Skip to main content
PMC home page
British Journal of Industrial Medicine logoLink to British Journal of Industrial Medicine
. 1993 Nov;50(11):1017–1031. doi: 10.1136/oem.50.11.1017

Mortality of iron miners in Lorraine (France): relations between lung function and respiratory symptoms and subsequent mortality.

N Chau 1, L Benamghar 1, Q T Pham 1, D Teculescu 1, E Rebstock 1, J M Mur 1
PMCID: PMC1035537  PMID: 8280627

Abstract

An increased mortality from lung and stomach cancer was found in previous studies on Lorraine iron miners. A detailed analysis, however, was not possible due to the lack of data for survivors. In this study the cohort included 1178 workers selected at random from all the 5300 working miners aged between 35 and 55 at the start of the follow up period, which ranged from 1975 to 1985. Occupational exposures and tobacco consumption, lung function tests, and respiratory symptoms were assessed for each subject in 1975, 1980, and 1985. This study confirmed the excess of lung cancer (standardised mortality ratio (SMR) = 389, p < 0.001) and of stomach cancer (SMR = 273, p < 0.05). There was no excess of lung cancer in non-smokers and moderate smokers (< 20 pack-years) or the miners who worked only at the surface or underground for less than 20 years. A significant excess (SMR = 349, p < 0.001) was found in moderate smokers when they worked underground for between 20 and 29 years. Heavy smokers (over 30 pack-years) or subjects who worked underground for more than 30 years experienced a high risk: SMR = 478 (p < 0.001) for moderate smokers who worked underground for over 30 years; 588 (p < 0.001) for heavy smokers who worked underground for between 20 and 29 years; and 877 (p < 0.001) for heavy smokers who worked underground for over 30 years. This showed an interaction between smoking and occupational exposure. The excess mortality from lung cancer was because there were some subjects who died young (from 45 years old). Comparison with the results of a previous study showed that additional hazards produced by diesel engines and explosives increased the mortality from lung cancer. The SMR was higher than 400 (p < 0.001) from 45 years old instead of from 56 years. A relation was found between a decrease in vital capacity (VC), forced expiratory volume in one second (FEV1) and of FEV1/VC and mortality from all causes and from lung cancer in heavy smokers or men who had worked underground for more than 20 years. Respiratory symptoms were related to mortality from lung cancer among smokers (moderate and heavy) who worked underground for more than 20 years. It is considered that the risk of lung cancer in the Lorraine iron miners was mainly due to dust, diesel engines, and explosives although the role of low exposure to radon daughters could not be totally excluded.

Full text

PDF
1021

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Amandus H. E., Piacitelli G. Dust exposures at U.S. surface coal mines in 1982-1983. Arch Environ Health. 1987 Nov-Dec;42(6):374–381. doi: 10.1080/00039896.1987.9934362. [DOI] [PubMed] [Google Scholar]
  2. Amandus H. E., Shy C., Wing S., Blair A., Heineman E. F. Silicosis and lung cancer in North Carolina dusty trades workers. Am J Ind Med. 1991;20(1):57–70. doi: 10.1002/ajim.4700200106. [DOI] [PubMed] [Google Scholar]
  3. Amandus H., Costello J. Silicosis and lung cancer in U.S. metal miners. Arch Environ Health. 1991 Mar-Apr;46(2):82–89. doi: 10.1080/00039896.1991.9937433. [DOI] [PubMed] [Google Scholar]
  4. Ames R. G., Gamble J. F. Lung cancer, stomach cancer, and smoking status among coal miners. A preliminary test of a hypothesis. Scand J Work Environ Health. 1983 Oct;9(5):443–448. doi: 10.5271/sjweh.2391. [DOI] [PubMed] [Google Scholar]
  5. Ames R. G. Gastric cancer and coal mine dust exposure. A case-control study. Cancer. 1983 Oct 1;52(7):1346–1350. doi: 10.1002/1097-0142(19831001)52:7<1346::aid-cncr2820520734>3.0.co;2-y. [DOI] [PubMed] [Google Scholar]
  6. Atuhaire L. K., Campbell M. J., Cochrane A. L., Jones M., Moore F. Specific causes of death in miners and ex-miners of the Rhondda Fach 1950-80. Br J Ind Med. 1986 Jul;43(7):497–499. doi: 10.1136/oem.43.7.497. [DOI] [PMC free article] [PubMed] [Google Scholar]
  7. Axelson O., Sjöberg A. Cancer incidence and exposure to iron oxide dust. J Occup Med. 1979 Jun;21(6):419–422. [PubMed] [Google Scholar]
  8. Axelson O., Steenland K. Indirect methods of assessing the effects of tobacco use in occupational studies. Am J Ind Med. 1988;13(1):105–118. doi: 10.1002/ajim.4700130107. [DOI] [PubMed] [Google Scholar]
  9. Barregård L., Sällsten G., Järvholm B. Mortality and cancer incidence in chloralkali workers exposed to inorganic mercury. Br J Ind Med. 1990 Feb;47(2):99–104. [PMC free article] [PubMed] [Google Scholar]
  10. Battista G., Belli S., Carboncini F., Comba P., Levante G., Sartorelli P., Strambi F., Valentini F., Axelson O. Mortality among pyrite miners with low-level exposure to radon daughters. Scand J Work Environ Health. 1988 Oct;14(5):280–285. doi: 10.5271/sjweh.1919. [DOI] [PubMed] [Google Scholar]
  11. Beaty T. H., Newill C. A., Cohen B. H., Tockman M. S., Bryant S. H., Spurgeon H. A. Effects of pulmonary function on mortality. J Chronic Dis. 1985;38(8):703–710. doi: 10.1016/0021-9681(85)90024-4. [DOI] [PubMed] [Google Scholar]
  12. Boyd J. T., Doll R., Faulds J. S., Leiper J. Cancer of the lung in iron ore (haematite) miners. Br J Ind Med. 1970 Apr;27(2):97–105. doi: 10.1136/oem.27.2.97. [DOI] [PMC free article] [PubMed] [Google Scholar]
  13. Buffler P. A., Cooper S. P., Stinnett S., Contant C., Shirts S., Hardy R. J., Agu V., Gehan B., Burau K. Air pollution and lung cancer mortality in Harris County, Texas, 1979-1981. Am J Epidemiol. 1988 Oct;128(4):683–699. doi: 10.1093/oxfordjournals.aje.a115022. [DOI] [PubMed] [Google Scholar]
  14. Cardesi E., Provana A. Contributo al problema dell'associazione silicosi-carcinoma polmonare. Pathologica. 1978 Jul-Aug;70(1005-1006):377–401. [PubMed] [Google Scholar]
  15. Carta P., Cocco P. L., Casula D. Mortality from lung cancer among Sardinian patients with silicosis. Br J Ind Med. 1991 Feb;48(2):122–129. doi: 10.1136/oem.48.2.122. [DOI] [PMC free article] [PubMed] [Google Scholar]
  16. Chau N., Bertrand J. P., Mur J. M., Figueredo A., Patris A., Moulin J. J., Pham Q. T. Mortality in retired coke oven plant workers. Br J Ind Med. 1993 Feb;50(2):127–135. doi: 10.1136/oem.50.2.127. [DOI] [PMC free article] [PubMed] [Google Scholar]
  17. Chen S. Y., Hayes R. B., Liang S. R., Li Q. G., Stewart P. A., Blair A. Mortality experience of haematite mine workers in China. Br J Ind Med. 1990 Mar;47(3):175–181. doi: 10.1136/oem.47.3.175. [DOI] [PMC free article] [PubMed] [Google Scholar]
  18. Cothern C. R. Indoor air radon. Rev Environ Contam Toxicol. 1990;111:1–60. doi: 10.1007/978-1-4612-3340-4_1. [DOI] [PubMed] [Google Scholar]
  19. Davies J. M., Easton D. F., Bidstrup P. L. Mortality from respiratory cancer and other causes in United Kingdom chromate production workers. Br J Ind Med. 1991 May;48(5):299–313. doi: 10.1136/oem.48.5.299. [DOI] [PMC free article] [PubMed] [Google Scholar]
  20. Davis D. L., Hoel D., Fox J., Lopez A. International trends in cancer mortality in France, West Germany, Italy, Japan, England and Wales, and the USA. Lancet. 1990 Aug 25;336(8713):474–481. doi: 10.1016/0140-6736(90)92020-i. [DOI] [PubMed] [Google Scholar]
  21. Dechoux J., Wantz J. M. Le cancer bronchique chez les mineurs des houillères du Bassin de Lorraine. Rev Mal Respir. 1985;2(2):69–74. [PubMed] [Google Scholar]
  22. Ebi-Kryston K. L. Respiratory symptoms and pulmonary function as predictors of 10-year mortality from respiratory disease, cardiovascular disease, and all causes in the Whitehall Study. J Clin Epidemiol. 1988;41(3):251–260. doi: 10.1016/0895-4356(88)90129-1. [DOI] [PubMed] [Google Scholar]
  23. Edling C. Lung cancer and smoking in a group of iron ore miners. Am J Ind Med. 1982;3(2):191–199. doi: 10.1002/ajim.4700030210. [DOI] [PubMed] [Google Scholar]
  24. Feron V. J., Emmelot P., Vossenaar T. Lower respiratory tract tumours in Syrian golden hamsters after intratracheal instillations of diethylnitrosamine alone and with ferric oxide. Eur J Cancer. 1972 Aug;8(4):445–449. doi: 10.1016/0014-2964(72)90130-2. [DOI] [PubMed] [Google Scholar]
  25. Finkelstein M., Kusiak R., Suranyi G. Mortality among miners receiving workmen's compensation for silicosis in Ontario: 1940-1975. J Occup Med. 1982 Sep;24(9):663–667. doi: 10.1097/00043764-198209000-00012. [DOI] [PubMed] [Google Scholar]
  26. Forastiere F., Lagorio S., Michelozzi P., Perucci C. A., Axelson O. Mortality pattern of silicotic subjects in the Latium region, Italy. Br J Ind Med. 1989 Dec;46(12):877–880. doi: 10.1136/oem.46.12.877. [DOI] [PMC free article] [PubMed] [Google Scholar]
  27. Gilman P. A., Ames R. G., McCawley M. A. Leukemia risk among U.S. white male coal miners. A case-control study. J Occup Med. 1985 Sep;27(9):669–671. [PubMed] [Google Scholar]
  28. Goldsmith D. F., Guidotti T. L., Johnston D. R. Does occupational exposure to silica cause lung cancer? Am J Ind Med. 1982;3(4):423–440. doi: 10.1002/ajim.4700030408. [DOI] [PubMed] [Google Scholar]
  29. Gurevich M. A. O pervichnom rake legkogo u gornorabochikh zhelezorudnykh shakht. Sov Med. 1967 May;30(5):71–76. [PubMed] [Google Scholar]
  30. Gurevich M. A., Slinchenko N. Z. Morfologiia raka legkogo u gornorabochikh zhelezourudnykh shakht. Arkh Patol. 1971;33(6):22–26. [PubMed] [Google Scholar]
  31. Gustavsson P., Gustavsson A., Hogstedt C. Excess of cancer in Swedish chimney sweeps. Br J Ind Med. 1988 Nov;45(11):777–781. doi: 10.1136/oem.45.11.777. [DOI] [PMC free article] [PubMed] [Google Scholar]
  32. Hansen E. S. A cohort study on the mortality of firefighters. Br J Ind Med. 1990 Dec;47(12):805–809. doi: 10.1136/oem.47.12.805. [DOI] [PMC free article] [PubMed] [Google Scholar]
  33. Henry M. C., Port C. D., Kaufman D. G. Importance of physical properties of benzo(a)pyrene-ferric oxide mixtures in lung tumor induction. Cancer Res. 1975 Jan;35(1):207–217. [PubMed] [Google Scholar]
  34. Hill C. Overview of available data on diet and cancer mortality in France. Tumori. 1990 Aug 31;76(4):299–305. doi: 10.1177/030089169007600401. [DOI] [PubMed] [Google Scholar]
  35. Howe G. R., Nair R. C., Newcombe H. B., Miller A. B., Abbatt J. D. Lung cancer mortality (1950-80) in relation to radon daughter exposure in a cohort of workers at the Eldorado Beaverlodge uranium mine. J Natl Cancer Inst. 1986 Aug;77(2):357–362. [PubMed] [Google Scholar]
  36. JAMES W. R. Primary lung cancer in South Wales coal-workers with pneumoconiosis. Br J Ind Med. 1955 Apr;12(2):87–91. doi: 10.1136/oem.12.2.87. [DOI] [PMC free article] [PubMed] [Google Scholar]
  37. Junod B., Briançon S., Houot O., Doumergue T. Un modèle pour l'évaluation des tests de dépistage. Le cas des tumeurs colorectales. Rev Epidemiol Sante Publique. 1989;37(1):49–59. [PubMed] [Google Scholar]
  38. Kellie S. E., Attfield M. D., Hankinson J. L., Castellan R. M. Spirometry variability criteria--association with respiratory morbidity and mortality in a cohort of coal miners. Am J Epidemiol. 1987 Mar;125(3):437–444. doi: 10.1093/oxfordjournals.aje.a114549. [DOI] [PubMed] [Google Scholar]
  39. Kinlen L. J., Willows A. N. Decline in the lung cancer hazard: a prospective study of the mortality of iron ore miners in Cumbria. Br J Ind Med. 1988 Apr;45(4):219–224. doi: 10.1136/oem.45.4.219. [DOI] [PMC free article] [PubMed] [Google Scholar]
  40. Lawler A. B., Mandel J. S., Schuman L. M., Lubin J. H. A retrospective cohort mortality study of iron ore (hematite) miners in Minnesota. J Occup Med. 1985 Jul;27(7):507–517. [PubMed] [Google Scholar]
  41. Magnani C., Pannett B., Winter P. D., Coggon D. Application of a job-exposure matrix to national mortality statistics for lung cancer. Br J Ind Med. 1988 Jan;45(1):70–72. doi: 10.1136/oem.45.1.70. [DOI] [PMC free article] [PubMed] [Google Scholar]
  42. Malissard L., Nguyen T. D., Jung G. M., Forçard J. J., Castelain B., Tuchais C., Allain Y. M., Denepoux R., Lagrange J. L., Panis X. Localized adenocarcinoma of the lung: a retrospective study of 186 non-metastatic patients from the French Federation of Cancer Institutes--the Radiotherapy Cooperative Group. Int J Radiat Oncol Biol Phys. 1991 Jul;21(2):369–373. doi: 10.1016/0360-3016(91)90784-2. [DOI] [PubMed] [Google Scholar]
  43. Meijers J. M., Swaen G. M., Slangen J. J., van Vliet K., Sturmans F. Long-term mortality in miners with coal workers' pneumoconiosis in The Netherlands: a pilot study. Am J Ind Med. 1991;19(1):43–50. doi: 10.1002/ajim.4700190106. [DOI] [PubMed] [Google Scholar]
  44. Menotti A. Food patterns and health problems: health in southern Europe. Ann Nutr Metab. 1991;35 (Suppl 1):69–77. doi: 10.1159/000177680. [DOI] [PubMed] [Google Scholar]
  45. Miller B. G., Jacobsen M. Dust exposure, pneumoconiosis, and mortality of coalminers. Br J Ind Med. 1985 Nov;42(11):723–733. doi: 10.1136/oem.42.11.723. [DOI] [PMC free article] [PubMed] [Google Scholar]
  46. Mooney F. Letter: Coal worker's pneumoconiosis and carcinoma of the lung. Lancet. 1975 Jan 4;1(7897):43–43. doi: 10.1016/s0140-6736(75)92410-1. [DOI] [PubMed] [Google Scholar]
  47. Mur J. M. Epidemiology of respiratory hazards: recent advances. Rev Epidemiol Sante Publique. 1992;40 (Suppl 1):S27–S41. [PubMed] [Google Scholar]
  48. Mur J. M., Meyer-Bisch C., Pham Q. T., Massin N., Moulin J. J., Cavelier C., Sadoul P. Risk of lung cancer among iron ore miners: a proportional mortality study of 1,075 deceased miners in Lorraine, France. J Occup Med. 1987 Sep;29(9):762–768. [PubMed] [Google Scholar]
  49. Myers C. E. Anthracosilicosis and bronchogenic carcinoma. Dis Chest. 1967 Dec;52(6):800–805. doi: 10.1378/chest.52.6.800. [DOI] [PubMed] [Google Scholar]
  50. Nettesheim P., Creasia D. A., Mitchell T. J. Carcinogenic and cocarcinogenic effects of inhaled synthetic smog and ferric oxide particles. J Natl Cancer Inst. 1975 Jul;55(1):159–169. doi: 10.1093/jnci/55.1.159. [DOI] [PubMed] [Google Scholar]
  51. Nicholson W. J. Research issues in occupational and environmental cancer. Arch Environ Health. 1984 May-Jun;39(3):190–202. doi: 10.1080/00039896.1984.9939523. [DOI] [PubMed] [Google Scholar]
  52. Pham Q. T., Chau N., Patris A., Trombert B., Henquel J. C., Geny M., Teculescu D. Prospective mortality study among iron miners. Cancer Detect Prev. 1991;15(6):449–454. [PubMed] [Google Scholar]
  53. Pham Q. T., Gaertner M., Mur J. M., Braun P., Gabiano M., Sadoul P. Incidence of lung cancer among iron miners. Eur J Respir Dis. 1983 Oct;64(7):534–540. [PubMed] [Google Scholar]
  54. Pham Q. T., Mur J. M., Beigbeder R., Deniau R., Leonet O. Incidence à long terme de basses teneurs de nuisances gazeuses sur l'appareil respiratoire. Résultats d'une enquête épidémiologique chez les ouvriers des mines de fer du Bassin de Lorraine. Rev Epidemiol Sante Publique. 1977;25(4):255–273. [PubMed] [Google Scholar]
  55. Pham Q. T., Mur J. M., Chau N., Gabiano M., Henquel J. C., Teculescu D. Prognostic value of acetylcholine challenge test: a prospective study. Br J Ind Med. 1984 May;41(2):267–271. doi: 10.1136/oem.41.2.267. [DOI] [PMC free article] [PubMed] [Google Scholar]
  56. Pham Q. T., Mur J. M., Teculescu D., Chau N., Gabiano M., Gaertner M., Henquel J. C. A longitudinal study of symptoms and respiratory function tests in iron miners. Eur J Respir Dis. 1986 Nov;69(5):346–354. [PubMed] [Google Scholar]
  57. Pham Q. T., Teculescu D., Bruant A., Chau N., Viaggi M. N., Rebstock E. Iron miners--a ten year follow-up. Eur J Epidemiol. 1992 Jul;8(4):594–600. doi: 10.1007/BF00146382. [DOI] [PubMed] [Google Scholar]
  58. Radford E. P., Renard K. G. Lung cancer in Swedish iron miners exposed to low doses of radon daughters. N Engl J Med. 1984 Jun 7;310(23):1485–1494. doi: 10.1056/NEJM198406073102302. [DOI] [PubMed] [Google Scholar]
  59. Saffiotti U., Montesano R., Sellakumar A. R., Kaufman D. G. Respiratory tract carcinogenesis induced in hamsters by different dose levels of benzo-(a)pyrene and ferric oxide. J Natl Cancer Inst. 1972 Oct;49(4):1199–1204. [PubMed] [Google Scholar]
  60. Scarano D., Fadali A. M., Lemole G. M. Carcinoma of the lung and anthracosilicosis. Chest. 1972 Sep;62(3):251–254. doi: 10.1378/chest.62.3.251. [DOI] [PubMed] [Google Scholar]
  61. Schilling C. J., Tams I. P., Schilling R. S., Nevitt A., Rossiter C. E., Wilkinson B. A survey into the respiratory effects of prolonged exposure to pulverised fuel ash. Br J Ind Med. 1988 Dec;45(12):810–817. doi: 10.1136/oem.45.12.810. [DOI] [PMC free article] [PubMed] [Google Scholar]
  62. Schüttmann W. Die Strahlenbelastung der Atemwege durch die Radionuklide der Umwelt. Z Erkr Atmungsorgane. 1983;161(3):248–256. [PubMed] [Google Scholar]
  63. Shannon H. S., Hertzman C., Julian J. A., Hayes M. V., Henry N., Charters J., Cunningham I., Gibson E. S., Sackett D. L. Lung cancer and air pollution in an industrial city--a geographical analysis. Can J Public Health. 1988 Jul-Aug;79(4):255–259. [PubMed] [Google Scholar]
  64. Sherson D., Sigsgaard T., Overgaard E., Loft S., Poulsen H. E., Jongeneelen F. J. Interaction of smoking, uptake of polycyclic aromatic hydrocarbons, and cytochrome P450IA2 activity among foundry workers. Br J Ind Med. 1992 Mar;49(3):197–202. doi: 10.1136/oem.49.3.197. [DOI] [PMC free article] [PubMed] [Google Scholar]
  65. Smith G. H., Williams F. L., Lloyd O. L. Respiratory cancer and air pollution from iron foundries in a Scottish town: an epidemiological and environmental study. Br J Ind Med. 1987 Dec;44(12):795–802. doi: 10.1136/oem.44.12.795. [DOI] [PMC free article] [PubMed] [Google Scholar]
  66. Steenland K., Thun M. Interaction between tobacco smoking and occupational exposures in the causation of lung cancer. J Occup Med. 1986 Feb;28(2):110–118. [PubMed] [Google Scholar]
  67. Talton B. M., Constable W. C., Kersh C. R. Curative radiotherapy in non-small cell carcinoma of the lung. Int J Radiat Oncol Biol Phys. 1990 Jul;19(1):15–21. doi: 10.1016/0360-3016(90)90128-7. [DOI] [PubMed] [Google Scholar]
  68. Vollmer W. M., McCamant L. E., Johnson L. R., Buist A. S. Respiratory symptoms, lung function, and mortality in a screening center cohort. Am J Epidemiol. 1989 Jun;129(6):1157–1169. doi: 10.1093/oxfordjournals.aje.a115237. [DOI] [PubMed] [Google Scholar]
  69. Woodward A., Roder D., McMichael A. J., Crouch P., Mylvaganam A. Radon daughter exposures at the Radium Hill uranium mine and lung cancer rates among former workers, 1952-87. Cancer Causes Control. 1991 Jul;2(4):213–220. doi: 10.1007/BF00052136. [DOI] [PubMed] [Google Scholar]

Articles from British Journal of Industrial Medicine are provided here courtesy of BMJ Publishing Group

RESOURCES