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Nonmalignant respiratory disease mortality among woodworkers participating in the American Cancer Society Cancer Prevention Study-II (CPS-II)

Demers, Paul A.; Stellman, Steven D.; Colin, Didier; Boffetta, Paolo

Nonmalignant respiratory disease (NMRD) mortality was examined among woodworkers participating in the American Cancer Society’s CPS-II cohort study. During the 6-year prospective follow-up, there were 97 NMRD deaths among 11,541 men reporting employment in wood-related occupations and 1,338 NMRD deaths among 317,424 men reporting no exposure to wood dust or wood-related jobs. Relative risks, adjusted for age and smoking, were calculated using Poisson regression. A small excess of NMRD was observed among woodworkers. However, the relative risk was higher among woodworkers who did not report exposure to wood dust (RR = 1.52, 95% CI = 1.18–1.97) than those who did (RR = 1.27, 95% CI = 0.91–1.77), and no clear trend with duration of exposure was observed. An excess of NMRD was observed among woodworkers reporting exposure to asbestos (RR = 1.59, 95% CI = 0.85–2.96), as well as the small number of woodworkers reporting exposure to formaldehyde (RR = 1.95, 95% CI = 0.63–6.06), but men not reporting exposure to these substances also had an excess risk. Although limited by a short follow-up period and crude indicators of exposure, the strengths of this analysis were the ability to compare woodworkers to a similar, healthy population and to adjust for the effects of smoking. Cohort studies with better exposure information are needed to examine the role of occupational exposures among woodworkers in the etiology of respiratory disease.


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American Journal of Industrial Medicine

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December 3, 2014


In the early 1980s, not long after I started working at the American Cancer Society, I was sifting and sorting materials left over from the Cuyler Hammond era and came upon a box of punch cards labeled "Woodworkers." Larry Garfinkel, who became VP for Epidemiology and Statistics in 1980 when the legendary Hammond retired and who was my boss, identified the cards as representing confirmed lung cancer death records among 10,000 or so men employed in woodworking industries and who were enrollees in Hammond's million person cohort study Cancer Prevention Study I (CPS-I) between 1960-72. The hard data extraction work in this intended sub-study had been completed but the data were never analyzed or published. So we analyzed the data and wrote up the results which were published in Amer J Indust Med 1984; 5:343-57. I left ACS when it moved to Atlanta in 1988. In 1992 I received an ACS grant to study occupational mortality in woodworkers in Cancer Prevention Study 2 (CPS-2), a cohort study of 1.2 million men and women which Larry and I had initiated at ACS in 1982. At the time I was an NIH Fogarty International Senior Fellows at the International Agency for Research on Cancer (IARC) in Lyon, France. While there, I had the good fortune to meet Paul Demers, an accomplished epidemiologist with the University of British Columbia and an authority on occupational health in the woodworking industry. I was doubly fortunate because Paul was familiar with newer statistical methodology for cohort studies that I was just then learning. Together, and with the collaboration of Paolo Boffetta and Colin Didier in the IARC Environmental Cancer Epidemiology Unit, we completed this mortality analysis of nonmalignant respiratory diseases such as COPD and pneumonia, along with a companion paper "Cancer mortality and wood dust exposure among participants in the American Cancer Society Cancer Prevention Study-II (CPS-II)" [AJIM 1998; 34(3):229-37].