Cancer Incidence Among Painters And Some Allied Trades

Our plain-English summary of Cancer Incidence Among Painters And Some Allied Trades, by A. Englund (1980).

The study

• Author: A. Englund
• Published: Journal Of Toxicology And Environmental Health 6(5-6):1267-1273, September-November (1980)
• Type of article: Journal article
• Our copy: from Johns-Manville's own medical library, J-M no. 000798. The article is still under copyright, so we describe it here rather than post it.

In plain English

This Swedish study looked at cancer among painters, plumbers and pipe fitters, and insulators. The author followed three groups, drawn from union and certificate records, forward through national death and cancer registers. Painters had about twice the expected esophageal cancer (17 against 7.9) and excesses of respiratory cancer deaths and lymphatic leukemia. Plumbers had significantly fewer deaths than expected, possibly a 'healthy worker effect', the author said. But they had 72 bronchus and lung cancer deaths against 38 expected, and 8 larynx cancers against 3.3. Insulators had 6 respiratory cancer deaths against 1.9 expected. A second analysis, linking the cancer registry to the 1960 census, found excess nasal sinus, larynx, lung and pleural cancers in plumbers, 23 lung cancers in insulators (almost four times expected) and 6 pleural tumors in painters (twice expected). The author suggested past asbestos exposure as one reasonable explanation for the respiratory cancers in plumbers and insulators, and raised past solvent exposure as a possibility for the painters' esophageal, liver and bile duct cancers. Neither exposure nor latency could be estimated, the author noted.

We wrote this plain-English summary from the full article with the help of AI, and a second AI model checked each sentence against the article. It is not the authors' wording; the abstract and the article are their own account.

What the study did and found

• Design: Retrospectively defined cohort study, followed forward in time by record linkage to Swedish death and cancer registers (Study 1), plus a second analysis linking Cancer Registry data to the 1960 Population Census and calculating standardized ratios (Study 2)
• Who was studied: Study 1: three Swedish cohorts, namely members of the painters' union and workers with certificates for insulation work or plumbing. The cohort sizes are not legible in the scanned table. Study 2: men listed as painters, plumbers or insulators in the 1960 Swedish census. This included about 38,000 painters with 2064 cancer cases, 900 cancer cases among plumbers and 77 among insulators.
• Exposure: Work as a painter, plumber or pipe fitter, or insulator. No measured exposures are given. In the discussion the author raised solvents for painters and past asbestos exposure (no fiber type named) for plumbers and insulators.
• Main results:
  • Painters (Study 1): about a twofold excess of esophageal cancer. In the cancer registry, 17 cases were observed against 7.9 expected.
  • Painters (Study 1): a statistically significant excess of deaths from cancers of the respiratory tract, with 135 deaths observed. The expected figure is damaged in the scan.
  • Plumbers (Study 1): 836 deaths from all causes, significantly fewer than expected. The author cautioned that the 'healthy worker effect' will be strong in a group with selection mechanisms and short follow-up.
  • Plumbers and pipe fitters (Study 1): deaths from cancers of the bronchus and lungs were 72 observed against 38 expected, an almost twofold excess.
  • Plumbers (Study 1): 8 larynx cancers were reported to the Cancer Registry against 3.3 expected, a more than twofold excess.
  • Insulators (Study 1): 6 deaths from respiratory tract tumors against 1.9 expected. The article calls this slightly more than a threefold excess, which confirms that the printed '19' means 1.9.
  • Plumbers (Study 2): cancers of the nasal sinus, larynx, lung and pleura were in excess among the 900 cancer cases reported for plumbers.
  • Insulators (Study 2): 23 lung cancer cases among 77 cancer cases, almost four times the expected number. There were no pleural tumors among insulators, which the author attributed to the small total number of cancer cases.
  • Painters (Study 2): 6 pleural tumors, twice the expected number.
• The authors' conclusion: The author suggested that one reasonable explanation for the excess respiratory cancer among plumbers and insulators, from the nasal sinus down to the lungs and pleura, could be past exposure to asbestos. The author said it was not clear whether their gastrointestinal cancers had a similar cause. For the painters' pattern of esophageal, liver and intrahepatic bile duct cancer, the author raised exposure to solvents as a possibility.
• Limitations the authors state:
  • The healthy worker effect is likely to be strong in a group with selection mechanisms and short follow-up.
  • The author could not identify which specific products were used, so neither exposure nor latency period could be estimated.
  • Whether the excess of gastrointestinal cancer in plumbers and insulators had a similar cause to their respiratory cancers was unclear to the author.
  • Nothing was known about diet in these groups.

Topics

Medical terms in this study, explained in our Lexicon: Insulator, Esophageal Cancer, Healthy Worker Effect, Bronchus, Lung Cancer, Laryngeal Cancer, Cancer Registry, Asbestos Exposure.

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