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D
DESCRIPTIVE TABLES OF CANCER STUDIES
This appendix contains two tables that describe the studies used in Chapter 4 (on cancer). Table D.1 provides information on cohort studies related to exposures to fuels and combustion products, and Table D.2 provides information on case-control studies. The studies are referred to repeatedly in Chapter 4. For each study, the following information is provided: a description of the study population, the number of subjects in the study group, how the type of cancer was determined, how exposure was assessed, what type of analysis was conducted, and which potential confounders were adjusted for.
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TABLE D.1 Description of Cohort Studies Related to Exposure to Fuels and Combustion Products
Reference
Population
Study Group
Health-Outcome Assessment
Exposure Assessment
Analysis, Adjustment for Potential Confounders
Imperial Oil Cohort
Hanis et al. 1979
Mortality experience (1964–1973) of male Imperial Oil workers (at least 1 yr for active workers; at least 5 yrs for inactive workers) in Canada; internal comparison of refinery and non-refinery workers
15,032; 5,731 refinery, 9,301 non-refinery
Vital status followed through provincial registrars, Statistics Canada
Job titles classified as in or outside refinery work
RR; age
Schnatter et al. 1992
Mortality experience (1964–1983) of Imperial Oil workers (at least 1 yr) in Canada; external comparison with Canadian general population
34,597
Vital status followed through Statistics Canada, internal data sources, NDI
Company employment in 11 operating segments and HC exposure assigned by industrial hygienists on basis of detailed work histories
SMR; sex, age, calendar period
Schnatter et al. 1993
Mortality experience (1964–1983) of male Imperial Oil petroleum-marketing and distribution workers (at least 1 yr) in Canada; external comparison with Canadian general population
6,672
Vital status followed through Statistics Canada, internal data sources, NDI
HC exposure frequency assigned by industrial hygienists based on basis of detailed work histories
SMR; sex, age, calendar period
Schnatter et al. 1996
Nested cases of lymphohematopoietic malignancies among Imperial Oil workers (at least 1 yr) in Canada; internal controls selected from males in cohort, matched 4:1 on age and were alive at case date of death
14 leukemia
7 MM
8 NHL
Cause of death on death certificates coded by Statistics Canada
Company employment in 11 operating segments and HC exposure assigned by industrial hygienists on basis of detailed work histories
Mantel-Haenszel OR; age, smoking, family cancer history, frequency of chest x rays
Lewis et al. 2000
Mortality experience (1964–1994) of Imperial Oil workers (at least 1 yr in 1964–1983) in Canada; external comparison with Canadian general population
34,560
Vital status followed through Statistics Canada, internal data sources, NDI
Company employment in 11 operating segments and presumed HC exposure derived from job titles
SMR; sex, age, calendar period
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Reference
Population
Study Group
Health-Outcome Assessment
Exposure Assessment
Analysis, Adjustment for Potential Confounders
Lewis et al. 2003
Incidence and mortality experience (1964–1994) of Imperial Oil workers (at least 1 yr, first hire in 1964–1994) in Canada; external comparison with Canadian general population
25,292
Vital status and cancer incidence followed through Statistics Canada, internal data sources, NDI
Similar exposure-group codes developed by industrial hygienist from detailed work histories
SIR, and SMR; sex, age, calendar period
Mobil Oil Cohort
Raabe et al. 1998
Mortality experience (1946–1987) of Mobil Oil employees (at least 1 yr in 1945–1987) in Beaumont, Texas; external comparison with US general population
7,119
Vital status followed through company records, Pension Benefits Information Inc., SSA, NDI
Company employment; two job categories assigned on basis of job title
SMR; age, sex, race, calendar period
Rosamilia et al. 1999
Cases of lung cancer and controls in cohort of Mobil Oil employees (at least 1 yr in 1946–1987) in Beaumont, Texas
112 cases, 490 controls
Vital status followed through company records, Pension Benefits Information Inc., SSA, NDI
Four job categories assigned from work-history records
OR (nested case-control); age, race, smoking, prior job assignments
Wong et al. 2001
Mortality experience (1946–1996) of Mobil Oil employees (at least 1 yr in 1945–1996) in Beaumont, Texas; external comparison with US general population
7,543
Vital status followed through company records, Pension Benefits Information Inc., SSA, NDI
Company employment; two job categories assigned on basis of job title
SMR; age, sex, race, calendar period
Texaco Mortality Study
Divine et al. 1985
Mortality experience (1947–1977) of white male Texaco refinery, petrochemical-plant, and research laboratory workers (at least 5 yrs) in the US; external comparison with US white male population
19,077
Vital status followed through company records, SSA
Company employment
SMR; race, sex
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Reference
Population
Study Group
Health-Outcome Assessment
Exposure Assessment
Analysis, Adjustment for Potential Confounders
Divine and Barren 1986
Mortality experience (1947–1977) of white male Texaco refinery, petrochemical-plant, and research-laboratory workers (at least 5 years) in the US; external comparison with US white male population
18,798
Vital status followed through company records, SSA
Company employment; job or process unit determined from work histories
SMR; race, sex
Divine et al. 1999a
Mortality experience (1947–1993) of Texaco refinery, petrochemical plant, and research laboratory workers (at least 5 yrs) in the US; external comparison with US general population
28,480
Vital status followed through company records, SSA, NDI, HCFA
Company employment; job or process unit determined from work histories
SMR; race, sex
Divine et al. 1999b
Mortality experience (1947–1993) of Texaco refinery, petrochemical-plant, and research lab workers (at least 5 yrs) in the US; external comparison with US general population
28,480
Vital status followed through company records, SSA, NDI, HCFA
Company employment; job or process unit determined from work histories
SMR; race, sex
Italian Oil Refinery Cohort
Bertazzi et al. 1989
Mortality experience (1949–1982) of male workers (ever employed) at refinery near Milan, Italy; external comparison with national and local (Lombardy region) male populations
1,595
Vital status followed through Population Statistics Office
Company employment in 29 occupation units determined from work histories
SMR; age, sex, calendar time
Consonni et al. 1999
Mortality experience (1949–1991) of male workers (ever employed in 1949–1982) at refinery near Milan, Italy; external comparison with local (Lombardy region) male population
1,583
Vital status followed through Population Statistics Office
Company employment in 29 occupation units determined from work histories
SMR; age, sex, calendar time
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Reference
Population
Study Group
Health-Outcome Assessment
Exposure Assessment
Analysis, Adjustment for Potential Confounders
ACS Cancer Prevention Study II
Boffetta et al. 1988
Mortality experience (1982–1984) of male subjects, 40–79 yr old, enrolled in ACS Cancer Prevention Study II
461,981
Follow up through personal contact; death certificates obtained from state health departments
Self-administered questionnaire at baseline assessed current, last, and longest-held occupations, exposure to 12 groups of substances
RR; age, smoking factors, other occupational exposures
Pope et al. 1995
Mortality experience (1982–1998) of subjects, at least 30 yr old with one household resident at least 45 yr old, enrolled in ACS Cancer Prevention Study II
552,138
Follow up through personal contact (through 1988) with death certificates obtained from state health departments; record linkage with NDI (through 1989)
Mean concentrations of sulfate and fine-particle air pollution provided by EPA databases
RR; age, sex, race, cigarette-smoking, exposure to passive cigarette-smoking, BMI, drinks per day of alcohol, education, occupational exposure
Pope et al. 2002
Mortality experience (1982–1998) of subjects, at least 30 yr old with one household resident at least 45 yr old, enrolled in ACS Cancer Prevention Study II
About 500,000 (number of subjects depends on pollution index used)
Follow up through personal contact (through 1988) with death certificates obtained from state health departments; record linkage with NDI (through 1998)
Mean concentrations of air pollution (PM, sulfate, SO2, NO2) provided by EPA databases
RR; age, sex, race, smoking, education, marital status, body mass, alcohol consumption, occupational exposure, diet
Other Cohorts
Abbey et al. 1999
Mortality experience (1977–1992) of nonsmoking, white, Seventh Day Adventist residents of California who had lived at least 10 yr within 5 mi of current residence
6,338
Vital status followed through record linkage with California death-certificate files (1977–1992), NDI (1979–1992), church records
Monthly estimates of ambient concentrations of air pollutants (PM10, SO2, NO2) provided by fixed-site monitoring stations maintained by CARB provided
RR; sex, years of education, pack-years of past smoking, alcohol use
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Reference
Population
Study Group
Health-Outcome Assessment
Exposure Assessment
Analysis, Adjustment for Potential Confounders
Boffetta et al. 2001
Incidence experience (1971–1989) of occupationally active (1960 and 1970 censuses; excluding farmers) residents of Sweden; internal comparisons made across exposure intensities and probabilities; external comparison to Swedish general population
55,883 total exposed cancer cases
Follow up for incidence through Swedish Cancer Register; vital status tracked through national Register of Causes of Death
Job and industry titles classified for probability and intensity of exposure to diesel-engine emissions
SIR, sex, age, calendar year RR; age, calendar period, geographic region, urban or rural residence
Borgia et al. 1994
Mortality experience (1965–1988) of male taxi drivers (registered in 1950–1975) in Rome, Italy
2,311
Vital status tracked through local registry office or through record linkage with national or regional mortality files
Taxi drivers registered in Rome
SMR; age, calendar period
Chow et al. 1994
Incidence experience (1961–1979) of stomach cancer in occupationally active (1960 census) Swedish men; external comparison with Swedish general population
16,872 cases
Cancer incidence tracked through Swedish Cancer-Environmental Registry which links census data to Swedish Cancer Registry
Occupation and industry codes from census data
SIR; age, sex, region
Chow et al. 1995
Incidence experience (1961–1979) of esophageal cancer in occupationally active (1960 census) Swedish men; external comparison with Swedish general population
2,394 cases
Cancer incidence tracked through Swedish Cancer-Environmental Registry which links census data to Swedish Cancer Registry
Occupation and industry codes from census data
SIR; age, sex, region
Gamble et al. 1996
Nested cases of kidney cancer among Exxon employees of at least 1 mo at three US refineries and chemical plants in 1970–1992; internal controls matched on sex, race, age, date of hire, at-risk status
37 cases, 148 controls
Vital status followed through SSA, NDI
Industrial hygienist constructed JEM from company records and job titles
OR (nested case-control); logistic regression BMI, mean arterial pressure, smoking
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Reference
Population
Study Group
Health-Outcome Assessment
Exposure Assessment
Analysis, Adjustment for Potential Confounders
Guberan et al. 1992
Incidence and mortality experience (1949–1986) of lung and gastrointestinal cancer in male professional drivers (1949–1961) in canton of Geneva, Switzerland; external comparison with Geneva male population
6,630
Follow up for incidence through Geneva Cancer Registry; vital status tracked through National Office of Statistics
Subjects had valid (in 1949) or new (1949–1961) licenses issued as drivers of heavy-duty-road goods vehicles, taxis, buses, coaches, professional transports; subjects classified as “more” or “less” exposed to exhaust gases
SIR, SMR; age, year
Gustavsson et al. 1990
Incidence (1958–1984) and mortality (1952–1986) experience of male bus garage workers (at least 6 mo in 1945–1970) from five locations in Stockholm, Sweden; external comparisons with Stockholm general population and occupationally active population in Sweden; internal comparisons made for cumulative exposure indices
695
Cancer incidence tracked through Swedish Cancer Registry; mortality ascertained from Statistics Sweden
Industrial hygienist constructed JEM from historical data from garages on numbers and types of diesel engines present, ventilation, job types and duration
SMR; age, sex, cause of death OR; conditional logistic regression, age
Hansen 1993
Mortality experience (1970–1980) of truck drivers (1970 census) in Denmark compared with population of unskilled workers
14,225 truck drivers, 43,024 unskilled laborers
Record linkage with Central Population Register, Death Certificate Register
Truck-driver job title in 1970 census
SMR (expected numbers of deaths in driver group calculated in reference to unskilled group); age, period
Hansen 2000
Nested cases of male breast cancer among Pension Fund members in Denmark in 1970–1989; internal controls matched on age
230 cases
Cancer incidence tracked through Danish Cancer Registry
Job titles obtained from Pension Fund files and Central Person Registry; author assigned exposure to gasoline, combustion products
Conditional logistic regression; birth year, SES
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Reference
Population
Study Group
Health-Outcome Assessment
Exposure Assessment
Analysis, Adjustment for Potential Confounders
Hoek et al. 2002
Mortality experience (1986–1994) of a subcohort of males, age 55–69 yr old, in Netherlands Cohort Study on Diet and Cancer
4,492
Vital status followed through Dutch Central Bureau of Genealogy
Self-administered questionnaire at baseline gave location of residence in 1986; exposure to traffic-related air pollution determined through National Air Quality Monitoring Network data
RR; age, sex, education, Quetelet index, occupation, active and passive cigarette-smoking, neighborhood SES score
Huebner et al. 2000
Incidence experience of lymphohematopoietic malignancies among Exxon employees of at least 1 mo at three US refineries and chemical plants in 1970–1992 or US-based employees of at least 1 day in 1979–1982 with all subjects having current, final, or active (1983–1994) employment at Baton Rouge, Louisiana facility; internal controls matched on sex, race, age, date of hire, at-risk status
8,942
59 LH malignancies
Record linkage with the Louisiana tumor registry
Job type obtained from company records
SIR; modified life-table approach stratified by sex, race, age, year of diagnosis
Jarvholm and Silverman 2003
Incidence and mortality experience (1971–1995) of Swedish male construction workers (1971–1993); internal comparisons of truck drivers and heavy-equipment operators within carpenters and electricians; external comparisons to Swedish general population
6,364 truck drivers, 14,364 heavy equipment operators, 119,984 carpenters and electricians
Record linkage with National Cancer Registry and National Death Registry
Job title obtained at initial health examination (1971–1993)
SIR, SMR; age, period, smoking habits
Jarvholm et al. 1997
Incidence experience (1958–1991) of male workers (at least 1 yr) in 26 companies in petroleum industry in Sweden; external comparison with Swedish general population
4,128
Cancer incidence followed through the Swedish Cancer Registry
Employment in refinery operations, distribution, other occupations determined from job titles
SIR (90% CI); sex, age, calendar year
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Reference
Population
Study Group
Health-Outcome Assessment
Exposure Assessment
Analysis, Adjustment for Potential Confounders
Kneller et al. 1990
Incidence experience (1980–1984) of stomach cancer in occupationally active (1982 census) residents over 30 yr old in Shanghai, China; internal comparison among census registrants
13,489 cases
Cancer incidence tracked through Shanghai Cancer Registry
Occupation at time of diagnosis or retirement ascertained through interview of patient or next of kin
SIR; age, sex
Krewski et al. 2000
Mortality experience (1974–1991) of participants in Six Cities Study in northeast and midwest US; audit of original study with updated exposure assessment methods
8,111
Annual letters mailed to assess vital status; nonrespondents prompted family follow up and NDI records searches
Air-pollutant measurements from central locations in communities
RR; sex, education, diabetes, hypertension, BMI, smoking history, occupational exposure to dusts or fumes
Lagorio et al., 1994
Mortality experience (1981–1992) of self-employed gas-station attendants (in 1980) in Italy; external comparison with Latium region, Italian general population
2,665
Vital status followed through registries of last municipality of residence with record linkage with National Mortality File (pre-1986) or Regional Death Index
Environmental survey, duration of employment
SMR; age, sex
Lan et al. 2002
Incidence experience (1976–1992) of lung cancer in farmers, 41–75 yr old, in Xuanwei County, China
21,232
Lung-cancer incidence tracked through record searches of six regional hospitals
Interview with standardized questionnaire assessing kitchen practices as surrogates for indoor air pollution
RR; sex, age, family history of lung cancer, chronic bronchitis or emphysema, tuberculosis, other SES and demographic variables
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Reference
Population
Study Group
Health-Outcome Assessment
Exposure Assessment
Analysis, Adjustment for Potential Confounders
Larkin et al. 2000
Mortality experience (1959–1976) of railroad workers, 40–64 yr old, with 10–20 yr of experience in 1959
55,395
Vital status tracked through US RBB records
Interstate Commerce Commission job code obtained from US RBB records and classified for diesel exposure
RR; age, calendar year
McLaughlin et al. 1987
Incidence experience (1961–1979) of renal cancer in occupationally active (1960 census) Swedish men; external comparison to Swedish general population
7,405 renal-cell cases
821 renal-pelvis cases
Cancer incidence tracked through Swedish Cancer-Environmental Registry, which links census data to Swedish Cancer Registry
Occupation and industry codes from census data
SIR; age, sex, region
Nafstad et al. 2003
Incidence experience (1972–1998) of lung cancer in males, 40–49 yr old, in Oslo, Norway
16,209
Cancer incidence tracked through Norwegian cancer registry
Estimated average concentrations of air pollutants (SO2, NOx) from Norwegian Institute for Air Research records; initial questionnaire established home address
RR; age, education, tobacco-smoke exposure, other pollutant
Nelson et al. 1985, 1987
Mortality experience (1970–1982) of Amoco Oil refinery workers (at least 6 mo, with 1 day in 1970–1980); external comparison with US general population
10,763
Vital status followed through SSA, NDI, company telephone survey
Company employment industrial hygienist assigned three job types and exposure types; frequency on basis of job titles
SMR; age, sex, race
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Reference
Population
Study Group
Health-Outcome Assessment
Exposure Assessment
Analysis, Adjustment for Potential Confounders
Poole et al. 1993
Nested cases of kidney cancer and controls from several cohorts of workers in 36 petroleum refineries
102 cases, 408 controls
Author and nosologist confirmed cases from death certificates obtained from each cohort
Industrial hygienists assigned HC exposure types, intensity, and frequency on basis of detailed work histories
RR (nested case-control), conditional logistic regression; control for matching factors: employer and location, age, at-risk status
Rafnsson and Gunnars-dottir 1991
Mortality experience (1951–1988) of professional truck and taxi drivers in Reykjavik, Iceland; external comparison with general male population of Iceland
1,021
Record linkage with National Register, Register of Deceased
Truck and taxi drivers identified through membership rolls of Hreyfill cooperative taxi agency
SMR; age, calendar year
Ritz 1999
Mortality experience (1951–1989) of male uranium-processing plant workers (at least 3 yr, with first hire in 1951–1972) in Ohio; external comparison with US general population; Internal comparison among workers monitored for exposure
3,814
Vital status followed through SSA (pre-1979) NDI (1979–1980)
Exposure matrixes generated by employees, industrial hygienists
SMR, RR (conditional logistic regression); age, calendar year, time since first hired, pay type, radiation dose
Saverin et al. 1999
Mortality experience (1970–1994) of lung cancer in male potash miners (at least 1 yr from 1969–1991) in South Harz Mountains area, Germany; internal comparison within subcohort of subjects who worked underground at least 10 yr, held one job for 80% of their time, had three or fewer underground jobs; external comparison to general male population of Germany
5,536; 3,258 subcohort
Vital status followed through local population registers
Personal and area dust-sampling concentrations were averaged and assigned to work categories of production, maintenance, workshop
RR, age SMR; age
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Reference
Population
Number of Cases
Number of Controls
Relevant Exposures
Exposure Assessment
Analysis; Adjustment for Potential Confounders
Xu et al. 1996
Lung-cancer cases, 30–70 yr old, diagnosed among residents of Shenyang, China, in 1985–1987; controls randomly selected from population registers and matched on age, sex distribution; subcohort of 610 cases, 959 controls active or retired from Anshan Iron-Steel Complex was analyzed with respect to benzo[a]pyrene exposure
1,249 lung
1,345
Kang, coal, gas, indoor air pollution, Benzo[a]pyrene
Interview with standardized questionnaire assessing cooking habits; indoor air-pollution index generated from questions on cooking fuel, place of cooking, weighted by duration; benzo[a]pyrene exposure assigned to subcohort on basis of indoor, outdoor measurements, person’s job history
RR/ORs; age, education, smoking
Yu et al. 1990
Nasopharyngeal-cancer cases, under 50 yr old, identified among residents of Guanzhou City, China, from files of Sun Yat-Sen University Tumor Hospital in 1983–1985; neighborhood controls selected, matched on sex, age
306 nasopharyngeal
306
Combustion products
Interview with standardized questionnaire assessing occupational, dietary factors
Conditional logistic regression; matched pairs, age, sex, dietary factors, birthplace, marital status
Zheng et al. 1992
Oral- and pharyngeal-cancer cases, 20–75 yr old, identified through population-based cancer registry as newly diagnosed in 1988–1990; controls randomly selected from Shanghai Resident Registry, matched on age, sex
204 oral and pharyngeal
414
Petroleum products, kerosene-stove use
In-person interview with standardized questionnaire assessing lifestyle factors
Chi-squared test
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Reference
Population
Number of Cases
Number of Controls
Relevant Exposures
Exposure Assessment
Analysis; Adjustment for Potential Confounders
Zheng et al. 1994
Nasopharyngeal-cancer cases diagnosed beginning in 1986 at Wuzhou Cancer Institute or Nasopharyngeal Carcinoma Institute of Zangwu, China, with histologic confirmation; neighborhood controls selected, matched on sex, age, place of residence
88 nasopharyngeal
176
Wood-fuel use
In-person interview with standardized questionnaire assessing lifestyle factors
Conditional logistic regression; matched pairs, sociodemographic score
Zheng et al. 1996
Cases of salivary-gland cancer, 20–75 yr old, identified through the Shanghai cancer registry and diagnosed in 1988–1990; controls randomly selected through Shanghai Resident Registry, matched on sex, age
41 salivary gland
414
Petroleum products, kerosene, coal, gas
In-person interview with standardized questionnaire assessing job history, household exposures, and dietary factors
Mantel-Haenszel OR; sex, age, income
Zheng et al. 2002
Bladder-cancer cases, age 40–85 yr old, identified and histologically confirmed by State Health Registry of Iowa among Iowa residents in 1986–1989; controls randomly selected through driver’s license records (under 65 yr old) or HCFA listing (65 yr old and older), matched on sex, age
1,452 bladder
2,434
Petroleum, coal products industry, petroleum-refining industry
Mailed questionnaires obtained lifetime occupational histories of all jobs held 5 yr or more
Unconditional logistic regression; age, lifetime pack-years of cigarette-smoking, family history of bladder cancer
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Reference
Population
Number of Cases
Number of Controls
Relevant Exposures
Exposure Assessment
Analysis; Adjustment for Potential Confounders
NOTE: HCFA=Health Care Financing Administration; NHL=non-Hodgkin’s lymphoma; HD=Hodgkin’s disease; JEM=job exposure matrix; MM=multiple myeloma; NIOSH=National Institute for Occupational Safety and Health; OR=odds ratio; RDD=random-digit dialing; RR=relative risk; SES=socioeconomic status; SIR=standardized incidence ratio; SMR=standardized mortality ratio.
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Representative terms from entire chapter:
industrial medicine