Document M4Mv7oa967RzZ0GZbVZb1ykny
CorporatHeealthPWsics
3M Center2,20-2E-02
CorporatOeccupationMaeldicine PO Box33220
CorporatPeroductResponsibffity St.PaulM,N 55133-3220
CorporatTeoxicology
6517331110
3M MedicalDepartment
MortalitSytudyofEmployeesat3M PlantinDecaturA,labama
A retrospectciovheormtortalisttyudyofemployeewsh,o workedatleasotneyear (beginninginMarch, 1961)atthe3M chemicaland filmplantsinDecaturAlabama, was conductedby UniversityofMinnesota epidemiologisttso determinewhetherthe mortalityexperienceoftheseemployeeswas significantdliyfferenftrom thatwhich would be expected. The cohortsconsisteodf 1,050and 1,116men who were ever employed inthe chemicaland filmplantsr,espectivelyO.f thesemale employees,485 and 547 were onlyemployed inthechemicaland filmplants,respectivelyA.totalof318 femaleemployeeswere identifie(dbothplantscombined).Vitalstatuswas searched throughDecember 31, 1991 and determinedfor99.7% ofthecohort.Of the74 deceased employees,deathcertificatwesre obtainedfor72 (97.3%). StandardizeMdorality Ratios(SNIRS)were calculateudsingU.S.,Alabama and a regionalAlabama countiesfor comparisons. Therewas no significantellyevatedSNlRs. Investigatorescommended thestudybe updatedin 1998 tocoveran additionafliveyearsof mortaliteyxperience.
3K inconjunctiownithepidemiologistfsromtheUniversityofMinnesotaDivisionof Occupationaland EnvironmentalHealth areinthemidst of completingthisupdated retrospectivceohortmortalitsytudy. Severalmethodologicimprovementshave occurredsincetheoriginasltudy. Sincethecompletionoftheoriginamlortalitsytudy which abstractedonlythebeginningand stopdatesof employment from work history
data,3M has now computerizedtheentirework historyrecordsofemployees atthe Decaturlocation.The computerizatioonfthisdetailejdob and departmentinformation, inconjunctionwith informatioanboutserum fluorochemicallevelsacquiredfrom medicalsurveillanceexams and therandom sample (describeadbove),willallowforthe construcfioonf apotentia-lperfluorooctanesulfon(aPtFeOS) exposurematrix.This matrixwillbe used tomore thoroughlyassessthemortalityexperienceofDecatur employees as itrelatetsotheworker@ occupationaflluorochemicalevels.Estimated dateofthefinalreportforthisupdatedretrospectivceohortmortalitsyt.udyisNovember 1,2000.
A;.
FNAL REPORT
MortalityStudy of Employees at3M Plant
in P-ecatur,Alabama
Submitted by-.' Jick S. mAne,,cLPhD., HLP.IL Robe= A. Johnson,PHJD.,HEPIL DivisionofEaviromentaI and OccupadonalHealth
Schoolof PublicHealth Univmity ofMmesota
Box 807 UMHC 420 Delaware SL Sm
MN 55455
March 13,1995
Table of Contents
Listof Tables..................................................3........... rntroduction....................................................6........... Methods ........................................................6...........
Definition of Cohort ..................................................6............. Enwmradon ofCohort and Ascertdmmnt OfPerdmnt EnWloynwnt Infomuttion.....6.. Fogow-14PofCohort and Dewm&sadon ofVs*W SAun ..........................8........... Obobsing and Co&w ofdeath Cffocata ......................................1.2.......... Selection of Comparison Populations ..................................1.3............ SuAdyDatabase .................................0................................1.3........... Analysis ..................................................................1.4.............. Resgilt.it.......................................................................1.6............
.....................................................4.0............ Reco?mnendatf.o.n.................o..........................................41............
.....................................................4.1............ .....................................................42............
2
Listof Tables
Table1: Descriptionof IncHgibleEmployees inStudyDatabase (n= 1,212.)...............................................8............
Table 2.- DescriptionofFmal Employment Statusand VitalStatusfor men. (n= 1,639).......o........................................1.0............
Table3: DescriptionofFnud Emp
Swo and VitalStatusfor
Women (n - 3 18)..........................................1.0............
Table 4.- DescriptionofEmployees Lost tOFDUOW-UP (n 6)......................1.1......
Table 5:
Descdpdm of StateofReddmm atTime ofD=& for Decm%A Employ= forWhom a Death Czrdficm Was Obtained (n - 72).........................................12.............
Table 6.- DistributioonfDeathsby Year ofDeath (n= 74) ....................1.2............
Table7: Characteristicosf Men .(n 1,639)............................1.6..............
Table Ch wacomisticsOf Women (n 318)..............................16.-............
Table 9-. Distnbutkm of Men by Ap and Year ofEntryinto Follow-up (n = 1,639.)....................;................................1.7..........
Table 10.- DistributioonfW=en by Age and Yen ofEntryinto Follow-up (n= 3 18)...o.......................................18.............
Table 11: Dbtribudm ofPftsm-Yom forMen by Age and Calendu Period(n- 1,639)..........................................19.............
3
Table 12: DistributioonfPerson-YearsforWomen by Age and Calendar Period (n = 318)...................................20.............
Table 13: DistributioonfAbsoluteNirmberatRiskby CalendarPeriod for Men (n = 1,639.)......................................2.1............
Table 14.- DistributioonfAbsoluteNumber atRisk by CalendarPeriod forWomen (n= 318)........................................2.1 ...........
Table 15: SelectedCause-SpecificSMRs forMen by Comparison Population(nn 1,639)......................................2.3............
Table 16-. Cause-SpecificSMits forMen Using theU.S.as comparison Population(n= 1.639)..............................25............
Table 17: Cause-SpecificSMP-S forWomen Using theU.S. as Comparison Population (n - 318) .............................2.8.............
a 1,@@ Table 18: Cane-Specific SMRs forMen Ever Employed
]3epu=ent(s) Using theU.S.as Compwism Populadon (n= 1,050.)..................o........................................29............
Table 19: Cane-SpecificSMRs forI&n Only Employed inCbemical Department(s)Using theU.S.as Comparison Population (n= 485)................................................3.2............
Table 20.- Cause-SpecificSMRs fbrMen Ever Employed m Film Department(s)Using theU.S.as Comparison Population (n= 1,116.)..............................................35.............
Table 21: Cause-SpecificSMRs forMen Only Employed inFilm
Depamment(s) Using theU.S. asComparison Population
(n= 547)
...................................03.8............
Table22.- Cause-SpecificSMRs forMen Using Alabama as Comparison Population(n= 1,639).............................4.2............
4
Table23: Cause-SpecifiScMPs forWomen Using Alabama as Comparison Population(n = 318)............................4.5............
Table24.-Cause-SpecifiScMRs forMen UsingAb6ama Countiesas ComparisonPopuMon (n- 1,639).............................4.6..........
Table25: Cause-SpecifSiMcRs forWomen UsingAlabamaCounties
as
Populadon(n 318)............................4.,8...........
MortalityStudy of Employees at 3M Plant
in Decatur, Alabama
InmAuction A retrospectivceohortmortalitystudyof employees who worked atleastone yearatthe3M PlantinD==, Alabama was conductedtodeterminewhetherthemortalityexperienceof theseemployees was significantdliyfferenftrom thatwhich would be expectedina comparablepopulation.'Me majorelementsof thestudywere tD:(1)ddine and
enun=atr.dw cohort(;2)as=tainpmlinmt empkwnxm informad= (3) determinevital::mm asofDecember 31, 1991;(4)obtaindeathcertificatfeosrdeceased cohortmembers and code theundeiiymgcausesofdeath,(-5)selectappropriatceomparison populations;an 1(6)compam thenumber ofdeathsobservedtothenumber ofdeaths expected,based on themmufity ratesofthecomparisonpopulations.
Methods DqUition of Cohort Mm cohortcompdsed allemployees who had worked atleastone yea atthe3M Plantin D=att3r,Alabama and atkm one day afterM=h 1,1961. The cohortwas followedfrom March 1,1961 throughDecember 31, 1991. M=h 1,1961 was.chosen as thebegindate because3M reportedthatdieplantinDecaturbegan operationsinMarch of 1961 and revzw ofemployment recordsrevealedthatveryfew =ployew startewdork priorto March 1,.1961. December 31, 1991 was chosen astheend dateforthecunmt follow-up studybecauseNationalDeath la&x reportingwas completethrouihthatdaw-
Enwmradon ofCohort and Ascermirvmntofperdmnt Employment Informadon I"@e3M PlantatDecaturprovideda c=puter fileand computer-generatepdagesfbr1,263 ,individualasctivelyemdloved anytimesince1986. Tne computer fLIconly contained
n about themost recentjob or employment statusw,hereas thecomputerpage containedtheentirjeob history.Inaddition3,M providedphotocopiesof employment recordsforemployeeswho were: (1)terminateduring1961 - 1971,(2). terminatedsince1972,and (3)hiredpriorto1986 and currentlwyorking.
6
To identifoyverlapamong therecordsources,a labelwas created@foerach employee in the computer file.Ifboth a computer recordand a photocopiedemployment recordexistedfor an employee, thelabelwas affixedto,and thecomputer-generatedpage was attachedto, thephotocopiedemployment record.Subsequently,new recordswere added tothe study databaseforthoseemployees who had photocopiedemployment records,but were notin thecomputer file.A totalof 1,906uniqueemployees were added tothe studydatabase.
For allemployees in thestudydatabase,therelevantemployment informationwas abstractefdrom thephotocopiedemployment recordsand/orcomputer generatedpages. In thoseinstanceswhere therewere minor discrepancieisnemployment datesbetween the photocopiedemployment recordand thecomputrr-generatedpage,thedateson the photocopiedemployment recordwe= Lm=ed tobe correct
Listswere sentto3M fordxm employeesforwhom employment informationwas
missing,insutxient@and/orinconsistenl3M al-;wrajs asked to.providemissing
demographic information(eg.,sex,dateofbirth,etc.)orinformationneeded todetermine
thevitalsmtus of the employee or,iftheemployee was deceased,toobtaina copy of the
deathcertificatWeh.= possible3,M wwdied dieDomir Plantpersonnelmcmds,
cmparate human mwu=s computerdatabasesa,nd micros'flmeadnd micmfiched corpm=.
payrollrecordstoprovi& additionailnformationand rwdve
Howeve4
despite3Ms effortsa,smallnumber ofemployees were stilmlissinga s= dateand/orend
date.The dateoffi= employment and thedateofbw employment arerequh-edfor determiningwhed= theemployee worked foratleastone yea duringthetimeperiodfrom
March 1,1961 throughDecember 31,1991. For such employees,eitherthe employee was
con=tod dhwdy and suppliedthedate(so)ra knowledgeableemployee atthe3M Plantin
T-)em= estimatedthedate(s)T.he studydatabasesand employment recordswere updated
usingtheinformationprovidedby thevarioussou=s. Any informationwhich remained
missingwas coded as unknown.
There were niuncrousqualitycontrolprocedurestoensurethevaliditoyf informationinthe studydatabam. Idormation acquiredfmm thecomputer-genemtedpages orphotocopied employment records,providedby 3M oritsemployees,orobtainedduringvitalstatus fbuow-up was keyed and vcnfied.AU sou=s ofinformationwere reviewedtoensurethat alleugibleemployees had be= enteredin thestudydatabase.Tne studydatabasewas examined forduplicaterecords.Wben duplicaterecordswere ioentifiedt,hebest informationffm both recordswas combined intothefirsrtecordand thesecondrecord
7
was marked as a duplicate.A random sample of recordswas selectedand key employment informationwas reabstmctedtodetermineabstractinegrrorratesand toidentifyany systematicerrorswhich may have occw7e& 'Me datawere checked inordertoidentify missingor inconsistenitnformationand 3M was askedtofollow-upon thisinformation.A comprehensiveezscxcheckingprogram was writtentoexamine whether. (1)theindividual valuesforkey variableswere acceptablea,nd (2)thevaluesforkey variableswere consistenwtith one another.Errorsidentifiebdy thisprogram were resolvedand the study databasewas updated.
ne studydatabaseincluded3,181records.Of these,12 wen duplicaterecordsand 1,212 were ineligibleemployees. A descriptioonf ineligibleemployeesisshown below inTable I
Table 1: Descriptionof IneligiblEemployees in Study Database
(n
ReasonforIneligibility
N
Wadmd l@m ThanOne Yew
l@zio
Did Not Wo& at3M Pim inD==
1
Not SM Employee
TOTAL
1,212
Thus, a totalof 1"7 ehgibleemployees(1,639males and 318 females)we= includedin thefinalcoharl
Fol&ow-upofCohort and Determwadon ofVUd Stam For thoseemployees forwhom vad swu was im known (mchxtingthosereportedas deceased.butforwhom a deathcmuftcatehad notbeenobamed), follow-upmcluded cpmputmized deathsearchesviathe:(1)National'DeatIhndex(NDI),(2)EquffaxDeath Search,and (3)TRW FACS+ Summary. In additions,ome employees who terminated employment priorw 1979 were activel=ycod throughdriver'ksmse recordsr,elatives, neighbors,and/orcoworkers.
A computerft ofemployees forwhom vitalstatuswas notknown was submittedtoNDI formatching againstinformationfortheyears1979 - 1991.
8
Equifaxhas informationaboutdeathsreportedtotheSocialSecurityAdministration(SSA) and from sourcessuch as themilitaryc,orpor-atpeensionplans,insurancecompanies, etc. A computer fileof employees forwhom vitalstatuswas notknown was submittedto Equifax.
TRW FACS+ Summary containsinformationaboutdeathsand ismaintainedby theCredit ReportingDivisionofTRW. The majorityofdeathinformationcontainedinTRW alsois providedby theSSA. TRW was used tosearchfordeathsamong employees forwhom vitalstatuswas not known. CurrentlyT,RW typicallpyrovidesthename, dateofbirth, and dateofdeathforindividualwsho have been reported=ued. Throughout most of thestudy,however, 'rRW onlyprovidedinformationthattherehad been a reporteddeath
with thesocialsecuritnyumber,withoutprovidingadditionaWlendfying informationor deatl:kdb=don.
Because allof theccaapuumizeddeathsearcheswere dependent upon having thecorrect somal secuntynumber foran employee,effortswe= made toensmr.theaccuracyof social securitynumbers. L) additiontocomparing socialsecuritynumbers fi-amthevarious sourcesof informationCLe.,tlccomputerfilee,mployment r=or&, etc.)T.RW Social Searchwas used toverifytheaccuracyof socialsecuritnyumb= foremployees. Some socialsecuritynumbers were notfoundinTRW. For-thewempIMm thesocialwcmity numbers were assumed tobe correm becausedu= area nilrm ofvalidrmons why a personmay not be includedinTRW (e.g.a,personmay ask tobe removed from theTRW fileora personmay nothave any creditactivity)A.dditLonalncing was done toresolve discrepancieisn socialsecuritynumbers.
Activeundng ofemployees was performedforallemployeeswho =iim@ priorto1979 (when NDI was unplemented)and forwhom vitalstatuswas notpreviouslyknown. Driveeslicenserecordsbrequentlwyere used todeterminevitalsmm. In addition, intm-activseoftwarewas used to ssMetronet a nationalconsumer database,and addressesand/ortelephonenumbers of relativesn,eighbors,and/orformer employees were obtained.Other wamng sourcesincludedother3M employees and law enforcement gencw& Once a =cing leadwas idendfad,telephon=e= followedup tode=iine, directloyrindirectlyt,hevitalsmm oftheemployee.
The resultosf thevitalstatusfollow-upa,longwith theemployment s=us asofthestudy end date,are shown inTables2 and 3 formales and females,respectively.
9
Table 2: Descriptionof rinalEmployment Statusand VitalStatus forMen (n 1,639)
FuW EmploymentStatus andVitalSam C)mtntlyEmployed Redmd
Alive
Dead Unknown Terminated Alive Dead Unknown DiedWhile Employed TOTAL mayam addtoIW dw o mmft
N 810
59 10 0
694 29 6 31 1,*639*
% 49.4
3.6 0.6 0.0
42.3 1.8 0.4 1.9 100.0*
Table 3: Demipflo!d of FhW Employment Shlus and Vital Status for Women (n 318)
.FmalEmpkrynx=Sum
and VitalSmm
N
CurrentlEymployed
141
Redred
AH,m
9
Dead
0
Unknown
.0
Terminated
Alive
164
Dead
1
Unknown
ol
Died WhileEmployed
3
WRAL
319
p=enuga maynotaddtoIW duetomauft
% 44.3
2.8 0.0 0.0
51.6 0.3 0.0 0.9 ioo.o*
10
Six (0.3%)employees were losttofollow-up.For them employees,thelastknown date dw theemployee was allveisthedateOf MnninRtiOnOf eMplOyMenL A descriptioonf the employees who were losttofollow-upisshown inTable4.
Table 4: Smdy ID
20067
20"8
:ZlO28
21057 21194 21639
Descrfpdon of Employees Lost to Follow-up (n = 6)
bkmtb/yearof Montb/Yearof
Sex
Birth
Embloyment
Job T"itle(s)
male
08/49
08173 - 10(75 generalhelper,
processhelper,
materialhandler,
resinhandler
nWe
12J37
07.165- 07471 generalhelper,
@pr@,ocew help%r, processoperator, chemwal opcra",
forr.man
male
06/41
01/66 -07/68 generalhelper.
processhelper,
processoperator, chemicaloperator
male
01/46
04/66-07/67 generalhelper,
processhelper,
processoperator
male
11146
08166 - 03/69 generalhelper,
processoperator
male
08145
01/69 - 09M
generalhelper,
processhelper, packcr,
materialhandler helper,material
handler,process operator,
warehouseman, orderfiller,
chemical operator
ObtaininagndCodingofdeathCerliflcxes DeathcertificwaetreesrequestferdomstatveitasltatisotfitcismsI.fa deathcertificate couldnot be obtainedor thedeath=tificateobtainedwas notforthecorrectperson, additionamlcing was implemented Overall.72 (97.3%)deathcertificatweesre obtained forthe74 deceased employees (70 men and 4 women). A descriptioonfthe stateof residenceattime of death forthe72 deceasedemployees forwhom a deathcertificatweas obtainedisprovided in Tabk 5. N*metypercentdiedinAlabama.
Table S: Descriptionof Stateof Residenceat Time of Death
for Deceased Employees for Whom a Death CertificateWas Obtained (n 72)
stme
N
Abdxtma
65*
Florida
1.
Gmrgia
I
Mchipn
Nfmnesota
Ohio Tennessee
To=
TOTAL
72
The distributioofn&Aft by calendaryearisshown inTable6.
Table 6: Distributioonf Deaths by Year of Death.
(n 74)
YearofDeath
N
1967-1969
3
1970-1974
9
1975-1979
9
1980-1984
12
1985-89
33
1990-1991
8
TMAL
74
12
Death certificatweesre coded by a professionanlosologisatccordingto theEighthRevision oftheInternationCalassificatioofnDiseases(ICD 8).The underlyingcauseofdeathand any mention of cancerwere coded.
Selecuon of Convarison Populanons Tbree comparison populationswere selected.(-1)theU.S.,(2)thestateof Alabama, and (3)Alabama countieswhere mom thanone-halfofthecounr,-wlas within100 milesof Decatur,excludingthosecountiesinwhich therewas a citywithgreaterthan 100,000 persons.Countiesincludedinthertgionaclomparisonwere: (1)Blount,(2)Calhoun,(3) Cherokee,(4)Colbert,(5)CalLman,(6)Do KAlb,M Etowah,(8)Fayette,(9)Fhmkiin, (10)Jackson,(11)Lamar. (12)Lauderdale(.13)Lawrence,(14)Limestone,(15)?Aadon, (16)hfwshall(17)Moqpn. (18)St.Clak.(19)Shelby,(20)Talladega,(21)Tuscaloosa.. (22)Walker,and (23)Vrmstm Based upon 1990 cmm Pgmrs, dw combined populatiofnorthesecountieswas 1.387,61p5ersons.Countiesexcludeddue to a populationcenterof 100,000personsormore were: (1)K-wlisonGage cityisHunuvWe), and(2)Jeffasm (larpcityisBhniingbam).
Race-.sex-.age-.and time-qxciftmortalitryates4.usted toICD 6,vmm obtainedfor thethreecompanson populaum fim ft Maruauy and PopulationData System (beDS) attheUmvmiity ofPittsburghN.o mortahtynmes am avaflablferom the bn3DS priorto 1950 and onlycancermort&Htyratesam availablperiorto 1962. I"nemost currentmormhty ratesavailablearefor1989.
Sn&dyDamlwe lle finalstudydambase was a combinationof datafi-omthefollowingsources:the computerMr..compater-gen=tedpagm pho=*cd employmentrecords3.K employem wacing(vitaslwu follow-upa,nd deathcmtficatm Ile followingkey infcmadon was availablienthestudydatabase:
0 StudyID; 0 firsntame, middle name, and lastname; - st=t address,city,sta and zipcode; o tel-phonenumber o socialsecuritnyinnber, o sex; - dateofbirth,
13
0 dateOf firsetmployment at3M PlantinDecatur, - dateof lastemployment at3M PlantinDecat= o number of lapsedmonths betweendateof firsetmployment and dateof lastemployment
when notactuallyworking at3M PlantinDecatur-, datefmt employed inchemicaldcpartinent(s); datelastemployed inchemicaldepartrncnt(s); number ofmonths worked L-ichemicaldcpartrnent(s()accountingforany lapseswhen
notactuallwyorldng inchemicaldcparttncnt(s)); flagsindicatinwgork inspecifidccpm tie,nt(s)(ic.,worked inchemicaldcpw=cnt(s),
worked infilmdep ,i, ent(s)e,tc.); finalemployment status(Le.,currentlwyorjdng,redmd, odimvise terminatedfrom
employmen4 died whileemployedy, vitalstatus(Le.,alive,presumed alive,deceased,or unknovm); dateof deathor datelastknown tD be allveCifdifferenftiam lastdateof employment or dateofterminadw); undciiyingcause ofdeathcoded toICD 8;and contdbiltincgausesofdeathorotha significanctondition(sifcancer)coded toICD S.
The namsary datafOw foranalysiwsere preparedusingft key informationcontainedin thestudydataba . As partofthisprocess,defimh valueswere automaticallsyubstituted forany missingcnmponents of employment dates(ie.,06 fora missingmonth and 15 for a missingday). Ifthisautomaticsubstitutiofnormissingdatescmated a date thatwas chronologicalloyut of sequewe, a datawas manually estimatedand thisestimateddatewas enteredin thestudy database.
Anaiysis The method of analysiswas based upon a compmison of theobserved toexpectednumbers of deathsspecificforthecauseof death,race,sex,age,and time. The estimateof the expectednumber of deathswas calculatebdy applyingcause-,rn -,sex-,age-,and timespecificratesforthecomparisonpopulationtotheperson-yearastrisl Follow-up began March 1.1961. Cohort members didnotcorivibump=on-years untiltheyhad met the
.. um lengthof work criterio(ni.eo.n,e yearor more).Pcrson-yem of follow-up
were contdbuteduntildeath,104'tofollow-upc.r theend of d2a study(December 31, 1991). No informationon racewas availablet;hus,employees were assumed tobe white. Deceased studymembers forwhom a deathcertificactoeuldnotbe obtainedonly wem includedin the"allcausesof death"and "unimown causeof death"categories.
14
Standardizmeodruhtyratio(sSMRS)werecomputedusintgheOccupationaClohott MortalityAnalysisProgram (OC2AAP).1 Mortalitymtrs forwhiteswere used tocalculate theexpected numbers forallmen and allwomen. For 1961,when mortalityratesfor noncancercauses were unavailablet,heexpected numb= of deathswere not calculated (i.e.t,heexpected nmnbm of deathswere setto zero).Tt=e were no observed deaths priorto 1967. Mortalityrate for1989 were used toestimatemortalityratesforsubsequent yew. SMRs w=. calculatedusingbothOCMAP and theUnited StatesDeath Rates (USDR) program developed by Monson.2 Resultswere V=ay idendcaj.
mm ovemli patternof mormhty".vasexamined formen and womal For men, thepattern
of mortahty by depwtm
wodwd dw was ommined. For thisanalysis,thefollowing
subgroupsof employees vA= etTmaL- (1)everampkried In thechemical iPpm =ergs);
(2)onlyemployed in diechemical kyament(s),*(3)everempk*-ed inthefilm
depm=enKs); and (4)onlyeml@oyed inthefilmdepa=mt(s). Depament codes atthe
3M DecaturPlantwere defmad by four-(hgictodel ne fim two chpts wem'57 fbrfilm
departmentsand were 76 foicrh=ical
t[nam For II empioycm atleastone
depar=mt was unknown-,and,for3 of !hwc, all--.-,
were unknown. Tbus, dww
3 employ= c6uU not be iwluded indw-subgroup analysibsy depwnmt(s) wodm&
15
Chuacwbdcs ofmale and femalecohortmembers aregiveninTables7 and 9, respectivelyM.en contribute3d3,108person-yearsof follow-upand women contributed 4,907person-years.There were 70 (95%) deathsaznongmen and 4 (5%) among women. On average,men enteredthecohortatan'calierpointintime(1971 versus1977) and ata slightlyyounger age thanwomen (25versus26).
Table 7: Characterbtics of Men (n = 1,639)
Variable
Vahn
N.=ber ofEmployees
1,639
Number ofPersm-Yum
33,109
Number of Deaths
70
Average AV StartedWozk
25
Average Yea ofEntry
1971
Average Ap atDeath
47
-A@vc-rYAePa ofDdath
1984
Table 9: C
vad" Number ofEmploye= Number ofPa=-Years
Number ofDeaths Average Age StartedWedc
Avcmgc Yea ofEntry Avemgr. AV atDeath Av=2p Year ofDeath
es of Women (n Vabit 318 4,807 4 26 1977 28 1980
@ls)
16
In Table9,thedistributoifomnen byageandyearofentriyntofollow-uipsshown.Table 10 shows thesame distributiofnorwomen. Most men entemd thecohortduringthelate 1960s and early1970s and between theages of 20 and 30,whereas most women entered thecohortatsimilarage3,butbetween 1970 and 1980.
Table 9: Distributioonf Men by Age and Year of Entry lnto_Follow-up(n = 11,639)
YearofEntryintoFollow-up 1960 1965 1970 1975 1980 1985 1990
Ago <20 20-24 25-29 30-34 35-39 40-44 45-49 50-54 55-59 60+ TOTAL
1964 19 '114 64. 21 22 19 3 0 0 0 261
1969 34 238 139 58 25 19 3 1 1 0 517
1974 '86 301 65 33
9 4 4 0 0 0 502
1979 31 96 37 19 15 10 5 0. 0 0 213
1994 4 28 21 8 6 8 0 2 0 0 77
1989 2 18 14 10 5 2 2 3 0 0 56
1991 TOTAL
0
175
3
798
5
345
4
153
1
83
0
61
0
17
0
6
0
1
0
0
13 1,639
17
Table 10: Distributionof Women by Age and Year o! Entry IntoFollow-up(n = 318)
Yew ofEntry intoFoUow-up 1960 1965 1970 1975 1980 1995 1990
Alp <20 20-24 25-29 30-34 35-39 40-" 45-49 50-54 55-59 60+ TOTAL
1964 1969 19,74 1979 1994 1989 1991 TOTAL
2
12 18 16
4
0
0
52
4 22 23 50 4 9
1
113
.3 4
4 47 4
5
3
70
2
3
2 15 1 4 2
29
1
2 3 16 3 3
2
30
0
0
0
9
3
2
0
13
0
0
05
1
1
0
7
0
0
0
3
0
0
0
3
0
0
0
1
0
0
0
1
0
0
0
0
0
0
0
0
12 43 50 161 20 -24 8
319
18
Tables II and 12 pmvide thedistributiofnperson-yearsby age and calendarperiodfor men and w(xnen,respectively.
Table 11: Distributioonf Person-Yearsfor Men by Age and Calendar Period_(n = 1,639) CalendarPeriod 1960 1965 1970 1975 1980 1985 1990
Age 1964 1969 1974 1979 1984 1989 1991 TOTAI.,!
<2020-24 25-29 30-34 35-39 40-44
9
19 43 23 2
I. 0
182 583 985 930 244 64 21
124 861 1,536 1,633 1,171 341 66
60 463 1,254 1,672 1,728 1,229 209
50 198 609 1,.339 1,716 1,760 636
35 129 272 645 1,390 1,719 738
96 3,008 5,724 6,613 6,297 4,927
45-49 21 91 180 29:5 665 1,387. 630 3,270
50-54 0 28 103 184 308 650 456 1,728
55-59 0 60-64 0
5 27 101 195 3(Y7 204 8Z7
0
5
27 101 174 96
402
65 -69 0
0
0
5 24 86 47
161
70-74 0
0
0.- 0
5 18 25
47
75-79 0
0
0
0
0
5
1
5
80-84 0
0
0
0 .0 0
2
2
85+
0
0
0
0
0
0
0
0
TOTM.:O 479 2,365 5,006 6,9@3 7,536 7,739 3,129 33,108
wtwismay na beag-Itos= ofindividmaws oreciummduetorounftg
19
Table 12: Distributioonf Person-Yearsfor Women by Age and Calendar Period (n = 318) Cdendar Period
1960 1965 1970 1975 1980 1985 1990
_AE
1964 1969 1974 1979 1984 1989 1991 TOTAL.@
<20
1
9 20 21 12 0
0
63
20-24 9 65 138. 182 139 38 5- 576
25-29 7 39 115 253 337 171 34 955
30.-34 2
19 55 171 376 346 106 1,074
35-39 2 14 .26 St 235 383 160 900
44J- 44 2
5 17 48 136- 243 143 594
45-49 0
2
5 14 70 141 91
332
53-54
0
0
2
8 49 70 43
172
55-59, 0
0
0
3 18 49 19
89
60-64
0
0
0
0
5 19 is 41
65-69
0
0
0
0
0
5
7
12
70-74 0
0
0
0
0
0
0
0
75-79 0
0
0
0
0
0
0
0
80-94 0
0
0
0
0
0
0
0
85+. 0
0
0
0
0. 0- 0
0
TOTAV 22 153 377 790 .1,3771,463 624 4,807 wtds may na beeqadtosmn ofindvidugwws orcalmam dw m rouraing
20
The distributionf the absolutenumber of personsatriskby calendarperiodisprovidedin Table 13 formen and inTable 14 forwomen.
Table 13: Distributionof AbsolitteNumber at Risk by Calendar Period
forMen (n 1,639)
CalendarPeriod
Number atRisk
1960-1964 1965-1969 1970-1974 1975-1979 1980-1984
261 778 1,274 1,477 1,545
1985-1999 1990-1991
IWAL
1,591
(1a) 1,639
Table
14: Distribution of Absolute Number at Risk by Calendar
for Women (n. z 318)
Calen Pddod
Number atRisk
1960-1964
12
1965-1969
55
1970-1974
105
1975-1979
266
1980-1984
284
1985-1989-
306
1990-1991
314
TOTAL
318
Period
Inthe tableswhich follow,theobservednumber of deaths,theexpectednumber of deaths, theobservedtoexpectedratio(Le.,theSUR), and the95% confidenceinuu-.,W(95% Cl) am shown forspecificausesofdeath The observednumber ofdeathsfora spectm cause isthenumber ofdeathsfim thatcausethatoccurredduringthestudytimeperiod.Mw
number of deathsfora specificcause isthenumber of deathsthatwould have occucmd iftheemploye= experiencedthesame cail -specifimcortalitryatesasobserved inthecomparison population.The expectednumber ofdeathswas calcubuedby applying themce-, sex-,age-,and time period-specifriactesforthecomparisonpopulationtothe
21
number ofpemn-yem of follow-ucpontributebdy thecohortm=bcrs. 'Me observed number of deathsfora specificausewas dividedby theexpectednumber of deathsfor thatcauseand multipliedby 100 toobtainthecause-specifiScMR. An SMR may be interpreteadsfollows:(1)an SMR of 100 means thattheobservedand exrectednumber ofdeathswere equal (2)an SMR ku than100 means thatfewerdeathsoccurredthan expecuxland (3)an SMR greaterdm 100 means more deathsoccurreddm expwte& mn 95% a fortheSMR providesim indicadm ofthevariabilimtdy stuL-XrAsignificance offt esemwz of tbr.SMR. ne 95% a me= thatthereisa 95% chance dw ffiicnterval includesthemm valueoftheSMEL Ifdie95% CE does notinclude100,the SMR is consideredsmosdcallysignificant.
22
InTable 15,SHPs formen areprrsentedforselectedcauseof deathcategoriesforeach of thethreewhite comparison populations.
Table IS: SelectedCause-SpeciricSMRs for Men
by Comparison Population(n = 1,639)
SMR
(95% CDUfWence Intwig)
Cause of Deadi AllCauses of 'L)eath AllMalignantNoWlaM13 C=brovascuLw Disc= AUHeartDisom ReVkatoryDiwm
Observed Deaths 70
15
1
17
0
CompuLson Population
U.S. 62.9 (49.0,79.5) 68.4 (38.3,112.8) 33.5 (0.8,186.8) 59.1 (34.4,94.7)
Alabama
54.8 (42.7,69.3)
60.9 (34.1,100.4)
27.8 (0.7,155.2)
53.2 (31.0,85.1)
Alabama Counties
52.0 (40-5.65.7)
59.9 (33.5,98.8)
26.5 (0.7.147.5)'
49.1 (28.6,78.6)
F.xU=ml Causes
(0.0,91.2) (0.0,80.2) (0.0,73.9)
25
74.5
59.0
55.0
-
(48.2,110.0) (38.2,97.1) (35.6,81.3)
SMP,s basedupon theAW)ama and Alabama countiescomparisonpopulationswem similar to,butlower dim thosebasedupon theU.S.comparisonpopulation.Since theU.S death ratesaremcm stablethanthedeathrun fbrthestateaW regionalcompmison populations and becausetheU.S. commonly isusedas a comparisonpopulationin occupationalcohort mortalitysmdies,SMRs based upon theU.S. comparisonpopulationwillbe presentedin ft resultwshich follow.SMRs formen and women basedupon theAlabama and Alabama countiescompanson populationsareprovidedinTables22 through25 inthe appendices.
23
There were 70 deathsamong themen inthiscohorl Using theU.S. as thecomparison populationS,MRs formen areshown inTable 16. The SMks forallcausesofdeath,heart dise.g,and respiratordyisease(Le.,notunalignanrtespiratordyisease)were significantly lessd= 100. The SMR forallcausesof deathwas 62.9(95% Cl = 49.0,79.5)and the SMR forheartdiseasewas 59.1(95% Cl - 34.4,94.7).No respiratordyiseasedeaths occurred,although 4 deathswe= expected. Other defidtsoccurredforallcancerand externalcausesof death.The SMR forallcancers was 68.4(95% Cl - 38.3,112.8).Most of thespwfficcancerSbERs were lessthan 100, exceptfbrcancerof thebladderand otherunnwy organsand cancerof otherlymphaticand
dssm For then two causes,theSMRs wen based on only one or two deathsand wem not sudsdcallysiodrmnt Fwaximudcaunsof death,the SMR was 74-5 (gs% a - 4s.2,iloo). Len dm the ".pectednumber of deathswxunvd for motw vehicleaccidents,suicidesa,nd homicidesand otherext=d causesof death.
24
Table 16: Cause-SpeciriScMRs for Men
Using the U.S.as Comparison Population(n 1,639)
Cause of Death
Obswmd EVected Deaths Deaths SUR
95% Confidence
Interval
AllCauses of Death
70
AU MalignantNeoplasms
15
Cancer ofBuccal Cavityand
0
Pharynx
Cancer ofDigestive
1
Orgam and Pwhmcuzii
Cancer of Esophagus
0
Cancer of Stomach
0
CancerofImp kmntm
1
Cancer of Rectum
0
Cancer of Laver and BiHary 0
Passages
Cancer of Pancreas
0
Cancer of AllOdwr
0
DigestiveOrgans
Cancer of Respiratmy System
7
Cancer ofLarynx
.0
111.3 21.9 0.6
62.9 68.4 -
4.7
21.5
0.5
-
0.7
-
1.7
60.2
0.4
-
0.4
1.0 0.2
7.6
91.8
0.2
-
(49.0,79.5) (38.3,112.8) (0.0,628.2)
(0.5.120.0)
(0.0,722.6) (0.0.531.8) (1.5,.335.3) (0.0,1,003.1) (0.0.919.1).
(0.0,379.1). (0.0,2M2.9)
(36.9,189.2) (0.0,1,529.7)
Cancer ofBronchus, Trachea,and Lung Cancer of Other Respfiamy Orgam
7
7.3
96.4
(38.7.198.6)
0
0.1
-
(0.0,3,109.0)
.Cancerof Prostut
0
Cancer ofTwms and Cthcr
0
Male Gemud Organs
Cancer ofKidney
0
Cancer of Bladderand Other
1
0.5 0.3
0.6
-
0.3
341.3
(0.0,694.6) (0.0,1,123.9)
(0-0,592.5) (8.5,1,901.6)
UrinaryOrgans
25
Table 16: (Continued)
Cause ofDeath Cancer ofBrun and Other Cenwg Ncrf(juSsystem Cancer ofnyroid and Other Endocrine Glands
Observed EVected
Deaths Deaths
1
1.2
0
0.1
SNR 84.3
--
Cancer of Bone
0
CancerofA)!Lympbadc and
3
aclum
Lympboma
0
Hodgidn!.eDLw&w
0
Lmkemia and Aleuk=ia
1
Ca of OdierLympbatic' 2
and :ri
TLUW
0.1
-
3.0
101.1
0.4
0.5
1.2
86.4
1.0
203.8
MaHpant Melanows ofSidn
1
AllOtherMaRgam
1
Neoplasms
DiabetesMaMw
0
CerebrovascularDisease
1
AllHeat Disease
17
Hypemnsion
0
1;tJ@VirOlM ]DiSC4=
0
LTI= ofStomachand
0
Duodenum
0.9 1.9
1.5 .3.0 28.8 0.1 4.0 0.3
116.8 52.2
3i.5 59.1
CirrhosiosfLiver Nephritisand Nephrosis Exuwnal Causes
Accidents
Motor VehicleAccidem AllOdw Accidents
Suicides
3
4.1
73.7
0
0.4
-
25
33.5
74.5
19
20.6
92.4
9
11.8
76.1
10
8.8
113.6
4
7.9. 50.8
95% Confidence
Interval (2.1.470.0)
(0-0,3,749.2)
(0.0 3,035.4) (20'.9,295-5)
(0-0,997.3) (0.0.804.7) (2.2,481.4) (24.7.736-2)
(2.9,650.6) (1.3,290.7)
(0.0,240.2) (0-8,186.8) (34.4,94.7) (0.0,2,652.5) (0.0,91.2) (0.0,1,4Or7.9)
(15.2,215.3) (O.G.999.6) (48.2,110.0) (55.6,1".2) (34.8.1".5) (54.5,208.9) (13.9.130.1)
26
Table 16: (Continued)
Observed E.LTected
Cause of Death
Deaths- Deaths SMR
Homicides and Other External 2
4.9
40.7
Causes
ResidualCauses*
7
Unimown Causest
2
0 allothwcames ofdmb combinw
t no deatheadfwm obudned,h.wkdod onlyinallcan=
12.8
54.5
Ltdeathcaiesay
95% Confidence
Intmal' (4.9,147.0)
(21.9,112.3)
In Table 17, SMRs m povkw fbrwomen, usli@gft U.S. as ft fon_ arisonpopukdm No causeofdeathhad an SMR significantdliyffewntfrom 100. Them we= 4 deaths among &nulleemployees and dw allcauseSbO. -.va6s2.6(95% a m 17.1,160.4).Of the 4 deathswhich occuned, 3 death were frm externalcauses(S?AR = 213.4,9-5% Cl 44.0,623.6).By examining thedeathcatficatesf.orthespecificcausesof deathand
qmm a mding thedeathsitwas dewnuined it-Adto excea.martalityamong femalesdue towmmud can was notwmk-relara One oftheextunalcoil of death was due tomunic pdsoning and dw othertwo externalcausesof deathV'A= dw tomotor vehicleaccidentl
27
Table 17: Cause-SpeciriScMRs for Women
Using the U.S.as Comparison Population(n 318)
95cl,,
Obsuved ExMcled
Confidence
Cause ofDeath
Deaths Deaths SMR
Interval
AU Causes of Death AllMalignantNeoplasms CerebrovascularDisease
AllFkAntDisease Req&atory Disease
4
6.4
62.6
(17.1,160.4)
0
2.3
--
(0.0,162.4)
1
0.3
376.0
(9.4,2,095.3)
0
0.9
(0.0,413.1)
0
0.3
-
(0-0,1,3".7)
Exu=d Cai-i
3
Acci&nts
2
Motor VehicleAccidents
2
AllOdierAccidents
0
Suicides
0
Homicides and OtherExtmmd
1
1.4
213.4
(44.0,623.6)
0.8
247.3
(29.9,893.4)
0.6
364.7
(44.1,1,117.6)
0.3
-
(0.01.,-4L.5.3)
0.4
-
(0.0,992.2)
0.2
449.6
(11.2,2,505.4)
Causes
Tables19 through21 presentSMRs and95% Cls formen by the epartrncnt(s)wcnimd subgmups.
Bnd-ingswere sirnillformen everemployed inchemicaldepartznent(s()Table18). A*total of 57 deathswere observedforthew men and theallcauseSMR was significantly decreased(smR m 7oo; 95% a 53.0,90.6).7be SMR forheartdiseasealsowas sigaifi=dy lessthan 100 (SMR 48.9;95% Cl = 24.4,87.4).SMRs and 95% CIs for allcancerand exmrnd cail ofdeathwerr.76.9(95% a =40.9,131.5)and 90.2(95% CI 55.1,139.3),respectively.
28
Table IS: Cause-SpeciricSMRs for Men Ever Employed In Chemical Department(s)
Using the U.S. as Comparison Population(n = 1,050)
Cause ofDeath
Obw"ed Death
Expected Deaths SMR
95%
Confi&noe Interval
All CausesofDeath AllMahpant NeWla=s
Cancer of Buccal Cavityand Pharynx Can= of Digestive
(-57@ 13 0
1
81.5 16.9 0.5
3.6
70.0 k"' 76.9 -
(53.0,90.6) (40.9,131.5) (0-0,800.6)
27.5
(0.7,153.2)
Organs and Perimeum
Cm= ofEsophagmi
0
Cancer of Stmnach
0
Cancer of Large hm=w
1
Cancer of Rectum
0
Cancer ofLiver and Bmary
0
0.4
-
0.5
-
(0-0,913.3) (0.0.686.1)
1.3
76.9
(1.9,428.5)
0.3
-
(0.0,1,271.9)
0.3
-
(0.0,1,198.2)
Passages Cancer of Pancreas Cancer ofAllOdur DigestiveOrgans
0
0.8
-
(0.0,480.6)
0
0.1
-
(0.0,3,203.2)
Cancer of RespiratorySystem
7
Cancer ofLarynx
0
Cancer of Bronchus,
7
6.1
115.1
(46.3.237.1)
0.2
-
(0.0,1,891.9)
5.8
120.7
(48.5,248.7)
Trachea,and Lung
Cancer of Other
0
0.1
-
(0.0,4,214.1)
RespiratoryOrgans
Cancer of Prostate
0
0.5
-
(0.0,805.9)
Cancer of Testesand Other
0
0.2
-
(0.0,1,678.5)
Male GenitalOrgans
Cancer ofKidney
0
Cancer of Bladder and Other
1
UrinaryOrgans
0.5
-
(0.0,768.2)
0.2
415.5
(10.4,2,315.3)
29
TableIS: (Continued)
Cause ofDeath
CancerofBrainand Other
Cena-alNervous System Can= ofThyroidandOther
EndocrineGlands CancerofBone Can= ofAU Lympbaticand H=Ivb)POicdcTLUW
Lymphoma
Hodgic&s Disease
I.zukemiaand Alculamiia
CMM= OfOdkCrLymphadc
and
--- -2---- 1"Ls
MalipantMekwma ofSldn
AllOdmw MaEga=
Neopla=s
DiabetesMeMm
CmtbrovasculaDiwm AllHean DL-em
Hyper=don ReVkawryDisem
Ul= ofStomachand Duodenum
CirrhosiOsfliver Nephritiasnd Nephrosis
Ex=nal Causes Accidents
Motor VehicleAcddem AllOd= Accidem
Suicides
Observed Expected
Dmft Deaths
1
0.9
SMR 117.2
0
0.1
-
0
0.1
2
2.2
92.9
0
0.3
-
0
0.3
1
0.8 120.0
1
0.7 137.2
0
0.6
-
1
1.5
68.9
0
1.1
-
1
2.3' 43.4
11
22.5 48.9.
0
0.1
-
0
3.2
0
0.2
-
3
3.0 100.2
0
0.3
-
20
22.2 90.2
16
13.6 117.3
9
7.8 102.8
8
5.9 135.7
3
5.2
57.7
95% Confidence
Interval (2.9.653.0)
(0-0,5,113.2)
(0.0.4,368.3) (11.2,335.5)
(0-0,1,341.4) (0.0,1,163.3) (3.0,668.8) (3.4,764.5)
(0.6,614.7) (1.7.383.7)
(0.0.323.9) (1.1,241.7) (24.4,87.4) (0-0,3,389.9) (0.0,116.3) (0-0,1,796.3)
(20.7,292.7) (0.0,1,308.2) (55.1,139.3) (67.0,190.5) (44.4,202.5) (58.6,267.-4) (11.9,168.6)
30
Table 19: (Continued)
Observed Expec@
Cause ofDeath
Deaths Deaths SMR
Homicklesand OtherExternal 1
3.2
31.4
Causes
ResidualCauses*
7
9.0 77.6
Unknown Causest
2
*aRadw caunsofdeathcombhud
tnodcaihmdffcm obudne4kwhkbd onlyinaRcamesof&*& cmgmy
95% Confidence
Interval (0.8,175.1)
(31.2,159.9)
Mi@r..,,y-two owanrd among men onlyampkrjcdinchemicaldepartment(s()Tabk 19).The SMR foraU causesofdn& was 72.5and was notsudsdeallysignifica(n9t5%
a -,4.9.6,102.4).For he= disc=, theSMR was 53.4(95% a - 21.5,110.1@ Ile all
cancerSMR was 93.6m%a- 42.8,177.8).no obswmd.md expectednumbm of dlewt.&.es tocxmwlcmm we= o;ftnl+naml&ye =me- rawdngin =SUR of9:5.0 (95%a-45.CI74M.-
31
Table 19: Cause-SpeciriScMRs for Men
Only Employed in Chemical Department(s)
Using the U.S.as Comparison Population(n 48S)
95%
Obswied Expected
Confidence
Cail ofDeath
Dcaths Deaths SMR
Inuwval
AllCauses of Death
(22J
AllMalignantNeoplasms
9
Can= ofBuccalCavityand
0
44.1 72.5- (49.6,102.4)
9.6
93.6
(42.8,177.8)
0.3
-
(0.0,1,396.4)
Pharynx CancerofDigestive
0
2.1
-
(0.0,175.2)
Organs and Peritanemn Cancer of Esophagus Cancerof Swmach CancerofLaw hmsdw
0
0.2
-
0
0.3
-
0
'0.8
-
(0.0,1,577.7) (0.0,1,195.2) (0.0.488.5)
CancerofRectum
0
0.2
CancerofLlvw and Bffiwy 0
0.2.
(0.0,2,175.6) (0.0,2,072.6)
Passages Cancer ofPancreas CancerofAllOther
0
0.5
0.
0.1
(0.0,827.2) (0.0,5,692.4)
DigestiveOrgans
CancerofResphauxy System 5
Cancer ofLarynx
Cancerof Bronchus,
5
3.6
141.0
(45.8,329.0)
0.1
-
(0.0,3,198.4)
3.4
147.9
(48.0.344.9)
Trachea,and Lung CancerofOther
0
0.1
-
(0.0.7,763.4)
RespftutoryOrgans CancerofPmstm Cancer ofTestesand Odkw
0
0.3
-
(0.0,1,202.0)
0
0.1
-
(0.0,3,501.4)
Male Genird Organs Cancer of Mdney
0
0.3
-
(0.10,,365.0)
CancoefBr? and0dwr
1
0.2 669.9 (16.7,3,732.7)
UrinaryOrgans
32
Table 19: (Continued)
Cause of Death CancerofBrainand Other CentrA Nervous System Canceroflbyroidand Other Endomine Glands Cancerof Bone CancerofAU Lymphaticand Hemau)poicti7cU= Lymphoma Hod&n's Diseaw Leukemiaand Alcuk=ia CancerofOtherLymphatic and Malipanthftlanom ofSidn AllOtherMaHpmt Neoplawns
Diabam MCIHW C=brovascularDiseaw AllHe= Diwm .Rypmtcnsion Rmpiratmy DLsem Ul= ofStomachand Duodenum
CirrhosiosfLiver Nephritiasnd Nephrosis Exmmal Causes
Accklents Nkmr VehicleAcddem AllC)d= Accidents
Suicides
Ob=vcd Deaths
1
0
0 2
0. 0 1
'0 0
0 0 7
0 0
1 0 10 9 5 .4 1
ExpecW
Dwhs SMR
0.5
222.6
0.0
0.0
-
1.2 174.0
0.2 0.2 0.4 '0.4
-226.3 249.5
0.3 0.8
0.6
1.3
-
13.1 53.4
0.1
-
1.9
0.1
-
1.6
62.3
0.2
--
10.5 95..0
6.5 139.4
3.6 138.0
2.9 140.2
2.5
40.0
95% Confidence
Intmal (5.6,1,240.3)
(0-0,9,544.3)
(0.0,8,697.5) (21.1,628.7)
(0.0,,2,466.1) (0.0,2,346.1) (5.7..1,260.7) (6.2,1,390.1)
(0.1)1.,200.4) (0-0,455.3)
(0.0,589.0)(0.0,274.4) (21.5,110.1) (0.0,5,834.4) (0-0,195.3) (0.0,3,083.3)
(1.6,347.3) (0.0,2,346.9) (45.6,174.7) (63.7,264.5) (44.8,322.0) (38.2,359.0) (1.0.223.1)
33
Table 19: (Continued)
Observed Expected
Cause ofDeath
Deaths Deaths SMR
Homicides and OtherExt=al
0
1.5
f"'Rllse@q
ResidualCauses*
3
4.7
63.4
Unimown Causest
2
0 aR odw can= of dwh comwwd
t m deoh cmtfimw obminw- incbi&d ady in sH caum of deathcmgmy
95% Confidence
Interval (0-0,247.4)
(13.1.185.3)
T.#,aewae 37 death among men ow amployid inMm
3 (Table20).A
sudsdc&Uy sigwfwantdeficiwtas obswied foran cause ofdeathcombined (SMR m 58.6-,
g.,ai=cb41.3,80.8).Aldwugh
deficitaslsowat seenforheartdisease
(smR = 69.9,9-5% a- 33.5.128-5)a.llc-an= (SMR = 52-9-,95%a=19.4,115.2),
ar.tclxu=d causesof death(SMR 62.9;95% a-34.4,105.5).
34
Table 20: Cause-SpeciricSMRs for Men
Ever EmployeO. In Film Department(s) Using the U.S. as CoiL.@,parlsPoonpulation (n 1,116)
Cause of Death
Obsuved Exrcted Duiths Deaths SMR
95% Confidence
Interval
AU Causes ofDeath AU MalignantNeopla=s
3&
63.1
58.6
(41.3, 80.8)
6
11.3
52.9
(19.4,115.2)
Cancer ofBuccal Cavityand
0
Pharynx
Cancer ofDigestive
1
0.3
-
2.3 .43.1
(0.0,1,248.9) (1.1,240.0)
Organs and Periwnct= Cancer of Esophagus Cancer ofSwmach
0
0.3
-
(0.0.1,465.1)
0
0.4
-
(0.0,1,043.7)
CancerofImp btesum
1
0.8 .120.6
(3.0.672.1)
Cancer Of P.Octum
0
0.2
-
(0.0,2,040.6)
CancerofLwa andBM"
0
0.2
-
(0.0,1,798.6)
Passages
Cancer of Pancreas Cancer of AllC>dw DigestiveOrgans
0
0.5
-
(0.0,767.6)
0
0.1
-
(0.0,4,625.3)
Cancer of RespiratorySystem
2
Cancer ofLarynx
0
3.7
54.1
(6.5,195.4)
0.1
-
(0.0,3,253.4)
Cancer of Bronchus, Trachea,and L=g Cancer ofOther Resph=y Organs
2
3.5
56.9
(6.9,205.4)
0
0.1
(0.0,5,537.8)
Cancer of Prosmte
0
0.2
Cancerof Testesand Other
0
0.2
Male Gemml OM=
Cancer ofKklney
.0
0.3
Cancer ofBladder and Odier
0
0.1
(0.0,1,915.6) (0.0,1,711.8)
.(0.0,1,137.8) (0.0,2,877.2)
UrinaryOrgans
35
Table 20: (Continued)
Cause of Death
Observed Expected Deaths Deaths SMR
95% Confidence
Interval
CancerofBrainand Odw
0
Cena-alNervous System
Cancer ofThyroid and Other
0
Endocrine Glands
Cancer of Bone
0
0.7
0.1
6.1
-
(0-0,531.1) (0.0,6,576.8) (0.0.4,865.3)
Cancer of AU Lymphatic and
1
Mssue
1.7
58.4
(1.5,325.5)
Lymphoma
0
Hodgidn!s Disease
0
L&Wmmia and Akmimmia
0
Cm= ofOdierLymphatic 1
0.2
0.3
0.7
-
0.5
184.9
%0.0,1,785.5) f4f).1O,276.9) (0.0,545.8) (4.6,1,030.0)
and 1-kmiampaiedc7U=
MaHpant MeLmoma ofSidn
1
0.5
191.8
(4.8,1,CS8.9)
AU OtherMaligmmt Neoplasms DiabetesMeMm Cerebrovascul&Disc=
1
1.0 .97.6
(2.4.543.7)
0
0.9
-
(0.0,434.3)
1
1.5
66.3
(1.7, 369.6)
AllHe= Disease
10
14.3
69.9
(33.5,128.5)
Hypmlension P.MkawryDisem Ul= ofStomach and Duodenmn
0
0.1
.0
2.0
(0-0,5,311.6) (0.0,187.3)
0
01.1
-
(0.0,2,826.0)
Cirrhosiosf Uver Nephritisand Nephrosis Ext=al Causes
2
2.3
86.6
(10.5,312.7)
0
0.2
-
(0.0,1,870.8)
14
22.3
62.9
(34.4,105.5)
Accidents
10
Motor VehicleAccWents
4
13.7
73.2
8.0
50.2
(35.1,134.6) (13.7,128.7)
AJIOdterAccidem Suicides
6
5.7
104.6
(38.4,227.6)
2
5.2
38.6 __(4.7, 139.4)
36
Table 20: (Continued)
Cause of E)caffi
Hmkww and OtherExtmnal Causes Residual r-411me BUodw caum ofdeathcombfind
Obscived ExpecW Dmths Deaths
2
3.3
4
7.7
SMR 60.2
.52.0
95% Confidence
lnmmal (7.3.217.6)
(14.2,133.1)
Elevendenth w=t ObsavcdfOrmn ODIYemPlOYedinfilmdep=cnt(s) (Table21).
TwO sMdsd=Uy sinifwantSMRs o=umdd forthissubgmp. lU 0 cam SM wu
41.4m%a=2o.7, 74.o)Ed &e =Mmd cm= SUR wa 37-3 (gs% a m ioz 95-0- Nom@dvmcm-d=eLm 'wm as6n@ fm a can= (smR 46.9-,9:5a% 5.7. 169-5) and lx-.xt&wme (SMR 96.3; 95% a 31.3,224.8).
37
Table 21: Cause-SpeciriScMRs for Men Only Employed in Fii-.Dnepartment(s)
Using the U.S. as ComparisoiiPopulation(n S47)
Cause ofDeath
Observed Erpected Deaths 'Daaths
A.U Causesof Death
26.6
AU MalignantNeoplasms
2
4.3
CancerofBuccal Cavityand
0
0.1
PhwAx
CancerofDigestive Organs and Perimneum
0
0.9
Cancer ofEsophagus CancerOf Stomach
0
0.1
0
0.1
CancerofLargeTnuad
0
0.3
Cancer ofRectum
0
0.1
Caww ofLiverand BiBuy 0'
0.1
Passages
Cancer of P@mcrms CancerofAllOdwr DigestiveOrgans
0
0.2
0
0.0
CancerofResphwM System 0
1.3
CancerofLmynx
0
0.0
CancoefBrronchus, 0
1.2
Trachm and Lung
CancerofOther Respftwmy Organs
0
0.0
SMR 41.4 46.9 -
-
-
7-
95% Confidence
Intmval (20.77,4.0) (5.7,169.5) (0.0.3,497.2).
(0.0,438.8)
(0.0,4,205.1) (0.0.2,802.6) (0.0,1,223.0) (0.0.5.730.7) (0.0.4,808.4)
(0.0,2,170.9) (0.0.11,962.2)
(0.0,294.3) (0.100,,015.1)
(0.0,310.2)
(0.0,13,379.9)
Cancer ofProstate
0
Cancer ofTestesand Other
0
Male GenitalOrgans
CancerofKkbxy
0
CancerofBInd andodur
0
-Vdnary Organs
0.1
-
0.1
-
0.1
-
0.0
-
0.0,7,688.6) (0.0,3,598.5)
(0.0,3,050.4) (0.0,9,158.4)
38
Table 21: (Continued)
Cause of Death CancerofBmn and Other CentralNervous System I Cancer ofThyroid and Other Endocrine Glands Cancer of Bone Cm= ofAU Lymphaticand Hemawpywdcmssw Lymphoma Hod&Ws DLwm Leukemia and Akub=ia CancerofOther Lymphatic and - 1---.-@*i ticlissue Malignanthlelmxxna ofSidn AllOdierMaHpant Neoplasms
DiabetesMeHitus CerebrovascaluDisease AUHeartDiscase Hypemnsion ReVkatmy Disease
Uk:erofStomach and Duodenum CirrhosiosfLiver Nephritisand Nepbrosis Exu=al Causes
Accidents Motor VehicleAccidents
All OtherAccidents Suicides
Obswved Deaths
0
0
0 1
0 0 0 1
1 0
0 0 5 0 0 0
0 0 4 3 1 2 0
ExpecW Deaths
0.3
0.0
0.0 0.7
0.1 0.1 0.3 0.2
0.2 0.4
0.4 0.6 5.2 0.0 0.7 0.1
1.0 0.1 10.7 6.6 3.8 2.7 2.5
SMR
137.1 452.3 427.6' -
96.3 -
37.3 45.8 .26.1 73.3 -
95% Coit-.-idence
Interval (0.0,1,233.1)
(0.0,15,776.9)
(0.0,10,720.6) (3.4,763.8)
(0.0.4,372.5) (0.0,2,863.9) (0-0,1,260.7) (11.3.2.,520.4)
(10.7,2,382.!@) (0.0,920.0)
(0.0.1,056.3) (0.0,642.5) (31.3,224.8) (0.0,14,566.9) (0-0,509.5) (0.0,7,745.3)
(0-0,385.9) (0.0,4,857.8) (10.2,95.6) (9.5, 133.9) (0.7,145.4) (8.9,264.8) (0-0,147.2)
39
Table 21: (Continued)
Observed Expected
Cause of Death
Deaths Deaths
Homicides and Other External 1
1.6
Causes
SMR 60.9
95% Confidence
Interval (1.5,339.6)
Discussion A retrospectivceohortmortalitystudywas conductedof formerand currentemployees who had wodwd atlem one ymr atthe3M PlantinDm=, Ab"m and atleastone day after March 1,1961. V-ml sum was determinedthroughtheand of 1991.
Ulle and femaleemplc)ytesbad I= dm theexpectednumber of&aths fi-omallcauses. For men, thisd=tm w,-,sstadsticalsliygnificanSti.mila rwwts were seenfordw subgroupsof men defuiedby depa=cnt(s) wodcc& For eachof thesubgroups,the overallnumber ofdeath was les.t,h;anexp=te&
Them were a totalof4 death among w(xnen and 3 ofd= ticathwqere due toexternal causesresultinign a nons-.*gnifictawnot-foldincreaseinris]LFxamination of thedeath cerdficattfsorthosewomen withextemalcausesof deathrevealedthattheexcessmormuty was not work-related.
FoUow-upofthecohcxtand ---rninmenotfcausesofdeathfordeceasedcohortn2embers was vhtaallycomplete.V*ml smm was determinedfor1"1 (99.7%)of d2c1,957cohost members. Of the74 d=ascd employees.deathcertif@ were obtainedfor72 (97.3%). Qualitycontrolmeasures w= mplownted thmghout thestudytoensurethemmgnty of thedat& In ad&non, severalcompanson populationswere definedand theresultwse= compared and found tobe similnr.
3M providedtheinformationused toassemblethecohort-Although everycffortwas made toensmr.thatthecohortwas complete,them was no way tD independentlyvaify the completenessof thecohom in an attemptto assesswhetherthecohortwas complete,3M was askedtosupplyym-end countsofemployeesatthe3M Dec= Plantforeachyear duringthesu* period(i.e.1,961 - 1991).raese countsvA= compared tothecountsof employ= waddng atthe3M Dw.,Uw PlantinDecember ofeachyearasde=mined from
40
thestudydatabase.Tlhecountsfrom thestudydatabasewere nearlythesame as,or usually Smater than,thosempm-ted by 3NL
Recomwndation itis mmended thatthemortaliteyxperienceofthisgroupofemployees be updatedin 199& At dw time,theNDI willhavedu& mcordsavaale foran additionafliveyears,
I Analyns withadditionaylearsoffoUow-L-pand deathswould allow ofwhether themortalitpyroffliesconsistenotvertime.
1. Mush GK PzehdW hE OCMAP.- A analysipsrogmm Amer Stat190,34:245.
ledact--upmdwnclohortmor"w
2. Monson RR. Analysu ofrel=ve surwvalandpr%lccaonamlortalityC.omput Biomed Res 1974;7:325-332.
41
ft studydatabase.The countsfrom thestudydatabasewere nearlythesame as,or usually greaterthan,thosereportedby 31VL
Recommendadon
Itisrecommended thatthemortaliteyxperienceofthisgroupof employees be updatedin
1999.At dw time,theNDI willhave deathrecordsavailablfeoran additionafliveyears,
199 . Analyseswithadditionaylearsof fouow-r-pand deathswould allow
C^m
of whether themm-talitpyrofiliesconsistenotvertime.
1. Mush OKPsehdWK
OOAAP.- A
analysipsrogram AinerStat198&,34:245.
O=Upadwjllcohormtortahw
2. Monson RR. Andysis ofrelativseurvivaalndprottcdonalmortalityC.omput Bwmed Res 1974,-7:325-332.
41
Anipendicr.s
Table22: Cause-SpecirSiMcPs forMen
UsingAlabama as ComparisonPopulatio(nn 1,639)
95%
Cai-i ofDeath
Obsw.vd Expected Deaths Deaths SMR
ConELdence interval
AU Causes ofDeath
70
127.7 54.8
(42.76,9.3)
AU MaUpwt Neopla=s
is
24.6 60.9
(34.1,100.4)
Cancerof BuccalCavityand
0
0.6
-
(0.0,649.5)
Pharynx
CancerofDipsdve
1
4.3
23.1
(0.6.128.8)
Organs andPahoncim
Cancer ofEsophagus
0
0.5
-
(0.0,810.9)
Cancerof Su)mach
0
0.6
(0.0.662.4)
CancerofImp bmsum
1
.1.6 63.9
(1.6,355.5)
CencerofPi==
0
0.3
-
(0.0.1,290.0)
Cui= ofIivw andBMM
0
0.5
(0.0, 779.
Passages Cancer ofPancreas CancerofAllOther DigestiveOrgans
0
1.0
0
0.1
(0.0,381.1) (0.0,2,904.8)
CancerofRespkatorySyftm
7
CancerofLmym
0
Cancer ofBron&us,
7
9.9 70.9
(28.5,146.1)
0.2
-
(0.0,1,651.8)
9.5
73.4
(29.5,15'1.3)
Tractma,and Lung Cancer OfOther
0
0.1
-
(0.0,3,160.3)
RespkatoryOrgans
Cancer ofProstate
0
CancerofTes= and Other
0
0.5
-
0.3
-
(0.0,728.3) (0.0,1,309.1)
Male CmnitalOrpm
CancerofKklwy
0
Cancerof Bladderand Other
1
0.6
-
(0.0,657.5)
0.2 419.9 (10.5,2,339.6)
Udnary Orgms
42
Table 22: (Continued)
C)bservedExpecW
Cause ofDeath
Deaths Deaft
Cancer ofBrainand Other
1
1.4
CenaW Nervous System
Cancerofnyroid and Other 0
0.1
EndocrineGlands
Cancer of Bone
0
0.1
Can= ofAilLymphaticand
3
2.9
Hemampoicticl-mm
Lymphoma HodgidWsDisease
0
0.4
0
0.4
LoukmmiaandAlmk=k
1
1.2
CancerofOther Lymphatic. 2
1.0
and. IIi..@-*-ticMssm
Malign=Mcbnoma ofSidn 1
1,1
AHOderMaHgn= Neoplasms
1
2.6
DiabetesMCM=
0
1.4
CerebrovasculuDiwm
1
3.6
AllHe= Disease
17
32.0
Hypemnsion
0
0.2
RcsphatmyDisem
0... 4.6
Ul= ofStmach and Duodenum
0
0.3
Cin-hosiosfLiver
3
-3.4
Nephritisand Nepbrosis
0
0.4
Extmmal Causes
25
42.4
Accidents
19
28.2
Motor VehicleAccidents
9
17.1
AllOtherAccidem
10
11.2
Suicides
4
7.8
SMR 70.7
--
104.4
84.6 2o8.7
95.2 38.9
27.8 (537.@:)
-
88.9 59.0
52.7 89.3 51.3
95% Confidence
Interval (1.8.393.8)
(0.0.3,017.6)
(0.0,3,406.6) (21.59'305.0)
(0.0,987.9) (0.0,1,018.5) (2.1,471.6) (25.3,.754.0).
(2.4.530.3) (1.0.216.7)
(0.0.259.0) (0.7,155.2) (31.0,85.1) (0.0.2,007.5) (0.0,80.2) (0.0,1Z6.6)
(18.3,259.7) (0.0.917.2) (38.2,87.1) (40.5,io5.1) (24.1,100.0) (42-8.164.2) (14.0,131.5)
43
Table 22: (Continued)
Observed Expected
Cause ofDeath
Deaths Deaths SMR
icitiaensd Odw Exterad 2
6.1
32.6
causes Reddual Causes*
7
13.8 50.6
UWmown Cauwst
2
aRothwc@ ofdeadicombimd
nodm* mffmo obtdo4 bcb*d ady inanam= ofdea*MOM
95% Confidence
interval (3.9,117.9)
(20.3,104.2)
Table 23: Cause-SpeciriScNM for Women
Using Alabama as Comparison Population(n 318)
Cause ofDeath
ObservedExpected Deaths Deaths SMR
95% Confidence
Interval
AU Cats:sofDeath AU Maligam Neopk=s CatbrovasculwDisc= AII.HanDiwAm Ropirarxy Disease
4
6.7
59.9
(16.3.153.4)
0
2.3
-
(0.0.162.5)
1
0.3 357.1
(8.9111989.6)
0
1.0
(0.0,372.0)
0
0.3
(0.0.1,391.2)
Examal Cailses
3
Acckkmts
2
M4%w VehicleAccidents
2
A.1O;dwr Accidents
0
Suiddes
0
HomiciWAdIeOsdiEaxtmd 1
Can=
1.7 179.5
1.1 185.8
0.8 251.1
0.3
-
0.3
-
0.3 392.8
(37.0.524.7) (22.5,671.2) (30.4,907.2) (0.0,1,323.4). (0.101.096.1) (9.8,2,188.8).
45
",.I
Table 24: Cause-SpecificSMRs for Men
Using the Alabama Counties as_Comparison Population (n 1,639)
95%
Cause of Death All Causes ofDeath AIIAWpmt Neopla=s
Cancer ofBuccal Cavityand Pharynx
Ob=vod Deaths 70 15 0
E%Wcted Deaths 134.7 25.1
0.5
SMR 52.0 59.9 -
Confidence Intmal
(40.5.65.7) (33.5,98.8) (0-0,822.6)
Can ofDigestive Orpns and Peritanom
1
4.2
23.7
(0.6,132.3)
Cancer ofEsophaps
0
Cancer of Sunnach
0
CancerofLarge kestm
1
Cancer of Rectum
0
Can= ofIiva andBffiuy 0
Passages
0.4
-
0.5
-
1.5
64.8
0.3
-
0.5
(0.0.1,048.0) (0.0.679.5) (1.6. 361.3) (0.0,1,491.0) (0-0,721.6)
Cancer of Pancreas CancerofAllOther DigestiveOrgans
0
1.0
(0.0,374.gy
0
0.1
-
(0.0,2,730.1)
Cancer'ofRespiratorySystem
7
Cancer OfLarynx 1
0
Cancer ofBronchus,
7
T=hm and Lung
10.2 69.0
0.2
-
9.8
71.3
(27.7, 142.1) (0.0,1,623.4) (28.7,146.9)
Can= ofOther RespirawryOrgm
0
0.1
-
(0.0,3,491.0)
CancerofProsmm
0
0.5
Cancer of Tesms and Other
0
0.3
Male GenitaOlrpns
(0-0,711.6) (0.0.1,409.3)
Cancer ofKidney
0
Ca ofBladderand Other
1
UrinaryOM=
0.6
-
(0.0,671.1)
0.3
358.7
(9.0,1,998.9)
46
Table 24: (Continue-d)
Cause of Death Cancer of Brainand Other Cena-dNlervousSys= CanceroflbyroidandOther Endoaine Glands Can= ofBobe CancerofAllLymphatic and
Observed EVected
Deaths Deaths
1
1.3
0
0.1
0
0.1
3
2.9
SMR 78.0
--
102.8
Lymphoma
0
Hodgides Disc=
0
Izulmmia and Aleukmnia
1
Ca of OtherLymphatic 2
and
7LSM
MaHpmt Mcknoma of SUn
1
AllOder Mafigaant
1
Neoplasms
DiabetesMenitus
0
CcmbmvascularDimm
1
AllHe= Dim=
17.
HypmimWon
0
unwry Disem
0
Uk:crofSt=ach and
0
Duodenum
CSrrhosiosf Uver
3
Nephntis and Nephrosis
0
Ex=ng Causes
25
Accidem
19
Motor VeWde Acd&nts
9
AJIOdierAccidem
10
Suicides
4
0.3 0.4 1.2 1.0
1.0 3.0
1.3 3.8 34.6 0.1 5.0 0.3
3.2 0.4 45.4 31.2 19.4 11.9 7.5
81.6 195.5
100.4 33.0
26.5 49.1 -
92.8 55.0 60.9 46.5 84.2 53.3
95% Coatdence
Interval (2.0,434.7)
(0.0,2,981.2)
(0.0,2,711.5) (21-2.300.5)
(0.0,1,194.5) (0.0,.'#,021.6) (2.0,454.9) (23.7.706.1)
(2.5,559.5) (0.8,183.9)
(0.0,275.4) (0.7,147.5). (28.6,78.6) (0.0.2,762.4) (0.0,73.9) (0.0,1,212.4)
(19.2,271.3) (0.0,925.1) (35.6,81.3)' (36.7,95.1) (21.2,88.2) (40.4,154.8) (14.5,-136.5)
47
Table24: (Continued)
Cause ofDeath Homicidesand OtherExtmiW
Causes ResidualCauses* Unknown Causest ataR odw emna of death combined t no death cutdcam abuinect inchwed
Obsuved Expwtod
Deaths Deaths
2
6.5
7
14.4
2
ady in aU causes of death cmm
SMR 30.9
48.7
95% Confidence
Intmal (3.7,111.8)
(19.6,100.4)
Tabl-.2-5: Caun-Spedfle ShM forWomen Using Alabama Coundes as C2=arlson Population(n 318)
Cmil ofDeath
Observed'EVected Deaths SMR
95% Cznfd=m
lnmrval
AllCausesofDeath
-4
6.8
58.6
(16.0.150.1)
An Maligna@tNoqgasms CerebrovascdwDisem ABHeartDiscam
Disease Extmnd Causes
Accklents
0
2'3
-
(0.0.162.4)
1
0.3 320.2 (8.0,1,784.0)
0
1.1
-
(0.0.343.9)
0
0.3
-
(0.0,1,381.0)
3
1.7
172.1
(35.5,502.9)
2
1.2
173.1
(20.9,625.3)
Momr Vehide Acddents
2
AllOtherAcddents
0
Suicides
0
HomicidesandOtherExt=d
1
Causes
0.9 230.5
0.3
-
0.3.
-
0.3 382.1
(Z7.9.832.6) (0.0,1,289.2) (0.0,1,142.5) (9.6,2,129.3)
48