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Epidemiological data

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Administrative data

Endpoint:
epidemiological data
Type of information:
experimental study
Adequacy of study:
key study
Study period:
From 1943 to 1979
Reliability:
1 (reliable without restriction)
Rationale for reliability incl. deficiencies:
other: see 'Remark'
Remarks:
All selected studies were evaluated with a check-list relating to population, exposure, endpoints, biases and confounders. Used check-list are established by Professor Philippe Hotz from the Institut für Sozial- und Präventivmedizin der Universität Zürich (EU RA 2008).
Cross-referenceopen allclose all
Reason / purpose:
reference to same study
Reason / purpose:
reference to other study

Data source

Reference
Reference Type:
publication
Title:
The mortality of cadmium workers
Author:
Armstrong BG and Kazantzis G
Year:
1983
Bibliographic source:
Lancet 321(8339): 1425-1427

Materials and methods

Study type:
cohort study (prospective)
Endpoint addressed:
carcinogenicity
Principles of method if other than guideline:
Epidemiological study was conducted to determine the association between the risk of cancer and occupational cadmium exposure
GLP compliance:
not specified

Test material

Reference
Name:
Unnamed
Type:
Constituent
Details on test material:
- Name of test material (as cited in study report): CdS

Method

Type of population:
occupational
Ethical approval:
not specified
Details on study design:
HYPOTHESIS TESTED (if cohort or case control study): Association between the risk of cancer and occupational cadmium exposure

STUDY POPULATION
E: 6995 (M only)
S: "exposed for more than 1 year between 1942 and 1970"
Lost cases: 90
Exposure assessment:
estimated
Details on exposure:
Exposure levels and categories
air Cd levels, CdU
ever high (N=3%)
ever medium (N=17%)
always low (N=80%)
Statistical methods:
no information

Results and discussion

Results:
-Overall:
Prostate cancer (o/e): 23/23.3
SMR (95% CI) prostate: 99 (63-148)
Lung cancer (o/e) : 199/185.6
SMR (95% CI) lung: 107 (92-122)
-ever high (N=3%):
Prostate cancer (o/e): 0/0.4
SMR (95% CI) prostate: 0 (0-962)
Lung cancer (o/e) : 5/4.4
SMR (95% CI) lung: 113 (37-263)
-ever medium (N=17%):
Prostate cancer (o/e): 0/2.5
SMR (95% CI) prostate: 0 (0-147)
Lung cancer (o/e) : 27/24.2
SMR (95% CI) lung: 112 (74-163)
-always low (N=80%):
Prostate cancer (o/e): 23/20.4
SMR (95% CI) prostate: 113(72-170)
Lung cancer (o/e) : 167/157.0
SMR (95% CI) lung: 106 (90-123)
→ No statistically significant excess of lung/prostate cancer
Confounding factors:
Considered confounders:
- Smoking: N.I.
- Other simultaneous exposures: N.I.; exposure to CdO dust & fumes, CdS, dust from Cd stabilisers, silver, copper + beryllium, nickel, mineral oils, arsenic, lead (from Kazantzis et al, 1992)
Strengths and weaknesses:
weaknesses: Smoking histories were not available

Any other information on results incl. tables

Excess of lung cancers in the always low group, more than 10 years exposure (probably not related to cadmium)

Applicant's summary and conclusion

Conclusions:
The authors stated that manual workers tend to smoke more than average, so that some excess in lung cancer mortality in all exposure groups would not be unexpected. This, together with the absence of any relation between the frequency of lung cancer and the intensity of exposure allowed the authors to conclude that it was unlikely that the small excess of lung cancers in the 'always-low' exposure group was related to cadmium.
Executive summary:

Armstrong and Kazantzis (1983) have investigated the mortality rate for cadmium-exposed workers in 17 plants in the U.K. where cadmium is produced or used, including primary production, silver cadmium-alloy production, oxide and pigments production and stabiliser production.

 

The cohort included workers born before 1940 and employed for more than a year on, or in the vicinity of, a cadmium process between 1942 and 1970. On the 6,995 subjects included in the study in 1983, most of the workers (N= 4,453) were involved in primary cadmium production. The remaining (N= 2,452) were engaged in the production of cadmium alloys (N= 1,559), pigment and oxides (N= 531) and stabilisers (N= 452). Deaths from 1943 to the end of 1979 were investigated and only deaths occurring at ages below 85 (N=1,902) were considered. Expected numbers of deaths were calculated from mortality rates for the population of and corrected for regional variation, and the results were expressed as SMRs.

 

Among the 199 men considered to have ever been subjected to high exposure levels of cadmium, 13 had died from cancer (vs 10.4 expected) and 5 of these patients had suffered from lung cancer (vs 4.4 expected). When including both “ever-high” and “ever-medium” in the cohort, there was a slight increase in lung cancer, a total of 32 cases compared to 28.6 expected but a deficit in prostate cancer (0 cases/2.9 expected). The only group showing a significant excess of lung-cancer deaths was that of the men employed for more than 10 years in the "always-low" exposure category (SMR 126, 18 cases/13.7 expected, p<0.05). Smoking histories were not available.

 

However, the authors stated that manual workers tend to smoke more than average, so that some excess in lung cancer mortality in all exposure groups would not be unexpected. This, together with the absence of any relation between the frequency of lung cancer and the intensity of exposure allowed the authors to conclude that it was unlikely that the small excess of lung cancers in the "always-low" exposure group was related to cadmium.