Cancer mortality in U.S. counties with shipyard industries during World War II

Our plain-English summary of Cancer mortality in U.S. counties with shipyard industries during World War II, by W.J. Blot, B.J. Stone, J.F. Fraumeni, et al (Environmental Research, 1979).

The study

• Authors: W.J. Blot, B.J. Stone, J.F. Fraumeni, L.E. Morris
• Journal: Environmental Research
• Published: 1979;18(2):281-90
• Cited by: 27 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. 001014).

Abstract

Respiratory cancer mortality, 1950-1969, was consistently high in U.S. counties where shipyards were engaged in the construction and repair of large naval and cargo vessels during World War II. Over three-fourths of the shipyard counties had elevated rates (in comparison to rates in counties of similar population size in the same region of the country) for lung and laryngeal cancer among white males, with the excess particularly evident in the South. Mortality from lung cancer was high also among white females, and the rate of increase in both sexes was greater than recorded nationally. In addition, rates for oropharyngeal, esophageal, and gastric cancers tended to be elevated in the shipyard counties, but mortality from other tumors was roughly comparable to national levels. A causal relation to asbestos exposures in shipyards cannot be inferred from this correlational analysis, but the unusual mortality patterns underscore the need for broadly based analytic studies to evaluate the risk of cancer in persons with wartime shipyard employment.

PubMed has no abstract for this study. This is the authors' abstract, copied from the article.

In plain English

The authors compared cancer death rates for 1950 to 1969 among white residents of 49 U.S. counties that had large shipyards during World War II. The study compared whole counties, not individual people, and did not measure anyone's asbestos exposure. Each shipyard county was compared with counties of the same region and population size, and the shipyard counties combined were compared with 80 large urban counties without major wartime shipbuilding. For white males, 76% of shipyard counties had higher lung cancer death rates and 76% had higher laryngeal cancer death rates than comparison counties. The excess was most consistent in the South, and lung cancer in the North Central region was the one exception. Among white females, 80% of shipyard counties had higher lung cancer rates. Lung cancer rates rose faster in most groups of shipyard counties than nationally. Mouth and throat, esophageal and stomach cancers also tended to be higher. Other cancers were roughly comparable. The authors stated that a causal link to shipyard asbestos cannot be inferred from this kind of analysis, and they called for studies of shipyard workers themselves.

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: Correlational (ecological) analysis of county-level cancer death rates; no data on individual people
• Who was studied: White residents of 49 U.S. counties with shipyards able to build or repair 2000-ton ships during World War II, cancer deaths 1950 to 1969. Comparisons were with counties of the same region and population size, and with 80 urban control counties (populations over 250,000) without major wartime shipbuilding.
• Exposure: Residence in a county with large World War II shipyards. The authors note that wartime shipyard workers were potentially exposed to asbestos used as insulation. No fiber types were named and no exposure was measured.
• Main results:
  • Lung cancer death rates among white males in most shipyard counties were higher than the U.S. rate of 38.0 deaths per year per 100,000 and the rate of 42.0 in the 80 urban control counties.
  • For lung cancer among white males, nearly all shipyard counties in the South had higher rates than southern counties of similar population size. Elevated rates were also seen in other regions except the North Central states.
  • For laryngeal cancer among white males, 76% of shipyard counties had higher rates than counties of the same region and population size.
  • In the authors' discussion, death rates from lung and laryngeal cancer tended to be high in shipyard counties outside the South as well. The one exception was lung cancer in the North Central region.
  • For lung cancer among white females, 80% of shipyard counties had rates higher than regional rates for counties of similar population size.
  • Among white males, the rise in lung cancer death rates in five of six regional groups of shipyard counties was greater than the rise nationally or in the urban control counties.
  • Among white males in Sagadahoc County, Maine (the county with the highest ratio of wartime shipyard workers to population), lung cancer death rates rose to the top 12, 11, 8, and 4% of all U.S. counties in successive 5-year periods from 1950 to 1969.
  • Nasal cavity and sinus cancer did not show a consistent excess in shipyard counties, though rates were substantially elevated in a few southern counties. No upward trends were seen for laryngeal or nasal cancer.
  • Among white males, the share of the 49 shipyard counties with elevated death rates was 71% for oropharyngeal cancer, 67% for esophageal cancer and 57% for stomach cancer.
  • Death rates from other cancers were roughly comparable between the combined shipyard counties and the urban control counties.
• The authors' conclusion: The authors concluded that a causal relation to shipyard asbestos exposure cannot be inferred from this correlational analysis. They wrote that the pattern of tumors suggested that shipyard asbestos exposures have contributed to the clustering of cancer deaths in coastal areas, and they called for case-control and cohort studies of shipyard workers, including those exposed during World War II.
• Limitations the authors state:
  • Correlations based on whole-population data give crude estimates that must be interpreted with caution.
  • There was no information on the people who died, including their occupations, residence, smoking habits or other characteristics.
  • Only fatal cancers were counted.
  • The movements of wartime workers after the war are unknown. Only anecdotal evidence indicates that former shipyard workers are more concentrated in the shipyard counties.

Topics

Medical terms in this study, explained in our Lexicon: Laryngeal Cancer, Lung Cancer, Stomach Cancer, Asbestos Exposure.

Related studies

• Recent geographic patterns of lung cancer and mesothelioma mortality rates in 49 shipyard counties in the United States, 1970-94 — A. Jemal, D. Grauman, et al. (2000)
• Lung cancer mortality in the United States: shipyard correlations — W.J. Blot, J.F. Fraumeni (1979)
• A historical cohort mortality study among shipyard workers in Genoa, Italy — R. Puntoni, F. Merlo, et al. (2001)
• Enduring health effects of asbestos use in Belgian industries: a record-linked cohort study of cause-specific mortality (2001-2009) — L. Van den Borre, P. Deboosere (2015)
• Mortality among shipyard workers in Genoa, Italy — R. Puntoni, M. Vercelli, et al. (1979)
• Historical perspective on asbestos: policies and protective measures in World War II shipbuilding — J.K. Corn, J. Starr (1987)

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