The Mortality of Workers with Occupational Lead Exposure

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  • Topic: Epidemiology, Cohort study, Lead poisoning
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R esearch Report PP06214, version 3
June 2011

The mortality of workers with occupational
lead exposure: A research proposal
John W Cherrie
Damien McElvenny
Martie van Tongeren

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PP06214 - V3– The mortality of workers with occupational lead exposure: A research proposal

CONTENTS
LAY SUMMARY

II

MAIN PROPOSAL

1

1

WHAT IS THE WORK WE WOULD LIKE TO DO?

1

1.1
1.2

Introduction
Specific Aims

1
1

2

WHY SHOULD THE WORK BE UNDERTAKEN?

2

3

WHO IS DOING OR HAS DONE SIMILAR WORK, AND HOW WILL
YOUR WORK ADD TO IT?

3

4

HOW DO YOU INTEND TO CARRY OUT THE WORK, AND WHY DO
YOU THINK THIS IS THE RIGHT APPROACH?

3

4.1
4.2
4.3
4.4
4.5
4.6
4.7
4.8

Introduction
The study database
Study power
Research governance
Tracing subjects
Exposure assessment
Data analysis
Limitations

3
3
4
5
6
6
8
8

5

WHAT RESOURCES WILL YOU NEED TO DO THE WORK, AND ARE
THESE RESOURCES AVAILABLE?

9

6

WHO WILL DO THE WORK, AND HOW MUCH TIME WILL EACH OF
THE PEOPLE INVOLVED DEVOTE TO IT?

9

7

HOW LONG WILL THE WORK TAKE?

10

8

HOW MUCH MONEY DO YOU NEED TO COMPLETE THE WORK?

10

9

WHEN DO YOU PLAN TO START?

10

10

REFERENCES

10

APPENDIX 1: A BRIEF REVIEW OF THE RISKS ASSOCIATED WITH LEAD EXPOSURE

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APPENDIX 1: A BRIEF REVIEW OF THE RISKS ASSOCIATED WITH LEAD EXPOSURE

12

APPENDIX 2: INSTITUTE OF OCCUPATIONAL MEDICINE

21

APPENDIX 3: CVS

23

Page i of ii

PP06214 - V3– The mortality of workers with occupational lead exposure: A research proposal

LAY SUMMARY
Inorganic lead compounds are classified by the International Agency for Research on Cancer (IARC) as 'probably carcinogenic to humans', based on ‘sufficient evidence of carcinogenicity in experimental animals’ and 'limited evidence of carcinogenicity in humans’. Much of the epidemiological evidence for carcinogenic effects in humans comes from studies of lead workers. However, previous studies have often involved relatively small numbers of workers and suffered from methodological constraints such as limited information on co-exposures to other risk factors or poorly characterised exposure assessments.

We propose to study the mortality of approximately 10,000 UK workers who were participants in the Health and Safety Executive (HSE) Lead Mortality Study between 1975 and the early 1980s, and who had at least one blood lead measurement recorded during the study. The main focus of the research will be an investigation of the association between lead exposure and cancer mortality risk. In the first instance, mean blood lead levels will be used to categorise blood lead exposure. We will use information on factory and process codes for the study participants with information from the HSE National Exposure DataBase (NEDB) and HSE Visit Reports to assign likely exposure categories to lead compounds and to provide a qualitative assessment for other known or potential carcinogens. We will do some preliminary work to assess what additional information might be obtained for workers in the study from existing records, should it be decided that a follow-up nested case-control study is recommended.

Given the length of follow-up, the large size of the cohort and the relatively high exposures that they experienced (as documented by blood lead levels), the proposed study would make a significant contribution to the evidence on the carcinogenicity of lead exposure. This study will fill an important knowledge gap identified as a research priority by IARC.

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