Lung cancer mortality in the United States: shipyard correlations

Our plain-English summary of Lung cancer mortality in the United States: shipyard correlations, by W.J. Blot, J.F. Fraumeni (Annals of the New York Academy of Sciences, 1979).

The study

• Authors: W.J. Blot, J.F. Fraumeni
• Journal: Annals of the New York Academy of Sciences
• Published: 1979;330:313-5
• Cited by: 3 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. 004022).

In plain English

This short 1979 article was a review in which the authors described their own earlier research on lung cancer death rates in U.S. counties. Maps of 1950-69 death rates showed that lung cancer among white males was highest in coastal areas of the South. Rates tended to be somewhat higher in counties with chemical, petroleum, paper and transportation manufacturing. In the 49 counties with major World War II shipyards, respiratory cancer rates were consistently high, particularly in the South. The authors then summarized a coastal Georgia case-control interview study of about 1100 males, about 500 of them with lung cancer. In that study, wartime shipyard work had an overall relative risk of 1.6, adjusted for age, race, other occupations and smoking, and the excess was greatest among heavy smokers. Information on asbestos exposure was scanty, and excesses appeared across many shipyard trades. The authors raised the possibility that wartime asbestos exposure may be related to the coastal excess. They noted that mapping studies raise questions rather than answer them, and they described further studies under way.

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: Review of the authors' own geographic mapping, county correlation, death certificate and case-control studies of lung cancer, with a description of field studies under way
• Who was studied: U.S. county lung cancer death rates for 1950-69, mainly among white males; the 49 counties with major World War II shipyards; and residents of coastal Georgia (about 1700 death certificates and about 1100 interviewed males, about 500 with lung cancer diagnosed between 1970 and 1976)
• Exposure: Shipyard employment during World War II (with asbestos as a possible agent); county-level industrial activity; cigarette smoking
• Main results:
  • In the reviewed mapping of 1950-69 county death rates, the highest lung cancer mortality among white males clustered in coastal areas of the South
  • In the reviewed county correlation study, lung cancer mortality tended to be higher in counties with chemical, petroleum, paper and transportation manufacturing; the elevations were small, were not accounted for by urbanization or other demographic factors, and were mainly in males
  • In the reviewed study of the 49 counties with major World War II shipyards, nearly all southern shipyard counties had high rates for cancers of the lung and larynx; oral cavity, esophagus and stomach cancer rates also tended to be high
  • In the reviewed coastal Georgia death certificate study (about 1700 certificates), more lung cancer cases than controls had worked in the construction industry, and few certificates listed shipbuilding as the usual occupation
  • In the reviewed Georgia case-control interview study, over 20% of the lung cancer subjects reported shipbuilding work, almost all for just a few years during the war; the overall relative risk for this employment was 1.6, adjusted for age, race, other occupations and smoking history
  • In the Georgia case-control study, a strong synergism was seen between shipyard employment and cigarette smoking level, with the greatest excess among heavy smokers
  • Of about 180 people in the Georgia study who reported shipyard work, only one was listed as an insulator; excess risks were seen across a variety of trades, not just those likely to have heavy asbestos exposure
• The authors' conclusion: The authors wrote that the pattern of cancers affecting the airways and upper digestive tract in shipyard counties raises the possibility that wartime asbestos exposure may be related to the coastal excess of respiratory cancer. They said further studies in Virginia, Maine and Louisiana should help evaluate the contribution of shipyard exposures.
• Limitations the authors state:
  • The mapping and correlation studies raise questions about the causes of cancer rather than answer them
  • Data on possible asbestos exposure in the Georgia study were scanty, and few people reported handling asbestos
  • In Georgia, subjects or their next of kin had to recall events from 30 or more years earlier
  • Data from the Virginia case-control study were not yet available

Topics

The National Library of Medicine indexes this study under subjects our site covers: Lung cancer, Shipyards and maritime work.

Medical terms in this study, explained in our Lexicon: Lung Cancer.

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)
• Asbestos disease in United States shipyards — I.J. Selikoff, R. Lilis, et al. (1979)
• Asbestos-associated disease in United States shipyards — I.J. Selikoff, E.C. Hammond (1978)
• Asbestotic radiological abnormalities among United States merchant marine seamen — I.J. Selikoff, R. Lilis, et al. (1990)
• Cancer mortality in U.S. counties with shipyard industries during World War II — W.J. Blot, B.J. Stone, et al. (1979)
• Asbestos related abnormalities among United States merchant marine seamen — P.J. Barrett (1990)

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