Mortality among unionized construction plasterers and cement masons

Our plain-English summary of Mortality among unionized construction plasterers and cement masons, by F. Stern, E. Lehman, A. Ruder (American Journal of Industrial Medicine, 2001).

The study

• Authors: F. Stern, E. Lehman, A. Ruder
• Journal: American Journal of Industrial Medicine
• Published: 2001;39(4):373-88
• Cited by: 25 articles, as counted by NIH iCite
• Read it: PubMed · Publisher

Abstract

Background: Plasterers perform a variety of duties including interior and exterior plastering of drywall, cement, stucco, and stone imitation; the preparation, installation, and repair of all interior and exterior insulation systems; and the fireproofing of steel beams and columns. Some of the current potential toxic exposures among plasterers include plaster of Paris, silica, fiberglass, talc, and 1,1,1-trichloroethylene; asbestos had been used by the plasterers in the past. Cement masons, on the other hand, are involved in concrete construction of buildings, bridges, curbs and gutters, sidewalks, highways, streets and roads, floors and pavements and the finishing of same, when necessary, by sandblasting or any other method. Exposures include cement dust, silica, asphalt, and various solvents.

Methods: Proportionate mortality ratios (PMRs) and proportionate cancer mortality ratios (PCMRs) were calculated for 99 causes of death among 12,873 members of the Operative Plasterers' and Cement Masons' International Association who died between 1972 and 1996 using United States age-, race-, and calender-specific death rates. Statistical significance (P value) of results was based upon the Poisson distribution.

Results: Among plasterers, statistically significant elevated mortality was observed for asbestosis, where the PMR reached 1,657 (P < 0.01) with eleven observed deaths and less than one death expected, for lung cancer (PCMR = 124, P < 0.01), and for benign neoplasms (PMR = 210, P < 0.05). Among cement masons, statistically significant elevated mortality was observed for cancer of the stomach (PCMR = 133, P < 0.01), benign neoplasms (PMR = 132, P < 0.01), and poisonings (PMR = 159, P < 0.05). Except for poisonings, which were not thought to be occupationally related, all of the statistically significant results occurred among those members who entered the union prior to 1950. However, the risk for lung cancer among plasterers was still elevated among those entering the union after 1970 as was the risk for stomach cancer among cement masons who entered the union after 1950.

Conclusions: The present study suggests that plasterers and cement masons still have elevated risks for certain diseases, especially lung and stomach cancer. Therefore, union members currently living should be screened for asbestos-related diseases and educated about the future risks for these diseases.

In plain English

This was a proportionate mortality study by researchers at the National Institute for Occupational Safety and Health. It compared the causes of death of 12,873 deceased male members of the Operative Plasterers' and Cement Masons' International Association with the pattern of deaths among U.S. men. The members died in the United States from 1972 to 1996, excluding 1981 to 1983. The authors noted that plasterers had used asbestos in spackling compound until about the late 1960s. Individual exposure was not measured. Among the 4,386 plasterers, there were 11 asbestosis deaths where less than one was expected (proportionate mortality ratio 1,657). Their proportionate cancer mortality ratio for lung cancer was 124, meaning 24% higher than expected. The asbestosis excess was statistically significant only among members who joined before 1950. A manual review of 9,449 death certificates found 40 mesothelioma deaths, half of them among plasterers. No expected rates were available to compare these with. Among cement masons, stomach cancer was 33% higher than expected among cancer deaths. Smoking data were not available. The authors suggested that asbestos exposure may have contributed to the elevated lung cancer risk.

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) and proportionate cancer mortality ratio (PCMR) study based on union death records, compared with U.S. male death rates
• Who was studied: 12,873 deceased male members of the Operative Plasterers' and Cement Masons' International Association who died in the United States between 1972 and 1996, excluding 1981 to 1983. They were 7,811 cement masons (61%), 4,386 plasterers (34%) and 676 shophands (5%). 11,442 were white and 1,431 nonwhite.
• Exposure: Work as a plasterer, cement mason or shophand, analysed by trade and by time period of entry into the union. Exposure was not measured individually. The authors state that plasterers had used asbestos in spackling compound until about the late 1960s, and that cement masons were potentially exposed to cement dust, silica, talc, asphalt and solvents.
• Main results:
  • Plasterers: 11 asbestosis deaths observed with less than one expected, PMR 1,657 (P less than 0.01).
  • Whole cohort: asbestosis was statistically significantly elevated only among members who entered the union before 1950 (13 observed, 1.24 expected, PMR 1,050). There were two asbestosis deaths among those entering from 1950 to 1969 and none among those entering after 1969.
  • Plasterers: lung cancer (trachea, bronchus and lung) PCMR was 124 (P less than 0.01), 24% higher than expected, based on 486 deaths.
  • Lung cancer PCMRs were elevated in all entry periods for both plasterers and cement masons. Only plasterers who joined by 1940 had a statistically significant result.
  • Whole cohort: only 4 deaths were coded as mesothelioma (PMR 188, not statistically significant).
  • A manual review of 9,449 death certificates found 40 mesothelioma deaths: 24 not specified as to site, 7 pleural mesothelioma or pleural cancer, and 9 of the lung. Half were plasterers, although plasterers were about one-third of the cohort. The average age at death was 71. No expected rates were available for comparison.
  • Cement masons: stomach cancer PCMR was 133 (P less than 0.01), based on 110 deaths. By entry period, the stomach cancer PCMR excess ranged from 10% to 53%, but none of these results was statistically significant.
• The authors' conclusion: The authors suggested that asbestos exposure may have contributed to the elevated lung cancer risk. They concluded that plasterers and cement masons still have elevated risks for certain diseases, especially lung and stomach cancer. They recommended that living members be screened for asbestos-related diseases.
• Limitations the authors state:
  • No smoking history was available for union members.
  • Union records could not separate active employment from union membership, so analyses by duration of employment were not possible.
  • Deaths from 1981 to 1983 were missing.
  • In a PMR study, the ratio for each cause depends on the ratios for other causes, for example on a deficit in heart disease deaths.
  • The authors list further limitations: no individual work histories, work processes or materials; loss of short-term workers from the study; and inaccuracies in cause of death on death certificates.
  • Mesothelioma was undercounted by standard death coding: only 4 of the 40 deaths found on manual review were coded as mesothelioma.

Topics

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

Medical terms in this study, explained in our Lexicon: Talc, Statistical Significance, Lung Cancer, Neoplasm, Stomach Cancer.

Related studies

• 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)
• Proportionate mortality among construction laborers — F. Stern, P. Schulte, et al. (1995)
• Occupational exposures and risk of esophageal and gastric cardia cancers among male Swedish construction workers — C. Jansson, A.L. Johansson, et al. (2005)
• Mortality patterns among electrical workers employed in the U.S. construction industry, 1982-1987 — C.F. Robinson, M. Petersen, et al. (1999)
• Airborne exposures and risk of gastric cancer: a prospective cohort study — K. Sjödahl, C. Jansson, et al. (2007)

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