A proportionate mortality study of bricklayers and allied craftworkers

Our plain-English summary of A proportionate mortality study of bricklayers and allied craftworkers, by J. Salg, T. Alterman (American Journal of Industrial Medicine, 2005).

The study

• Authors: J. Salg, T. Alterman
• Journal: American Journal of Industrial Medicine
• Published: 2005;47(1):10-9
• Cited by: 8 articles, as counted by NIH iCite
• Read it: PubMed · Publisher

Abstract

Background: Mortality among members of the International Union of Bricklayers and Allied Craftworkers (IUBAC) is examined. Bricklayers and allied craft workers may be exposed to cobalt, epoxy resins, pitch, lime, and to lung carcinogens such as asbestos, silica, and nickel.

Methods: Proportionate mortality ratios (PMRs) were computed using US age-, gender-, and race-specific mortality rates for members who died during 1986-1991.

Results: Statistically significant PMRs among white men were found for cancers of the esophagus (PMR=134), stomach (PMR=131), respiratory system, trachea, bronchus, and lung (PMR=144), other parts of the respiratory system (PMR=216), other and unspecified sites (PMR=125). Elevated PMRs were also found for other diseases of the blood and blood forming organs (PMR=201), emphysema (PMR=133) and for asbestosis (PMR=554), and other respiratory diseases (PMR=119).

Conclusions: Results are consistent with those found in previous studies, and suggest the need for intervention activities directed at the prevention of these cancers, and other respiratory diseases.

Copyright (c) 2004 Wiley-Liss, Inc.

In plain English

This proportionate mortality study covered members of the International Union of Bricklayers and Allied Craftworkers who died in the US from 1986 through 1991. It compared each cause's share of deaths with the share expected from US rates; a ratio (PMR) above 100 means a larger share. Exposures were not measured. The analysis covered 9,845 white men and 538 non-white men. Among white men, asbestosis deaths were elevated (13 deaths, PMR 554, 95% confidence interval 295 to 947). So were cancers of the trachea, bronchus and lung (PMR 144, interval 136 to 153), esophagus (PMR 134, 106 to 167) and stomach (PMR 131, 106 to 160). Mesothelioma appeared as an underlying or contributing cause on 52 white men's death certificates, 33 of them bricklayers or brick masons; no ratio was calculated for it. Silicosis was elevated (4 deaths, PMR 322), but its interval, 88 to 824, included 100. No cause was significantly elevated among non-white men. The authors had no smoking data. They concluded construction work may be associated with increased risk of malignant diseases, especially malignant and non-malignant respiratory diseases.

We wrote this plain-English summary from the full article with the help of AI, and a second AI model checked each sentence against the article. It is not the authors' wording; the abstract and the article are their own account.

What the study did and found

• Design: Proportionate mortality ratio (PMR) study based on union death records and death certificates, compared with US age-, gender- and race-specific mortality
• Who was studied: Members of the International Union of Bricklayers and Allied Craftworkers (IUBAC) who died in the US between January 1, 1986 and December 31, 1991. The computer file held 10,921 deaths. 480 deaths outside the US were excluded, death certificates could not be found for 55, and 3 white women were excluded. The analyzed groups were 9,845 white men and 538 non-white men, which totals 10,383. The Results text gives 10,386.
• Exposure: Union membership in bricklaying and allied trades: bricklayers; cement, stone and marble masons; mosaic workers; plasterers; tile layers; terrazzo workers; pointers. Exposures were not measured. The authors list potential exposures including asbestos, silica, nickel, cobalt, epoxy resins, pitch and lime. 93% of white men and 84% of non-white men had more than 20 years of union membership.
• Main results:
  • White men: asbestosis deaths were significantly elevated (13 deaths, PMR 554, 95% CI 295 to 947).
  • White men: cancer of the trachea, bronchus and lung was significantly elevated (1,186 deaths, PMR 144, 95% CI 136 to 153).
  • White men: esophageal cancer (PMR 134, CI 106 to 167) and stomach cancer (PMR 131, CI 106 to 160) were significantly elevated.
  • White men: emphysema was significantly elevated (PMR 133). So were other diseases of the blood and blood forming organs (PMR 201, CI 134 to 288).
  • Mesothelioma was listed as an underlying or contributory cause of death on 52 of the 9,845 white men's death certificates. No PMR was given for mesothelioma.
  • Of the 52 white men with mesothelioma listed, 33 were brick masons or bricklayers, 4 tile setters, 1 stone mason and 1 plasterer. The other 13 were listed as supervisors, foremen, owners, maintenance, engineers or missing. There were no mesothelioma deaths among non-white men.
  • White men: there were 4 silicosis deaths (PMR 322). The confidence interval (88 to 824) included 100, so this was not statistically significant.
  • Non-white men (538 deaths): no cause of death had a significantly elevated PMR.
• The authors' conclusion: The authors concluded that the study supports the hypothesis that construction work may be associated with an increased risk of malignant diseases, especially malignant and non-malignant respiratory diseases. They added that the results direct attention again to investigating and controlling occupational asbestos exposure.
• Limitations the authors state:
  • There was no information on cigarette smoking, alcohol use or other non-occupational factors.
  • In a PMR study each cause's ratio depends on the others: a high ratio for a common cause artificially lowers the others, and vice versa.
  • A mortality study cannot detect increased risk of non-fatal diseases.
  • Multiple significance testing may produce chance associations.
  • Numbers of non-white deaths were too small to detect elevated risks.
  • There were no records for members who had left the union, which is why a PMR design was used.

Topics

Medical terms in this study, explained in our Lexicon: Bronchus, Emphysema.

Related studies

• Proportionate mortality among construction laborers — F. Stern, P. Schulte, et al. (1995)
• Proportionate mortality study of the United Association of Journeymen and Apprentices of the Plumbing and Pipe Fitting Industry — E.J. Lehman, M.J. Hein, et al. (2008)
• Proportionate mortality among unionized roofers and waterproofers — F.B. Stern, A.M. Ruder, et al. (2000)
• Proportionate mortality among unionized construction ironworkers — F.B. Stern, M.H. Sweeney, et al. (1997)
• Mortality patterns among electrical workers employed in the U.S. construction industry, 1982-1987 — C.F. Robinson, M. Petersen, et al. (1999)
• Proportionate mortality among US shoeworkers, 1966-1977 — P. Decouflé, J. Walrath (1983)

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