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Pharmaceutical Production Workers and the Risks of Mortality From Respiratory System Cancer and Lymphatic and Hematopoietic Tissue Cancers

Youk, Ada O. PhD; Buchanich, Jeanine M. PhD; Marsh, Gary M. PhD; Cunningham, Michael MS; Esmen, Nurtan A. PhD

Journal of Occupational & Environmental Medicine:
doi: 10.1097/JOM.0b013e3181ab5999
Original Articles

Objectives: To evaluate further elevated mortality risks from respiratory system cancer (RSC) and lymphatic and hematopoietic tissue cancers (LHTC) in a cohort of 1466 male workers employed full-time in pharmaceutical production.

Methods: We computed standardized mortality ratios, and in nested case-control studies of RSC and LHTC, evaluated mortality risks by plant exposures with adjustment for potential confounding factors.

Results: Subjects with potential plant exposure had no elevated RSC risk and a statistically significant LHTC excess. The case-control study found many RSC risks reduced with adjustment for smoking, and LHTC risks increased with increasing levels of average exposure to dimethyl-formamide.

Conclusions: RSC mortality risks decreased, and we found limited evidence that positive confounding by smoking may explain some remaining excess risks. For LHTC, increased mortality risks and exposure-response patterns in the case-control study may indicate a possible workplace association.

Author Information

From the Center for Occupational Biostatistics and Epidemiology (Dr Youk, Dr Buchanich, Dr Marsh, Mr Cunningham), Graduate School of Public Health, University of Pittsburgh, Pittsburgh, Pa; and Division of Environmental and Occupational Health Sciences (Dr Esmen), School of Public Health, University of Illinois at Chicago, Chicago, Ill.

Address correspondence to: Ada O. Youk, PhD, A412 Crabtree Hall, Center for Occupational Biostatistics and Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA 15261; E-mail:

©2009The American College of Occupational and Environmental Medicine