Skip to main content
PMC home page
Occupational and Environmental Medicine logoLink to Occupational and Environmental Medicine
. 1995 Feb;52(2):73–81. doi: 10.1136/oem.52.2.73

Cancer and occupational exposure to inorganic lead compounds: a meta-analysis of published data.

H Fu 1, P Boffetta 1
PMCID: PMC1128158  PMID: 7757170

Abstract

OBJECTIVES--To review and summarise the epidemiological evidence on the carcinogenicity of occupational exposure to inorganic lead. METHODS--Case-control and cohort studies were reviewed and combined for meta-analysis. Fixed and random effect methods were used to estimate the summary effects. RESULTS--The combined results show a significant excess risk of overall cancer, stomach cancer, lung cancer, and bladder cancer, with relative risk ratios (RRs) and 95% confidence intervals (95% CIs) in the meta-analysis of 1.11 (1.05-1.17), 1.33 (1.18-1.49), 1.29 (1.10-1.50), and 1.41 (1.16-1.71) respectively. The RR (95% CI) for kidney cancer was also high, but did not reach significance (1.19 (0.96-1.48)). A separate analysis of studies of heavily exposed workers provided slightly increased RRs for cancers of the stomach (1.50) and lung (1.42). CONCLUSIONS--The findings from the workers with heavy exposure to lead provided some evidence to support the hypothesis of an association between stomach and lung cancer and exposure to lead. The main limitation of the present analysis is that the excess risks do not take account of potential confounders, because little information was available for other occupational exposures, smoking, and dietary habits. To some extent, the risk of lung cancer might be explained by confounders such as tobacco smoking and exposure to other occupational carcinogens. The excess risk of stomach cancer may also be explained, at least in part, by non-occupational factors. For bladder and kidney cancers, the excess risks are only suggestive of a true effect because of possible publication bias.

Full text

PDF
76

Selected References

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

  1. Ades A. E., Kazantzis G. Lung cancer in a non-ferrous smelter: the role of cadmium. Br J Ind Med. 1988 Jul;45(7):435–442. doi: 10.1136/oem.45.7.435. [DOI] [PMC free article] [PubMed] [Google Scholar]
  2. Baker E. L., Jr, Goyer R. A., Fowler B. A., Khettry U., Bernard D. B., Adler S., White R. D., Babayan R., Feldman R. G. Occupational lead exposure, nephropathy, and renal cancer. Am J Ind Med. 1980;1(2):139–148. doi: 10.1002/ajim.4700010204. [DOI] [PubMed] [Google Scholar]
  3. Beck B. D. An update on exposure and effects of lead. Fundam Appl Toxicol. 1992 Jan;18(1):1–16. doi: 10.1016/0272-0590(92)90189-o. [DOI] [PubMed] [Google Scholar]
  4. Bertazzi P. A., Zocchetti C. A mortality study of newspaper printing workers. Am J Ind Med. 1980;1(1):85–97. doi: 10.1002/ajim.4700010110. [DOI] [PubMed] [Google Scholar]
  5. Boeing H. Epidemiological research in stomach cancer: progress over the last ten years. J Cancer Res Clin Oncol. 1991;117(2):133–143. doi: 10.1007/BF01613137. [DOI] [PubMed] [Google Scholar]
  6. Boffetta P. Carcinogenicity of trace elements with reference to evaluations made by the International Agency for Research on Cancer. Scand J Work Environ Health. 1993;19 (Suppl 1):67–70. [PubMed] [Google Scholar]
  7. Calabrese E. J., Baldwin L. A. Lead-induced cell proliferation and organ-specific tumorigenicity. Drug Metab Rev. 1992;24(3):409–416. doi: 10.3109/03602539208996299. [DOI] [PubMed] [Google Scholar]
  8. Cantor K. P., Sontag J. M., Heid M. F. Patterns of mortality among plumbers and pipefitters. Am J Ind Med. 1986;10(1):73–89. doi: 10.1002/ajim.4700100109. [DOI] [PubMed] [Google Scholar]
  9. Cooper W. C., Gaffey W. R. Mortality of lead workers. J Occup Med. 1975 Feb;17(2):100–107. doi: 10.1097/00043764-197502000-00012. [DOI] [PubMed] [Google Scholar]
  10. Cooper W. C., Wong O., Kheifets L. Mortality among employees of lead battery plants and lead-producing plants, 1947-1980. Scand J Work Environ Health. 1985 Oct;11(5):331–345. doi: 10.5271/sjweh.2215. [DOI] [PubMed] [Google Scholar]
  11. Cordioli G., Cuoghi L., Solari P. L., Berrino F., Crosignani P., Riboli E. Mortalità per tumore in una coorte di lavoratori della industria del vetro. Epidemiol Prev. 1987 Mar;9(30):16–18. [PubMed] [Google Scholar]
  12. Correa P. Human gastric carcinogenesis: a multistep and multifactorial process--First American Cancer Society Award Lecture on Cancer Epidemiology and Prevention. Cancer Res. 1992 Dec 15;52(24):6735–6740. [PubMed] [Google Scholar]
  13. DINGWALL-FORDYCE I., LANE R. E. A FOLLOW-UP STUDY OF LEAD WORKERS. Br J Ind Med. 1963 Oct;20:313–315. doi: 10.1136/oem.20.4.313. [DOI] [PMC free article] [PubMed] [Google Scholar]
  14. Davies J. M. Long term mortality study of chromate pigment workers who suffered lead poisoning. Br J Ind Med. 1984 May;41(2):170–178. doi: 10.1136/oem.41.2.170. [DOI] [PMC free article] [PubMed] [Google Scholar]
  15. DerSimonian R., Laird N. Meta-analysis in clinical trials. Control Clin Trials. 1986 Sep;7(3):177–188. doi: 10.1016/0197-2456(86)90046-2. [DOI] [PubMed] [Google Scholar]
  16. Fanning D. A mortality study of lead workers, 1926-1985. Arch Environ Health. 1988 May-Jun;43(3):247–251. doi: 10.1080/00039896.1988.9934942. [DOI] [PubMed] [Google Scholar]
  17. Fontham E., Zavala D., Correa P., Rodriguez E., Hunter F., Haenszel W., Tannenbaum S. R. Diet and chronic atrophic gastritis: a case-control study. J Natl Cancer Inst. 1986 Apr;76(4):621–627. doi: 10.1093/jnci/76.4.621. [DOI] [PubMed] [Google Scholar]
  18. Gerhardsson L., Lundström N. G., Nordberg G., Wall S. Mortality and lead exposure: a retrospective cohort study of Swedish smelter workers. Br J Ind Med. 1986 Oct;43(10):707–712. doi: 10.1136/oem.43.10.707. [DOI] [PMC free article] [PubMed] [Google Scholar]
  19. Goldstein D. H., Benoit J. N., Tyroler H. A. An epidemiologic study of an oil mist exposure. Arch Environ Health. 1970 Nov;21(5):600–603. doi: 10.1080/00039896.1970.10667302. [DOI] [PubMed] [Google Scholar]
  20. Goyer R. A. Lead toxicity: current concerns. Environ Health Perspect. 1993 Apr;100:177–187. doi: 10.1289/ehp.93100177. [DOI] [PMC free article] [PubMed] [Google Scholar]
  21. Greene M. H., Hoover R. N., Eck R. L., Fraumeni J. F., Jr Cancer mortality among printing plant workers. Environ Res. 1979 Oct;20(1):66–73. doi: 10.1016/0013-9351(79)90085-9. [DOI] [PubMed] [Google Scholar]
  22. Greenland S. Quantitative methods in the review of epidemiologic literature. Epidemiol Rev. 1987;9:1–30. doi: 10.1093/oxfordjournals.epirev.a036298. [DOI] [PubMed] [Google Scholar]
  23. Kneller R. W., You W. C., Chang Y. S., Liu W. D., Zhang L., Zhao L., Xu G. W., Fraumeni J. F., Jr, Blot W. J. Cigarette smoking and other risk factors for progression of precancerous stomach lesions. J Natl Cancer Inst. 1992 Aug 19;84(16):1261–1266. doi: 10.1093/jnci/84.16.1261. [DOI] [PubMed] [Google Scholar]
  24. Kobayashi N., Okamoto T. Effects of lead oxide on the induction of lung tumors in Syrian hamsters. J Natl Cancer Inst. 1974 May;52(5):1605–1610. doi: 10.1093/jnci/52.5.1605. [DOI] [PubMed] [Google Scholar]
  25. Lilis R. Long-term occupational lead exposure, chronic nephropathy, and renal cancer: a case report. Am J Ind Med. 1981;2(3):293–297. doi: 10.1002/ajim.4700020309. [DOI] [PubMed] [Google Scholar]
  26. Malcolm D., Barnett H. A. A mortality study of lead workers 1925-76. Br J Ind Med. 1982 Nov;39(4):404–410. doi: 10.1136/oem.39.4.404. [DOI] [PMC free article] [PubMed] [Google Scholar]
  27. Mallin K., Rubin M., Joo E. Occupational cancer mortality in Illinois white and black males, 1979-1984, for seven cancer sites. Am J Ind Med. 1989;15(6):699–717. doi: 10.1002/ajim.4700150609. [DOI] [PubMed] [Google Scholar]
  28. Markovac J., Goldstein G. W. Picomolar concentrations of lead stimulate brain protein kinase C. Nature. 1988 Jul 7;334(6177):71–73. doi: 10.1038/334071a0. [DOI] [PubMed] [Google Scholar]
  29. McMichael A. J., Johnson H. M. Long-term mortality profile of heavily-exposed lead smelter workers. J Occup Med. 1982 May;24(5):375–378. doi: 10.1097/00043764-198205000-00008. [DOI] [PubMed] [Google Scholar]
  30. Michaels D., Zoloth S. R., Stern F. B. Does low-level lead exposure increase risk of death? A mortality study of newspaper printers. Int J Epidemiol. 1991 Dec;20(4):978–983. doi: 10.1093/ije/20.4.978. [DOI] [PubMed] [Google Scholar]
  31. Pasternack B., Ehrlich L. Occupational exposure to an oil mist atmosphere. A 12-year mortality study. Arch Environ Health. 1972 Oct;25(4):286–294. doi: 10.1080/00039896.1972.10666175. [DOI] [PubMed] [Google Scholar]
  32. Risch H. A., Burch J. D., Miller A. B., Hill G. B., Steele R., Howe G. R. Occupational factors and the incidence of cancer of the bladder in Canada. Br J Ind Med. 1988 Jun;45(6):361–367. doi: 10.1136/oem.45.6.361. [DOI] [PMC free article] [PubMed] [Google Scholar]
  33. Robinson T. R. 20-year mortality of tetraethyl lead workers. J Occup Med. 1974 Sep;16(9):601–605. doi: 10.1097/00043764-197409000-00005. [DOI] [PubMed] [Google Scholar]
  34. Sankila R., Karjalainen S., Pukkala E., Oksanen H., Hakulinen T., Teppo L., Hakama M. Cancer risk among glass factory workers: an excess of lung cancer? Br J Ind Med. 1990 Dec;47(12):815–818. doi: 10.1136/oem.47.12.815. [DOI] [PMC free article] [PubMed] [Google Scholar]
  35. Selevan S. G., Landrigan P. J., Stern F. B., Jones J. H. Mortality of lead smelter workers. Am J Epidemiol. 1985 Oct;122(4):673–683. doi: 10.1093/oxfordjournals.aje.a114146. [DOI] [PubMed] [Google Scholar]
  36. Sheffet A., Thind I., Miller A. M., Louria D. B. Cancer mortality in a pigment plant utilizing lead and zinc chromates. Arch Environ Health. 1982 Jan-Feb;37(1):44–52. doi: 10.1080/00039896.1982.10667532. [DOI] [PubMed] [Google Scholar]
  37. Siemiatycki J., Wacholder S., Dewar R., Cardis E., Greenwood C., Richardson L. Degree of confounding bias related to smoking, ethnic group, and socioeconomic status in estimates of the associations between occupation and cancer. J Occup Med. 1988 Aug;30(8):617–625. doi: 10.1097/00043764-198808000-00004. [DOI] [PubMed] [Google Scholar]
  38. Steenland K., Selevan S., Landrigan P. The mortality of lead smelter workers: an update. Am J Public Health. 1992 Dec;82(12):1641–1644. doi: 10.2105/ajph.82.12.1641. [DOI] [PMC free article] [PubMed] [Google Scholar]
  39. Sweeney M. H., Beaumont J. J., Waxweiler R. J., Halperin W. E. An investigation of mortality from cancer and other causes of death among workers employed at an east Texas chemical plant. Arch Environ Health. 1986 Jan-Feb;41(1):23–28. doi: 10.1080/00039896.1986.9935761. [DOI] [PubMed] [Google Scholar]
  40. Wingren G., Axelson O. Epidemiologic studies of occupational cancer as related to complex mixtures of trace elements in the art glass industry. Scand J Work Environ Health. 1993;19 (Suppl 1):95–100. [PubMed] [Google Scholar]
  41. Wingren G., Axelson O. Mortality in the Swedish glassworks industry. Scand J Work Environ Health. 1987 Oct;13(5):412–416. doi: 10.5271/sjweh.2019. [DOI] [PubMed] [Google Scholar]
  42. Wingren G., Axelson O. Mortality pattern in a glass producing area in SE Sweden. Br J Ind Med. 1985 Jun;42(6):411–414. doi: 10.1136/oem.42.6.411. [DOI] [PMC free article] [PubMed] [Google Scholar]
  43. Zelikoff J. T., Li J. H., Hartwig A., Wang X. W., Costa M., Rossman T. G. Genetic toxicology of lead compounds. Carcinogenesis. 1988 Oct;9(10):1727–1732. doi: 10.1093/carcin/9.10.1727. [DOI] [PubMed] [Google Scholar]

Articles from Occupational and Environmental Medicine are provided here courtesy of BMJ Publishing Group

RESOURCES