A cohort mortality study of lead-exposed workers in the USA, Finland and the UK

K. Steenland, V. Barry, A. Anttila, M. Sallmen, D. McElvenny, A. C. Todd, K. Straif

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OBJECTIVES: To investigate further whether inorganic lead is a carcinogen among adults, or associated with increased blood pressure and kidney damage, via a large mortality study. METHODS: We conducted internal analyses via Cox regression of mortality in three cohorts of lead-exposed workers with blood lead (BL) data (USA, Finland, UK), including over 88 000 workers and over 14 000 deaths. Our exposure metric was maximum BL. We also conducted external analyses using country-specific background rates. RESULTS: The combined cohort had a median BL of 26 microg/dL, a mean first-year BL test of 1990 and was 96% male. Fifty per cent had more than one BL test (mean 7). Significant (p40 microg/dL; for bladder, lung and larynx cancer; and for COPD. In a small subsample of the US cohort (n=115) who were interviewed, we found no association between smoking and BL. CONCLUSIONS: We found strong positive mortality trends, with increasing BL level, for several outcomes in internal analysis. Many of these outcomes are associated with smoking, for which we had no data. A borderline trend was found for brain cancer, not associated with smoking.
Original languageEnglish
Pages (from-to)785-791
Number of pages7
JournalOccup Environ Med
Issue number11
Early online date13 Oct 2017
Publication statusPublished - 2017


  • Aged Brain Neoplasms/blood/etiology/mortality Cause of Death Cohort Studies Female Finland Humans Laryngeal Neoplasms/blood/etiology/*mortality Lead/*adverse effects/blood Lung Neoplasms/blood/etiology/*mortality Male Middle Aged Occupational Diseases/blood/etiology/*mortality Occupational Exposure/*adverse effects Pulmonary Disease, Chronic Obstructive/blood/etiology/*mortality Smoking/blood United Kingdom United States Urinary Bladder Neoplasms/blood/etiology/*mortality *cancer *lead *occupation


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