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Mortality Among Hardmetal Production Workers: UK Cohort and Nested Case–Control Studies

McElvenny, Damien M. PhD; MacCalman, Laura A. PhD; Sleeuwenhoek, Anne PhD; Davis, Alice BSc; Miller, Brian G. PhD; Alexander, Carla MSc; Cowie, Hilary BSc; Cherrie, John W. PhD; Kennedy, Kathleen J. PhD; Esmen, Nurtan A. PhD; Zimmerman, Sarah D. MS; Buchanich, Jeanine M. PhD; Marsh, Gary M. PhD

Journal of Occupational and Environmental Medicine: December 2017 - Volume 59 - Issue 12 - p e275–e281
doi: 10.1097/JOM.0000000000001036
Original Articles

Objective: The aim of this study was to characterize the mortality at two hardmetal production factories in the United Kingdom as part of an international study.

Methods: Standardized mortality ratios (SMRs) were calculated on the basis of mortality rates for England and Wales, and local rates. A nested case–control study of lung cancer was undertaken.

Results: The cohort comprised 1538 workers, with tracing complete for 94.4%. All-cause mortality was statistically significantly low for all cancers and nonmalignant respiratory disease, and for lung cancer was nonsignificantly low. The SMR for lung cancer for maintenance workers was elevated, based on only six deaths. The odds ratio for lung cancer per year of exposure to hardmetal was 0.93 (0.76 to 1.13).

Conclusions: In this small study, there is no evidence to support that working in the UK hardmetal manufacturing industry increased mortality from any cause including lung cancer.

Institute of Occupational Medicine, Edinburgh, UK (Dr McElvenny, Dr MacCalman, Dr Sleeuwenhoek, Davis, Dr Miller, Alexander, Cowie, Dr Cherrie); Heriot Watt University, Institute of Biological Chemistry, Biophysics and Bioengineering, Edinburgh, UK (Dr Cherrie); Division of Environmental and Occupational Health Sciences, School of Public Health, University of Illinois at Chicago, Chicago, Illinois (Drs Kennedy, Esmen); Center for Occupational Biostatistics and Epidemiology, Department of Biostatistics, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, Pennsylvania (Zimmerman, Drs Buchanich, Marsh).

Address correspondence to: Professor Damien M. McElvenny, PhD, Institute of Occupational Medicine, Research Avenue North, Riccarton, Edinburgh EH14 4AP, UK (

Funding for this study was provided by the International Tungsten Industry Association via a subcontract from the University of Pittsburgh.

The design, conduct, analysis, and conclusions of the study are exclusively those of the authors.

The authors have no conflicts of interest.

Copyright © 2017 by the American College of Occupational and Environmental Medicine