{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,6]],"date-time":"2026-10-06T07:49:43Z","timestamp":1791272983645,"version":"4.1.0"},"reference-count":45,"publisher":"BMJ","issue":"2","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Occup Environ Med"],"published-print":{"date-parts":[[1995,2]]},"abstract":"<jats:p>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.<\/jats:p>","DOI":"10.1136\/oem.52.2.73","type":"journal-article","created":{"date-parts":[[2008,12,17]],"date-time":"2008-12-17T00:14:48Z","timestamp":1229472888000},"page":"73-81","source":"Crossref","is-referenced-by-count":125,"title":["Cancer and occupational exposure to inorganic lead compounds: a meta-analysis of published data."],"prefix":"10.1136","volume":"52","author":[{"given":"H","family":"Fu","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"P","family":"Boffetta","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[1995,2,1]]},"reference":[{"key":"ref_1","first-page":"0","article-title":"In a secondary 83 lead smeltery for 34 y The tumour (renal cell carcinoma) Baker et","volume-title":"contained 2-47 pg of lead\/g tissue, the renal contex contained 1-07, ug\/g, and renal medulla 0-78 pg\/g","author":"al","year":"1980","unstructured":"In a secondary 83 lead smeltery for 34 y The tumour (renal cell carcinoma) Baker et al (1980)1 contained 2-47 pg of lead\/g tissue, the renal contex contained 1-07,ug\/g, and renal medulla 0-78 pg\/g (normal adult range: 0-27-1-27"},{"key":"ref_2","article-title":"had been repeatedly tested for PbB Lilis","volume-title":"and treated with more than five courses of chelation treatment during the period of employment","author":"He","year":"1981","unstructured":"He had been repeatedly tested for PbB Lilis (1981)2 and treated with more than five courses of chelation treatment during the period of employment."},{"key":"ref_3","first-page":"UK)","article-title":"Male pensioners","year":"1926","unstructured":"Male pensioners (1926-60, UK)"},{"key":"ref_4","first-page":"UK)","article-title":"Pensioners (1644 Men and 254 women), 1925-76 (including those above, UK) 2352 Men and 4680 Men","volume-title":"2300 Men and 4519 Men, (same as above) 1987 White men employed monthly for >1 y","author":"USA","year":"1946","unstructured":"Pensioners (1644 Men and 254 women), 1925-76 (including those above, UK) 2352 Men and 4680 Men (1946-70, USA) 2300 Men and 4519 Men, (same as above) 1987 White men employed monthly for >1 y (1940-65, USA) 1900 Workers (same as above) 3831 Men first employed before 1967 for > 3 months, (Sweden) 437 Workers employed > 3 y at work sites with high exposure to Pb (subcohort from above) 57 Men with non-fatal clinical Pb poisoning (1930-45, UK) 1046 Men employed past and present at any time, (1940-69, USA) 700 Compositors and 460 Pressmen (USA) 1027 Compositors and 778 Pressmen (USA)"},{"key":"ref_5","article-title":"Workers employed for > 5 y","year":"1956","unstructured":"Workers employed for > 5 y (before 1956, Italy)"},{"key":"ref_6","article-title":"Pigment factory","year":"1981","unstructured":"-70 1946-70 1946-80 1946-80 1940-77"},{"key":"ref_7","article-title":"chromate pigment Printing Printing","unstructured":"Pigment factory < 1981"},{"key":"ref_8","article-title":"Male typesetters (employed in 1961, USA) 468 Workers employed for > 1 y","volume-title":"625 Male art glassworkers","author":"Finland","year":"1953","unstructured":"< 1979 chromate pigment Printing Printing"},{"issue":"2","key":"ref_9","first-page":"ug\/dl","article-title":"Mean: PbB","volume":"58","author":"33 6,","year":"1950","unstructured":"Male typesetters (employed in 1961, USA) 468 Workers employed for > 1 y, (1953-67, Italy) 625 Male art glassworkers ) 1 month of employment, (1964-1985, Sweden) 1803 Men and 1946 women, > 3 months of empoyment (Finland)"},{"key":"ref_10","article-title":"Pb: Zn = 9: 1 no data on exposure to Pb available Oil mist in air 5-21 mg\/m3; No exposure to Pb available Gross ink mist 12-2 mg\/mr; Respirable ink mist 1-4 mg\/mi No exposure to Pb available Job categories: compositors and stereotypes; photographers and photoengravers; pressmen; packers and forwarders; others","volume-title":"12, ug Pb\/m3, in 1942; < 10, ug Pb\/m3 in; Producing low quality glass containers","year":"1970","unstructured":"Mean: PbB (1950) 58 2,ug\/dl PbB (1974) 33 6,ug\/dl"},{"key":"ref_11","article-title":"Malcolm and Darnett","year":"1982","unstructured":"Pb: Zn = 9:1 no data on exposure to Pb available Oil mist in air 5-21 mg\/m3; No exposure to Pb available Gross ink mist 12-2 mg\/mr; Respirable ink mist 1-4 mg\/mi No exposure to Pb available Job categories: compositors and stereotypes; photographers and photoengravers; pressmen; packers and forwarders; others 12,ug Pb\/m3, in 1942; < 10,ug Pb\/m3 in 1970s Producing low quality glass containers"},{"key":"ref_12","article-title":"Cooper and Gaffey","year":"1975","unstructured":"Malcolm and Darnett (1982)'4"},{"key":"ref_13","article-title":"Cooper et","volume-title":"l","author":"al (1985)'6 Selevan et al","year":"1985","unstructured":"Cooper and Gaffey (1975)15"},{"key":"ref_14","article-title":"Sheffet et","author":"al","year":"1982","unstructured":"Cooper et al (1985)'6 Selevan et al (1985) l' Steenland et al (1992) 8 Gerhardsson et al (1986)'9"},{"key":"ref_15","article-title":"Pasternack and Ehrlich (1972)2'","author":"Goldstein","year":"1970","unstructured":"Sheffet et al (1982)2","journal-title":"Bertazzi and Zocchetti"},{"key":"ref_16","article-title":"Michaels et","volume-title":"Wingren and Englander","author":"al (1991)25 Cordioli et al","year":"1987","unstructured":"Goldstein et al (1970)22 Pasternack and Ehrlich (1972)2' Bertazzi and Zocchetti (1980)24"},{"key":"ref_17","article-title":"Cohort was divided into oral glass blowers, automated glass blowers, and other glass workers Sankila et","author":"al","year":"1990","unstructured":"Michaels et al (1991)25 Cordioli et al (1987)27 Wingren and Englander (1990)28"},{"key":"ref_18","article-title":"Battery: Dingwall-Fordyce and Lane (1963)'","volume-title":"All Malcolm and Barnett","year":"1982","unstructured":"Cohort was divided into oral glass blowers, automated glass blowers, and other glass workers Sankila et al (1990)29"},{"key":"ref_19","article-title":"Battery and smelter: Cooper and","year":"1975","unstructured":"Battery: Dingwall-Fordyce and Lane (1963)' All Malcolm and Barnett (1982)'4t"},{"key":"ref_20","article-title":"Cooper et","author":"al","year":"1985","unstructured":"Battery and smelter: Cooper and Gaffey (1975)"},{"key":"ref_21","article-title":"Smelter: Selevan et","volume":"7","author":"al","year":"1985","unstructured":"Cooper et al (1985)'6t"},{"key":"ref_22","article-title":"Steenland et","author":"al","year":"1992","unstructured":"Smelter: Selevan et al (1985)' 7"},{"key":"ref_23","article-title":"Gerhardsson et","author":"al","year":"1986","unstructured":"Steenland et al (1992)'8t"},{"key":"ref_24","article-title":"Pigment: Davies","year":"1984","unstructured":"Gerhardsson et al (1986)'9t"},{"key":"ref_25","article-title":"Sheffet et","author":"al","year":"1982","unstructured":"Pigment: Davies (1984)2Ot"},{"key":"ref_26","article-title":"Printing: Goldstein et","author":"al","year":"1970","unstructured":"Sheffet et al (1982)'t"},{"key":"ref_27","article-title":"Pasternack and Ehrlich","year":"1972","unstructured":"Printing: Goldstein et al (1970)22"},{"key":"ref_28","year":"1980","unstructured":"Pasternack and Ehrlich (1972)23"},{"key":"ref_29","article-title":"Michaels et","author":"al","year":"1991","unstructured":"All: Pressmen Bertazzi and Zocchetti (1980)24"},{"key":"ref_30","article-title":"Glassworks: Cordioli et","author":"al","year":"1987","unstructured":"Michaels et al (1991)25t"},{"key":"ref_31","article-title":"Wingren and Englander","year":"1990","unstructured":"Glassworks: Cordioli et al (1987)2't"},{"key":"ref_32","article-title":"Sankila et","author":"al","year":"1990","unstructured":"Wingren and Englander (1990)28t"},{"key":"ref_33","article-title":"Battery industry-The manufacture of electric storage batteries is a major source of occupational exposure to lead, especially lead oxide dust. In 1963, Dingwall-Fordyce and Lane conducted a retrospective study of 425 pensioners who had been exposed to lead in several companies in England.\"3 A non-significant increased risk for all malignant neoplasms was found. When the subjects were divided into categories of exposure according to urinary lead concentrations, however, no trend in risk was found with increased exposure","unstructured":"Sankila et al (1990)29t"},{"key":"ref_34","first-page":"1","article-title":"In an extended cohort of 1898 pensioners from four lead acid battery companies in England based on the earlier study there was no excess of deaths from all malignant neoplasms.'4 An excess of observed (136) over expected","volume-title":"18-33) deaths from all cancer was, however, noted in men who died in service (proportionate mortality ratio (PMR) 1 15, P > 0 05). An increase in the PMR was seen with exposure to lead, with a PMR for no exposure of 1 02, for light exposure 1-06, and for high exposure 1 30. A more detailed analysis showed an excess of malignant neoplasms of the digestive tract among men in the group with no exposure to lead who died in service, with 21 observed against 12-56 expected deaths (PMR","year":"(1","unstructured":"Battery industry-The manufacture of electric storage batteries is a major source of occupational exposure to lead, especially lead oxide dust. In 1963, Dingwall-Fordyce and Lane conducted a retrospective study of 425 pensioners who had been exposed to lead in several companies in England.\"3 A non-significant increased risk for all malignant neoplasms was found. When the subjects were divided into categories of exposure according to urinary lead concentrations, however, no trend in risk was found with increased exposure."},{"key":"ref_35","article-title":"In 1985, Cooper et al'6 updated their previous cohort study'5 to 1980. They expanded the period of follow up from 24 to 34 years. They found a significant excess of deaths due to all malignant neoplasms among the battery workers, which was largely explained by more","unstructured":"In an extended cohort of 1898 pensioners from four lead acid battery companies in England based on the earlier study there was no excess of deaths from all malignant neoplasms.'4 An excess of observed (136) over expected (1 18-33) deaths from all cancer was, however, noted in men who died in service (proportionate mortality ratio (PMR) 1 15, P > 0 05). An increase in the PMR was seen with exposure to lead, with a PMR for no exposure of 1 02, for light exposure 1-06, and for high exposure 1 30. A more detailed analysis showed an excess of malignant neoplasms of the digestive tract among men in the group with no exposure to lead who died in service, with 21 observed against 12-56 expected deaths (PMR 1-67, P = 0 009). This excess mortality was almost entirely confined to the period 1963 to 1966."},{"key":"ref_36","article-title":"Wingren and Axelson","year":"1987","unstructured":"In 1985, Cooper et al'6 updated their previous cohort study'5 to 1980. They expanded the period of follow up from 24 to 34 years. They found a significant excess of deaths due to all malignant neoplasms among the battery workers, which was largely explained by more"},{"key":"ref_37","article-title":"Siemniatycki","year":"1991","unstructured":"Wingren and Axelson (1987)36"},{"key":"ref_38","first-page":"34","article-title":"Ades and Kazantzis (1988)3\"","volume-title":"Fanning","year":"1988","unstructured":"Siemniatycki (1991)39"},{"key":"ref_39","author":"Wingren; Axelson","year":"1933","unstructured":"Ades and Kazantzis (1988)3\" Fanning (1988) 34"},{"key":"ref_40","article-title":"Fanning","year":"1988","unstructured":"Wingren and Axelson (1933)38 Siemiatycki (1991)39 Cooper (1989)"},{"key":"ref_41","author":"men, For","year":"1988","unstructured":"Fanning (1988)84"},{"key":"ref_42","article-title":"adjusted by cigarette smoking Siemiatycki","year":"1991","unstructured":"For men, Risch et al (1988)"},{"key":"ref_43","article-title":"Mallin et","volume-title":"deaths than expected from malignancies of the stomach and lung. Among the smelter workers, although there were excesses of deaths due to malignancies","author":"al","year":"1989","unstructured":"adjusted by cigarette smoking Siemiatycki (1991)"},{"key":"ref_44","article-title":"To attempt to evaluate the relative roles of occupational and non-occupational factors for a significant excess of deaths from stomach cancer found in the subcohort of 4519 battery workers already mentioned,16 a nested casecontrol study was carried out by Cooper et al.'0 Thirty cases and 120 controls were involved in the study. No association was detected between occupational exposure to lead and gastric cancer. Comparison of the cases and the controls based on quartiles for employment and on months of employment 10 and 20 years before death showed no trend of odds ratios (ORs) with the increasing employment period. There were more foreign people among the cases, with an OR of 1","unstructured":"Mallin et al (1989)40 deaths than expected from malignancies of the stomach and lung. Among the smelter workers, although there were excesses of deaths due to malignancies of all sites, the stomach, and lung, none reached significance because of small numbers. There were still deficits of deaths from malignancies of the kidney among both the battery and the smelter workers."},{"key":"ref_45","article-title":"Steenland et al extended the follow up of this lead smelter cohort from 1977 up to 1988.'1 There were still non-significant excesses of deaths due to cancers of the stomach, lung, kidney, and bladder in the entire cohort. A significant SMR (95% CI) of 2-39","volume-title":"for kidney cancer, however, was shown in the high exposure to lead group. A Table S Meta-analysis for selected cancer sites of the studies of occupational exposure to Pb","year":"(1 03-4-71)","unstructured":"To attempt to evaluate the relative roles of occupational and non-occupational factors for a significant excess of deaths from stomach cancer found in the subcohort of 4519 battery workers already mentioned,16 a nested casecontrol study was carried out by Cooper et al.'0 Thirty cases and 120 controls were involved in the study. No association was detected between occupational exposure to lead and gastric cancer. Comparison of the cases and the controls based on quartiles for employment and on months of employment 10 and 20 years before death showed no trend of odds ratios (ORs) with the increasing employment period. There were more foreign people among the cases, with an OR of 1 29 (P > 0.05)."}],"container-title":["Occupational and Environmental Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/oem.52.2.73","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,5,23]],"date-time":"2024-05-23T13:53:41Z","timestamp":1716472421000},"score":1,"resource":{"primary":{"URL":"https:\/\/oem.bmj.com\/lookup\/doi\/10.1136\/oem.52.2.73"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[1995,2]]},"references-count":45,"journal-issue":{"issue":"2","published-online":{"date-parts":[[1995,2,1]]},"published-print":{"date-parts":[[1995,2]]}},"alternative-id":["10.1136\/oem.52.2.73"],"URL":"https:\/\/doi.org\/10.1136\/oem.52.2.73","relation":{},"ISSN":["1351-0711","1470-7926"],"issn-type":[{"value":"1351-0711","type":"print"},{"value":"1470-7926","type":"electronic"}],"subject":[],"published":{"date-parts":[[1995,2]]}}}