Asbestos disease in sheet metal workers: proportional mortality update

Our plain-English summary of Asbestos disease in sheet metal workers: proportional mortality update, by D. Michaels, S. Zoloth (American Journal of Industrial Medicine, 1988).

The study

• Authors: D. Michaels, S. Zoloth
• Journal: American Journal of Industrial Medicine
• Published: 1988;13(6):731-4
• Cited by: 19 articles, as counted by NIH iCite
• Read it: PubMed · Publisher
• In J-M's library: Johns-Manville's company medical library held a copy (J-M no. 000255).

Abstract

This paper, updating the findings of an earlier study, provides additional evidence that sheet metal workers in the construction trades are at increased risk for asbestos-related disease. A proportional analysis of cause of death among 331 New York sheet metal workers found a significantly elevated PMR for lung cancer (PMR = 186). In addition, there were six deaths attributable to mesothelioma (three classified as lung cancer deaths) and three death certificates mentioned asbestosis or pulmonary fibrosis, although none of these three deaths were attributed to these diseases.

In plain English

This brief communication updated the authors' earlier proportional mortality study of New York sheet metal workers. They examined death certificates for 331 white male members of Local 28 of the Sheet Metal Workers International Association whose deaths were reported to the union benefit fund between January 1983 and October 1986. Deaths already counted in the first study were excluded. A proportional mortality ratio (PMR) compares the share of deaths from a cause with the share expected from the United States population; 100 means as expected. All cancers combined (PMR 148) and cancers of the stomach (259), liver (260), lung (186) and other lymphatic tissue (252) were significantly elevated. A colon cancer excess (149) was not statistically significant. Six deaths were caused by mesothelioma. Three were pleural and were counted as lung cancer, and three had no site specified. A seventh certificate listed suspected mesothelioma. Three certificates mentioned asbestosis or pulmonary fibrosis, but none gave these as the cause of death. The article reported no fiber types or exposure measurements. The authors concluded that the findings strongly support increased asbestos-related mortality risk in sheet metal workers. They noted that PMR analyses have known limitations.

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: Proportional mortality analysis of death certificates (brief communication updating an earlier study)
• Who was studied: 331 white male sheet metal workers, members of Local 28 of the Sheet Metal Workers International Association (New York metropolitan area), whose deaths were reported to the benefit fund between January 1983 and October 1986. Deaths in the initial study, women and non-whites were excluded.
• Exposure: Work as sheet metal workers in the construction trades. Asbestos exposure was inferred from documented exposure patterns in the trade. No fiber types, products or doses were reported.
• Main results:
  • Lung cancer PMR was 186, statistically significant (95% confidence interval 143 to 243 in the table).
  • Other statistically significant elevated PMRs: all malignant neoplasms 148, stomach cancer 259, liver cancer 260, cancer of other lymphatic tissue 252.
  • Colon cancer showed a non-significant excess (PMR 149).
  • Six deaths were caused by mesothelioma, plus a seventh certificate listing suspected mesothelioma. Three were pleural and three had no primary site specified.
  • The three pleural mesotheliomas were counted among lung cancer deaths. The authors stated that reclassifying them would not materially alter the lung cancer excess.
  • Three death certificates mentioned asbestosis or pulmonary fibrosis, but none attributed death to these diseases.
  • Mesothelioma accounted for 1.8% of deaths in this study (6 of 331), compared with 0.8% (3 of 385) in the authors' previous study.
• The authors' conclusion: The authors concluded that the elevated lung cancer PMR and the mesothelioma cases strongly support the contention that sheet metal workers are at increased risk of mortality from asbestos-related disease.
• Limitations the authors state:
  • The authors acknowledged that PMR analyses have well-known limitations.
  • No PMRs could be calculated for mesothelioma or asbestosis, because the U.S. mortality rate is too low to generate meaningful expected numbers.

Topics

The National Library of Medicine indexes this study under subjects our site covers: Lung cancer, Mesothelioma.

Medical terms in this study, explained in our Lexicon: Proportional mortality, Lung Cancer, Mesothelioma, Death Certificate, Pulmonary Fibrosis.

Related studies

• Asbestos-related disease among sheet-metal workers. Preliminary results of the National Sheet Metal Worker Asbestos Disease Screening Program — L.S. Welch, D. Michaels, et al. (1991)
• Change in prevalence of asbestos-related disease among sheet metal workers 1986 to 2004 — L.S. Welch, E. Haile, et al. (2007)
• Cancer risks among iron and steel workers in Anshan, China, Part I: Proportional mortality ratio analysis — Z. Xu, G.W. Pan, et al. (1996)
• Mortality among sheet metal workers participating in a respiratory screening program — L. Welch, J. Dement, et al. (2015)
• Asbestos-related disease among sheet metal workers 1986-2004: radiographic changes over time — L.S. Welch, E. Haile (2009)
• A mortality study of a research, engineering, and metal fabrication facility in western New York State — M.J. Teta, M.G. Ott (1988)

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