human mortality patterns could have a significant impact upon public health policy.

Mortality among workers in the Florida phosphate industry. II. Cause-specific mortality relationships with work areas and exposures

Small excesses of lung cancer and emphysema mortality had been detected among an historical cohort of 17,601 white and 4,722 nonwhite Florida phosphate industry workers. Internal mortality rate comparisons were made between worker subcohorts classified according to length of employment in 16 work areas and according to employment duration in jobs grouped by potential exposures to 10 agents, including alpha radiation. The only consistent associations seen were increased lung cancer mortality rates among long-term workers in plant-wide services and skilled crafts jobs. There was no evidence to support causal associations with exposures characteristic of the phosphate industry.

Pulmonary Emphysema in a Non-smoking Population

Smoking and air pollution appear in the literature to be the two etiologic variables most strongly associated with a risk for developing pulmonary emphysema. In most populations, however, it is difficult to separate these variables. This preliminary report presents the five-year emphysema mortality experience in an essentially non-smoking population of 64,256 Seventhday Adventists in California. They do not appear to differ greatly from the general population in respect to exposure to air pollution. There were four deaths due to emphysema as the “underlying cause” among SDA men whereas 22 would have been expected at concurrent California mortality rates for men. An additional 14 deaths attributed a secondary role to emphysema, whereas 51 would have been expected. The deceased with such a diagnosis appear to be drawn primarily from the SDA minority with a long-term smoking history. Other population variables do not appear able to explain this degree of difference, and it is concluded that smoking, particularly cigarettes, may indeed be an important differential factor related to the risk of mortality from pulmonary emphysema.