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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 and Environmental Medicine: August 2009 - Volume 51 - Issue 8 - p 903-915
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.

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