COMMENTARY ON TABLE 2 (FEMALE MORTALITY, 1974-1979)

Managers, Officials, and Proprietors NEC
Occupation code 290
Total deaths 492

Malignant neoplasms of other and unspecified sites show a mortal-
ity increase as does the subarachnoid hemorrhage rubric. Coronary heart
disease shows a deficit of deaths.

Grocers and Grocery Clerks
Occupation code 298
Total deaths 323

The other lymphoma category, lymphosarcoma, subarachnoid hemorrhage,
and homicide show mortality increases based on small numbers.

Bankers, Bank Clerks, and Managers
Occupation code 305
Total deaths 187

Total malignant neoplasms show a 38 percent increase in deaths due
primarily to increased mortality from malignant neoplasms of the large
intestine, lung, breast, and ovary.

Bookkeepers, Cashiers, and Payroll Clerks
Occupation code 310
Total deaths 1,058

Women in this group show increased mortality due to multiple sclero-
sis. Pulmonary embolism and infarction and chronic rheumatic heart disease
(age 20-64) also have increased deaths.

Postal Workers
Occupation code 340
Total deaths 192

Brain cancer has a PMR of 519 based on 7 deaths.

57


INDEX OF OCCUPATIONS FOR MEN

Number
of Occupation Grouped Commentary
Deaths Code Code Page
Filers, metal.... E00000000000 AE) 653 523 37
Filers, saw... sees 3,201 704 974 51
Firemen/fire protection workers... 850 -— - 49
Firemen, locomotive.........seeee. 460 = 32
Firemen, stationary 424 712 520 37
Fishermen........ 962 -—- 50
Flame cutters.... 721 45
Flight attendants, airline........ 10 009% --
Floor workers (covering, hardwood) 528 38
Floor men and managers, store..... 43 254% -—-
Florists... ssececeeececeees 249 17
Flour mill employees.. 402 967 34
Food processing workers. 527 38
Foremen, construction. 661 429 27
Foremen, farm....... 70 901 50
Foremen, garage 291 20
Foremen NEC...... 430 30
Foremen, railroad oO 427 29.
FOresteTs.. cee ceeessecsccecces 103 11
Forest service workers/lookouts... 724 45
Forgemen.......++ go0000000G00 17 431 30
Foundry, furnacemen...... . 211 670 30
Fountain/counter workers...... 39 830* --
Fruit/nut graders and packers. 89 654 52
Fruit inspectors...... 56 976 52
Fruit warehouse workers. 422 975 52
Fuel oil dealers/workers. 295 20
Fuel oil truck drivers....... 716 45
Fumigation workers............ 6 849% — --
Funeral directors........ 104 — 11
Furmacemen.......... 211 670 435 30
- Furniture finishers.............66 974 — 54
Furniture store owners, managers,
CLETKS. cer eccccccccccessecesecce 297 —— 21
Fur traders.... 266 387% — -
G
Game department workers...... . 724 45
Garage laborers, car washers.. 291 20
Garage owners..........eeeeee 291 20
Garbage collectors............ 891 49
Gardeners, landscape (not farm)... 964 50
Gas station attendants.. . 291 20
Gas station owners...........se006 291 20
Geologists and geophysicists...... 58 134* -- --

121


COMMENTARY ON TABLE 1 (MALE MORTALITY, 1950-1979)

Shipping and Receiving Clerks
Occupation code 343
Total deaths 832

Significant PMR increases are seen for chronic interstitial pneu-
monia, duodenal ulcer, and intestinal obstruction without hernia.

Stock Clerks and Storekeepers
Occupation code 350
Total deaths 1,075

Total malignant neoplasms have a small but significant PMR excess.
Cancers of the large intestine have a significantly elevated mortality.

Telegraph and Radio Operators
Occupation code 352
Total deaths 615

Elevated PMRs are seen for causes of death associated with alcoholism,
i.e., cancers of the buccal cavity and pharynx and alcoholic cirrhosis of
the liver. Hodgkin's disease and acute leukemia also have elevated PMRs.

Ticket, Station, Express, and Travel Agents
Occupation code 354
Total deaths 870

Lung cancer mortality is very low. Myeloid leukemia, other hyperten~
sive disease, and chronic bronchitis have elevated PMRs.

Railroad Clerks
Occupation code 361
Total deaths 923

Malignant brain tumors have very high PMRs in these men (observed 13
deaths, expected 3, PMR = 382). Chronic rheumatic heart disease also shows
excess deaths.

23


MICROFICHE TABLES - TABLE 1, MALE MORTALITY

Grouped Microfiche

Code Occupation Page Column
350 Stock Clerks and Storekeepers..........0eee0ee 5 9
352 Telegraph and Radio Operators...........ee.00. 5 10
354 Ticket, Station, Express, and Travel Agents... 5 11
361 Railroad Clerks .......cecsscccsccccccscccennes 5 12
362 Boeing Clerks......cccrcsccccarccccccsceresecs 5 13
363 Public Utility Workers p0000 5 14
364 Public Utility Supervisors and Officials...... 5) 15
370 Clerks NEC...... eee nce cee ec ceeeesesceseeeeene 5 16
380 Travelling Salesmen and Sales Representatives. 6 1
384 Lumber Salesmen......... cee cece cece cece eee eens 6 2
385 Insurance Agents, Brokers, Underwriters,

and Appraisers ..... ccc even eccsccccseccneces 6 3)
386 Car Salesmen...... ess eeeceeseeee ess ecceseccees 6 4
390 BERET 0000000000 000000000080 0000000000000000 6 5
393 Real Estate Agents, Brokers, Developers,

and Appraisers........0..ee00% . oe 6 6
395 Stocks and Bonds Salesmen... 6 7
396 Sales Clerks NEC... ccc ec c ccc e cece eee eeens 6 8
400 Carpet Makers and Layers. 6 9
401 Bakers ....cceceercces . 6 10
402 Blacksmiths. 6 11
403 Boilermakers ....cecescccccccscenesassccesssece 6 ales
405 Brickmasons, Stonemasons, and Tile Setters.... 6 13
406 Building and Construction Contractors and

6 14

407 6 15
410 Cabinetmakers ....... cee cccccscsccceccccccecees 6 16
411 Carpenters .....ccccccceceees 7 1
412 Fabric Workers .....cecee eee eeee 7 2
413 Cement and Concrete Finishers.... 7 3
415 Cranemen, Derrickmen, and Hoistmen............ 7 4
416 OAL Well Drillers .....essecevessceccreccsseces 7 5
420 Decorators and Window Dressers. 7 6
421 Electricians ........--csesscecccnvecnsctsececs 7
425 Road Graders and Pavers, Machine Operators,

and Excavators ....cceesceesecceccccccecscees 7 8
426 Water Well Drillers .....ccssccccrccccvccescecs 7 9
427 Railroad Foremen. 7 10
430 Foremen NEC... 7 i
434 GLAZLETS 20. cee see ecenseccceveccecseesvcveccees 7 12

152


INDEX OF OCCUPATIONS FOR WOMEN

Number
of Occupation Grouped Commentary
Deaths Code Code Page

Ranchers. .ssserecseccreccccecccces 20 203 200 56
Receiving clerks 62 343 --- 58
Receptionists..........06. 94 341 370 59
Recreation and group leaders. 67 165* — fo)
Religious workers......... 0 102 170 --- 55
Reporters..... 43 075* --- 5
Reporters, COULC..... eee ee eee eee 9 006* — =
Restaurant/cafe owners, managers

and workers......... 817 -—- 62
Roofers and slaters........... 2 514% — 5
Rubber welders and tire recappers. 6 477% --- -—

s

Sailmakers....ssseceecccccecceccee 5 412 59
Sailors and seamen. 2 703* --
Sales clerks. 396 59
Sales managers 30 285* -
Salesmen, auto.. 6 386% -
Salesmen, chemical. 2 388% -
Salesmen, lumber........ 5 384% --- =
Salesmen, stocks and bonds. 12 395* --
Salesmen, travelling...... 65 380% -
Sales representatives. . 65 380% =
Sandblasters. on 1 725* =
Sanitarians.............6. . 1 176* =
Sawyers and sawmill workers 5 704* -
School administrators..... 28 184 -—- 55
School janitors....... 22 836 63
Scientists, agricultural 5 130* -
Scientists, biological... 9 10 131* ~~
Scientists, social...........0.006 6 175* --- -
Seamstresses/dressmakers except

factory........-5+2-+-+ gogo0cc00:~— CN 651 --- 60
Secondhand store workers and

junk dealers...... cece eee cence 8 892% Ss
Secretaries.......... - 1,514 342 58
Sewers, garment factory. - 219 705 59
Sheepherders.............4- seaeee 9 907% =
Sheet metal workers, tinsmiths,

and coppersmiths..........e.eeee 17 525* =
Sheriffs........ . 9 854% =
Shipfitters.. O 121 507 60
Shipping clerks. 000 Q 62 343 58
Ships' officers/pilots/pursers.... 7 265* + --
Shipyard electricians........ a 1 422 507 60
Shipyard machinists.. 00 1 467 507 60
Shipyard workers NEC............. 121 507 --- 60

147


DISCLAIMER

The contents of this report are reproduced herein as received from the
contractor. Mention of company names or products does not constitute
endorsement by the National Institute for Occupational Safety and Health.

NIOSH Project Officer: Edward W. Dacey

DHHS (NIOSH) Publication No. 83-116


INDEX OF OCCUPATIONS FOR MEN

Number
of Occupation Grouped Commentary

Deaths Code Code Page
Cheesemakers........eeeeeeeeeeeeee 655 _ 41
Chefs....sscecsccenrccces 90 825 --- 47
Chemical company employees. 9000 985 -—- 53
Chemical engineers....... 106 081 093 11
Chemical salesmen... 77 388* --- -
Chemistry professors.. O 12 034 060 9
Chemists..........005 O 021 -— 8
Chiropodists.... . 21 016* — —
Chiropractors.....scscecececeeeees 022 -—— 8

City/county road construction and
maintenance workers............. 1,616 496 29
.- 255 18
Civil engineers.......... 082 10
Civil service employees.. D 255 -—- . 18
GF ono 00 00000000000000000000 28 824* ~
Clergymen..... . 023 — 8
Clerks, bank.. O 305 —- ~ 21
Clerks, Boeing..........cceeeceeee 362 24
Clerks, file............. 22 320% -
Clerks, furniture store.. 9 297 -—- 21
Clerks, grocery store... o 298 -—- 21
Clerks, NEC 2 . 370 - 24
Clerks, payroll and timekeeping... 333 310 yal
Clerks, postal...........00005 340 -—- 22
Clerks, 361 -_ 23
Clerks, sales NEC..............005 396 —_ 26
Clerks, shipping and receiving 343 -- 23
Clerks, stock..........eceeeee 350 —_ 23
Coaches, athletic................. 118 015* -- -—-
Coast Guard officers/enlisted men. 293 548 551 39

Cocktail bar owners/operators,

managers and workers............ 1,188 816 815 46
Collectors, bill and account...... 94 313* --- -
College presidents and deans.. 54 030* -_—- -
Compositors.............00 471 414 512 36
Comptrollers.......... 000 -- 7
Computer programmers. oe 174 --- 13
Concrete finishers...............5 413 — 28
Conductors, bus/street railway.... 101 645* --- --
Conductors, railroad.............. 252 --- 18
Conservationists...... 90000 103 - 11
Constables and marshals... 90000 106 852 853 49
Construction contractors.......... 3,591 406 -—- 27
Construction, city/county roads... 1,616 496 425 29
Construction engineers............ 351 094 093 11
Construction foremen.............. 661 429 406 27

117


COMMENTARY ON TABLE 3
(MALE MORTALITY BY OCCUPATION WITHIN CAUSE-OF-DEATH GROUPS)

cement, and metal-bearing dusts. Fishermen and oystermen and men in occupa—
tion code group 265 (officers, pilots, pursers, engineers, ship) work on
ships. The agent responsible for their gastric cancer increase remains to
be determined.

Malignant Neoplasm of the Large Intestine (ICD 153)

This cause of death is more common in upper social classes, presumably
due to dietary habits. This would account for the high PMRs seen in veterin-
arians, physicians, bankers, and engineers. This cannot, however, account
for the increased PMRs seen in many of the other occupational groups.

Malignant Neoplasm of the Rectum (ICD 154)

Occupations having high PMRs due to rectal cancer are a curious mix-
ture with no obvious common denominator. The excess in printers has been
reported elsewhere (38).

Malignant Neoplasm of the Biliary Passages and Liver (ICD 155)
Malignant Neoplasm of the Gallbladder, Bile Ducts and Ampulla of Vater
(ICD 155.1)

These cancers have also been related to alcohol ingestion. This would
seem to account for the high PMR seen in brewery workers for ICD 155. Men
in the accountants rubric show an increased mortality from these causes
over time while their alcoholic cirrhosis PMRs have fallen over time.
Laundry and dry cleaning workers also have solvent exposures.

Malignant Neoplasm of the Pancreas (ICD 157)

The excess of pancreatic cancer in chemists has been reported pre-
viously(18). Foresters and nurserymen have pesticide exposures. Motion
picture projectionists and aluminum workers are both exposed to coal tar
pitch volatiles released when anode binder material is burned.

Malignant Neoplasm of the Respiratory System (ICD 160-165)

With the exception of the two military code groups, and possibly
window dressers (code 420), all the occupations having high PMRs due to
respiratory cancer are employed in dusty, blue collar jobs, most of which
have exposure to known carcinogens. Cigarette smoking is probably also
involved. Exposure to known respiratory carcinogens is seen in asbestos

66


MICROFICHE TABLES - TABLE 1, MALE MORTALITY

Grouped Microfiche

Code Occupation Page Column
000 Accountants, Auditors, and Assessors........6+ L 1
012 Airplane Pilots and Navigators..... 1 2
013 Architects.........+.-- se eeeee 1 3)
014 Artists and Art Teachers. eee 1 4
021 Chemists. ...cecsccesaccccscecsccccccccssnceene 1 5
022 1 6
023 1 7
060 1 8
071 1 9
074 al, 10
075 Editors and Reporters..... 1 11
076 Newspaper Owners, Publishers, and Managers.... 1 12
080 Aeronautical Engineers......... 900000000000000 1 13
082 Civil Engineers....... 00 1 14
083 Electrical Engineers oe 1 15
085 Mechanical Engineers..... 900000000000G00000000 1 16
086 Marine Engineers..........- 2 1
093 Engineers NEC....... 2 2
094 Construction Engineers 2 3
096 Operating Engineers...... 2 4
103 Foresters and Conservationists.........seeeee> 2 5
104 Funeral Directors and Embalmers 2 6
105 Lawyers and Judges.. 2 7
120 Musicians and Music Teachers........seeeeeoeee 2 8
152 Optometrists. ....eeeeeeeeeeeeeeees 900000000000 2 9
154 Personnel and Labor Relations Workers. 2 10
160 Pharmacists and Druggists.........+- 2 1
161 Photographers.....+-+-+-++ dD0000000000000000000 2 12
162 Physicians.........eeeeee 000000000000000 000000 2 13
174 Statisticians, Actuaries, Analysts, and

Computer Programmers...... 2 14
181 SUTVEYOTS... eee eee e eee 2 15
184 School Teachers... 2 16
185 Medical and Dental Technicians............+e0- 3 1
190 Electrical and Electronic Technicians . 3) 2
194 Veterinarians.....eeeeeeeeeeee eee eeeees . 3 3
195 Professional and Technical Workers NEC....... . 3 4

150


TABLE B

OCCUPATIONS WITH HIGHEST PMRS DUE TO SOFT TISSUE CANCERS (ICD 197)

Observed Expected PMR

086 Marine engineers 3 <.5 >600
305 Bankers 5 ab 465
674 Laundry, dry cleaners 3 1 >300
510 Plumbers, pipefitters 10 3 300**
184 Teachers 7 3 272%*
196 Students 4 2 250
512 Pressmen, printing 3 1 209
982 Construction laborers 8 4 198%
386 Car salesmen 3 2 184
405 Brickmasons 2 1 179
551 Navy officers/enlisted men 4 2 177
080 Engineers, aeronautical 2 1 176
641 Bus drivers 2 al 175
526 Aluminum workers 2 1 158
480 Mechanics NEC 6 4 156

* P< .05; #* P< 01

10. Multiple Sclerosis in Indoor and Outdoor Workers

Noticing that fishermen, sailors, and painters had low PMRs for
deaths due to multiple sclerosis (MS), I extended the analysis to all
indoor and all outdoor workers. Many occupations are impossible to
categorize as being indoor or outdoor. For example, a policeman may
work outdoors if he is a patrolman or ma » alternatively, have an indoor
desk job. It is possible that chronically disabled MS patients are forced
to give up strenuous outdoor jobs; however, rheumatoid arthritis, another
disabling disease, showed no deficit of deaths in outdoor workers, while
chronic rheumatic heart disease showed only an 8% deficit of deaths in
outdoor workers.

Since with rare exception all outdoor workers are blue collar workers,
the best control group is indoor blue collar workers. MS has a PMR of 70
in outdoor blue collar workers versus 102 in indoor blue collar workers
(see Table).

If real, the deficit of MS deaths in men who work outdoors suggests

that exposure to sunlight or some other outdoor factor may moderate or
prevent MS.

77


COMMENTARY ON TABLE 1 (MALE MORTALITY, 1950-1979)

Pharmacists and Druggists
Occupation code 160
Total deaths 1,143

Elevated PMRs are seen for deaths due to multiple myeloma, the other
lymphomas, and acute pancreatitis. There is no excess for the cirrhosis
category, so the pancreatitis excess is probably not related to alcoholism.
There is no suicide excess in this group as seen in the Registrar General's
data.

Photographers
Occupation code 161
Total deaths 507

Mortality excesses based on small numbers are seen for respiratory
tuberculosis and diseases of the blood-forming organs. Intestinal cancer
has a low PMR (observed 3, expected 8, PMR = 38). Hyperplasia of the
prostate and aircraft accidents also show small number PMR elevations.
Arteriosclerotic heart disease including coronary disease has a slightly
elevated PMR.

Physicians
Occupation code 162
Total deaths 1,554

Cancer of the large intestine and prostate, cancers of the lymphatic
and hematopoietic tissues (age 20-64), aircraft accidents, and suicide show
statistically significant PMR excesses. The intestinal cancer and suicide
excesses agree with the Registrar General's data. Lung cancer and non-
malignant respiratory diseases have low PMRs. Other studies(25,26) support
the suicide excess.

Statisticians, Actuaries, Analysts, and Computer Programmers
Occupation code 174
Total deaths 220

Cancer of the large intestine and rectum (1970-1979), lymphosarcoma,
Hodgkin's disease, and acute leukemia have excess deaths. Other diseases
of the heart and hypertensive heart disease also show significantly
elevated PMRs.

13


INDEX OF OCCUPATIONS FOR MEN

Number
of Occupation Grouped Commentary
Deaths Code Code Page
Mechanics, logging................ 227 464 970 51
Medical sciences professors. D 15 043 060 9
Medical technicians. 0 185 14
Merchant Marines.. + 1,314 553 44
Messengers.......... . 47 324% ~—
Messengers, telegraph............. 22 351* ~
Metal filers, grinders, polishers. 153 653 37.
Metal heaters..........cceeeceeeee 21 671 30
Metal jobsetters...... 000 9 452 37
Metallurgical engineers . 79 090 11
Metal’ molders......... O 492 -- 35
Metal rollers and roll hands . 30 513 525 38
Metal workers, structural......... 523 -- 37
Metal workers, tin, copper, sheet. 525 -- 38
Metal working trades apprentices
NEC......04 op00000 14 614 523 37
Meteorologists............06 29 141* -—- =
Milk route deliverymen...... 656 -—- 42
Millers, grain, flour, feed 490 -— 34
Milliners................ . 17 680* --- =
Mill workers, paper/pulp... 500 35
Mill workers, sash-door/pole...... 974 --- 51
Millwrights.............ccceeeeeee 491 -- 34
9000000000 21 690% --- 5
Mine operatives and laborers NEC.. 685 -- 42
Mining engineers.................. 241 091 093 11
Mink ranchers............ sees = 266 387% --- --
Model makers, except paper. 0000 502 --- 35
Molders, metal........... 492 -—- 35
Motel owners and managers.... . 819 47
Motion picture projectionists. 493 35
Motormen, mine and factory........ 21 690% --- —
Motormen, street/subway/elevated
railway... see e cece eee eeeeeeeees 261 691 641 41
Musicians.... oes 120 --- 12
Music teachers...........ceceeeeee 120 --- 12
N
Navigators, airplane.............. 012 -—- 7
Navy officers and enlisted men 551 --- 39
Natural sciences professors... 20 052 060 9
Newsboys.........e cece eee a 390 --- 25
Newspaper owners........ 0 076 --- 9
Non-scientific professors.. 00 81 054 060 9

126


INDEX OF OCCUPATIONS FOR MEN

Number
of Occupation Grouped Commentary
Deaths Code Code Page
Shipyard workers NEC............4- 507 --- 36
Shoemakers and repairers. D 515 37
Shoeshine operators... » 110 820* -
Sign painters....... O 694 43
Silversmiths... . 451 31
Slaters..........-2006 . 514 37
Slaughterhouse butchers - 843 677 42
Smelter workers....... . 435 30
Smelter workers NEC. » 147 672 30
Social science professors D 20 053 9
Social scientists...... . 10 175* -
Social workers... - 209 171* -
Society officials 0 275 19
Spinners, textile..........eeeeeee 26 710 28
Sports instructors and officials.. 48 180* --
Starters, vehicle.......ceeeeeeaee 314 22
Station agents... O 354 -— 23
Stationary engineers O 520 = 37
Stationary firemen ~ 424 712 520 37
Statisticians.... D 174 — 13
Steam engineers 0 374 099 093 11
Steamfitters............. » 831 508 510 36
Steamfitters, atomic energy. 9 65 509 558 40
Stenographers............ 5 18 345% --- --
Stereotypers » 100 423 36
Stevedores..........00. . 965 SL
Stewards and housekeepers.. 204 832% 4
Stock clerks and storekeepers..... 350 23
Stocks salesmen..........eeeeeeeee 395 26
Stonecutters and stonecarvers...... 521 37
Stonemasons.......seeeeeceseeccces 405 = 27
Storage workers and truck drivers... 616 719 715 44
Store buyers.......... 250 —< 17
Structural metal workers. 523 > 37
Students 18 and over..... 196 — 15
Superintendents, building 262 _ 18
Supervisors, Boeing... 294 -- 20
Supervisors, public utility. 364 -- 24
SuLgeons...... cece ec eee eee ceeevees 162 -—- 13
Surveying chainmen, rodmen, axmen.. 21 642% --- --
SurveyOrs.......sssececccccecencces 181 -—- 14
Switchmen, railroad...............6 713 -_—- 44
T
LEVIS T9900 000000900000000000GG0000 524 -— 38
TAMMerS...sscecscccccccceae oeeccees 515 7 37


other groups shown in the accompanying table. This suggests that inhaled
and swallowed wood particles may cause gastric cancer. The gastric cancer
excess may also be related to the fact that a high proportion of men in
these trades, especially the loggers and mill workers, use chewing tobacco.
The lymphatic and hematopoietic cancer increases, especially in the paper,
pulp, and plywood workers, suggest that physical and chemical breakdown
products of wood may be carcinogenic. Men who work in sawmills where wood
is simply machined do not show a cancer excess as seen in the paper, pulp,
and plywood industries.

Nasal and paranasal sinus cancers, which have been related to wood dust
exposure, show an excess mortality (PMR 200) in the cabinetmakers class
(based on 2 deaths observed). Hodgkin's disease shows significant PMR
elevations in millwrights and in paper and pulp mill workers. Carpenters
and cabinetmakers also show slight elevations in the PMR for Hodgkin's disease.
The paper workers also show a significantly elevated PMR for deaths due to
multiple myeloma. The elevated leukemia PMR formerly seen in plywood workers
is not demonstrated in recent deaths, although plywood workers still have a
leukemia PMR of 142 based on 26 deaths for the entire study period.

These mortality figures are averages for all men in a given occupation.
Mortality figures for men working in high-risk processes may be much higher.

PMRs AND CANCER DEATHS FOR ALL WOOD-EXPOSURE OCCUPATIONS

IcD Nusbee————+ 151 155.1 160 197 201 203 204
Nose, Connective Hodgkin's Multiple
Malignant Neoplasw—+ Stomach Gallbladder 18S? | acs Disease _tyelona Leukemia

Code Occupation PMR Deaths PMR Deaths PR Deaths PYR Deaths PNR Deaths PMR Deaths PMR Deaths
410 Cabinetmakers Vee ML 9 2 >200 20 Oo 142 3 104 304300 3
411 Carpenters 12044 285 «88 «= 20119 9 96 11 150% 41 118 47 95 «18
491 Millwrights 1099 «1970 1 0 0 00 1 32ue*# 673 2 8 7
500 Paper and Pulp mill 9

Workars 10g 47142 & 56 1 91 3 194se 17 «82K 1912638
706 Plywood Workere 146s 4169 6 97 1 103 2% 4 1a 9 12 26
970 Loggers 115* 261 10l = 2292 7 61 7 60% 21 85 33 79% 100
974 Wood, Lumber and

Sawmill Workers 106 224 «136 = 2873 5 98 10 88 2% 8 30 98 i

# P< .05; ** P< .O1
3. Metal Workers

Workers in the 10 metal working occupations show increased mortality
from respiratory cancer. Boilermakers, smelter workers, plumbers, sheet-
metal workers and welders have a significant (P < .01) excess mortality
from respiratory cancer. Only machinists and aluminum workers have PMRs
below 110. Pancreatic cancer shows a significant excess of mortality in
aluminum workers only, suggesting that exposure in this occupation may be
different than that in the other metal working trades. T.2 total PMR for
pancreatic cancer in these workers is 96. Six of the 10 occupational
groupings have elevated PMRs for urinary bladder cancer.

72


COMMENTARY ON TABLE 1 (MALE MORTALITY, 1950-1979)

Foremen NEC
Occupation code 430
Total deaths 656

Cancer of the large intestine and kidney, Hodgkin's disease, and other
lymphomas show small number PMR increases. Cerebral embolism and thrombo-
sis (age 20-64) shows a significant PMR increase.

Glaziers
Occupation code 434
Total deaths 294

Digestive and peritoneal cancers (stomach, large intestine, and rectum)
and lymphatic and hematopoietic tissue cancers, especially multiple myeloma,
show excess deaths.

Smelter Workers
Occupation code 435
Total deaths 1,150

These men work at the American Smelting and Refining Company in Tacoma,
Washington, a large copper smelter which specializes in refining arsenic-
rich copper ores.

Lung cancers show an excess mortality in these workers. A population-
based study(35) in this work force corroborates this finding and relates it
to inhaled arsenic trioxide exposure.

Log/Lumber Inspectors, Scalers, and Graders, and Timber Cruisers
Occupation code 444
Total deaths 1,110

Cancer of the large intestine (age 20-64) and leukemia (1970-1979) have
elevated PMRs.

Railroad Inspectors
Occupation code 447
Total deaths 345

Asthma and chronic nephritis have increased PMRs.

30


EXHIBIT 4 -~ OCCUPATION GROUPINGS FOR MEN

Grouped Occupation
Code Code Occupation Title
352 352 Telegraph and Radio Operators
164 Radio Operators
354 354 Ticket, Station, Express, and Travel Agents
361 361 Railroad Clerks
362 362 Boeing Clerks
363 363 Public Utility Workers
364 364 Public Utility Supervisors and Officials
370 370 Clerks NEC
380 380 Travelling Salesmen and Sales Representatives
382 Demonstrators
383 Hucksters, Peddlers, and Promoters
384 384 Lumber Salesmen
385 385 Insurance Agents, Brokers, Underwriters,
and Appraisers
386 386 Car Salesmen
390 390 Newsboys
393 393 Real Estate Agents, Brokers, Developers, and
Appraisers
395 395 Stocks and Bonds Salesmen
396 396 Sales Clerks NEC
400 400 Carpet Makers and Layers
401 401 Bakers
402 402 Blacksmiths
403 403 Boilermakers

101


COMMENTARY ON TABLE 1 (MALE MORTALITY, 1950-1979)

Roofers and Slaters
Occupation code 514
Total deaths 681

Four lung-related diseases have elevated PMRs: respiratory tuber-
culosis, lung cancer, asthma, and pulmonary emphysema. Cancer of the
larynx, cirrhosis of the liver, and accidental falls also have elevated
PMRs. Hydrocarbons, including known carcinogens like Benzo(a)pyrene, are
inhaled in hot tar roofing.

Shoemakers, Shoe Repairers, and Leather Workers
Occupation code 515
Total deaths 1,006

Cancer of the esophagus and larynx, Hodgkin's disease, diabetes
mellitus (age 20-64), paralysis agitans, pulmonary embolism, and acute
pancreatitis have PMRs >200. The laryngeal cancer and Hodgkin's disease
increases are supported by a New York State study(40).

Stationary Engineers and Firemen
Occupation code 520
Total deaths 1,617

Cancer of the pancreas and non-lymphatic leukemias have elevated PMRs.
Urinary bladder cancer (age 20-64) also has a significantly elevated PMR.

Stonecutters and Stonecarvers
Occupation code 521
Total deaths 179

Of the 179 deaths in this group of workers, 8 were due to silicosis
versus less than .5 expected. Respiratory tuberculosis and cancer of the
pancreas also have excess deaths. The Registrar General's data support
the pneumoconiosis excess.

Structural Metal Workers
Occupation code 523
Total deaths 2,166

Cancer of the tongue, lung, and urinary bladder, fatal anemias, cerebral
embolism and thrombosis, and accidental falls from one level to another have
increased deaths.

37


MICROFICHE TABLES ~ TABLE 4, SIGNIFICANT MALE PMRS BY OCCUPATION

Grouped Microfiche
Code Occupation Page Row/Colum
000 Accountants, Auditors, and Assessors.. 19 A1-B1l
012 Airplane Pilots and Navigators...... o " cl
014 Artists and Art Teachers............... 0 " D1
021 Chem sts...ccsccssssccecece 00000000000000000a0 " El
023 Clergymen...........6 0 " F1-G1
060 Professors and Instructors.... oO " HL
O71 Dentists...........085 C " Il
074 Draftsmen..... 0 " Ji
075 Editors and Reporters. " K1
076 Newspaper Owners, Publishers, and Managers.... " Li
080 Aeronautical Engineers... 00000 6000000 " M 1-A 2
082 Civil Engineers... Q 900 " B2
083 Electrical Engineers....... oO 0 " C2
085 Mechanical Engineers....... " D2
086 Marine Engineers..... . " E2
093 Engineers NEC........ 0 " F2
094 Construction Engineers............0-- " G2
096 Operating Engineers.............. . " H 2
103 Foresters and Conservationists.. o " I2
104 Funeral Directors and Embalmers.. 0 " 32
105 Lawyers and Judges 5 oO oe " K 2-L 2
120 Musicians and Music Teachers. " M2
152 OptometristS.......eeeeeseeees . " A3
154 Personnel and Labor Relations Workers... " B3
160 Pharmacists and Druggists....... o " c3
161 Photographers.. 0 " D3
162 Physicians... 90000 - E3-F 3
174 Statisticians, Actuaries, Analysts, and
Computer Programmers..........e00000 9000000 " G3
181 SUIVEYOTS. cece eeee eevee " HS
184 School Teachers......... " I 3-3 3
185 Medical and Dental Technicians " K 3
190 Electrical and Electronic Technicians......... " L3
194 Veterinarians..... . " M3
196 Students..... " A4-B4
200 Farmers NEC. " C 4-E 4
201 Orchardists...... 0 " F 4-G 4

162


COMMENTARY ON TABLE 2 (FEMALE MORTALITY, 1974-1979)

Restaurant Owners, Managers, and Workers
Occupation code 817
Total deaths 359

Lung cancer, pancreatic cancer (age 20-64), and pulmonary emphysema
have PMR elevations.

Hotel/Motel Owners and Managers
Occupation code 819
Total deaths 346

Cancers of the buccal cavity and pharynx, stomach, and liver (second-
ary and unspecified), and suicide show excess deaths.

Hotel/Motel Maids and Housekeepers
Occupation code 821
Total deaths 155

Malignant neoplasm of the ovary, arteriosclerotic heart disease
(age 20-64), and pulmonary emphysema show PMR increases.

Charwomen and Cleaners
Occupation code 824
Total deaths 82

Vascular lesions affecting the central nervous system (age 20-64) show
a small number PMR increase.

Cooks, Candymakers, and Chefs
Occupation code 825
Total deaths 1,263

Cancers of the tongue and cervix, diabetes mellitus, and avitaminosis
and metabolic diseases show increased deaths. Arteriosclerotic heart
disease (age 20-64) and duodenal ulcer also have excess deaths.

62


INDEX OF OCCUPATIONS FOR WOMEN

Number
of Occupation Grouped Commentary
Deaths Code Code Page

Produce brokers.......sesecceeveee 2 251* --- _-
Professional workers NEC.......... 5 195* --- --
Professors/instructors, agri-

cultural sciences...........e00 1 031* --- —
Professors/instructors, biology... 1 032* -—_- =
Professors/instructors, chemistry. 2 034* --- co
Professors/instructors, medical

sciences........... tee e cece eeaee 3 043% -- -
Professors, instructors, natural

sciences NEC.....c.ecesencsccees 3 052* -_- --
Professors/instructors NEC.. 58 060* --- =
Professors/instructors, non-

scientific subjects............. 16 054* --- a
Professors/instructors, social

sciences NEC.........-..eceeeeee 4 053* =
Professors/instructors, statistics 1 051* —
Programmers, computer......ssseeeee 28 174% =
Proprietors NEC.... 290 57
Psychiatrists. 10 173% =a
Psychologists. ........cccecevceace 10 173* —
Public administration inspectors.. 6 260* —
Public administrators...........4. 61 270* =
Publicity writers..... O 27 163* a
Public relations workers. . 27 163* --- _
Public utility supervisors. o 78 364 58
Public utility workers. D 81 363 58
Publishers, newspaper. O 27 076* =
Pulp mill workers.. . 500 -- 60
Purchasing agents O 30 285 250 56
Pursers, ship........seseeeeeee 000 7 265* --- 5

R

Radio and television, mechanics/

repairmen... o 1 474% os
Radio announcers... . 10 010* =
Radiologists, medical. 00 18 186* aa
Radio operators....... O 1 164* os fea
Railroad brakemen/carmen. P 2 640% — =
Railroad clerks NEC... . 67 361 370 59
Railroad contractors . 3 408* --- --
Railroad inspectors. . 1 447% -- —
Railroad laborers NEC. . 11 981% =
Railroad workers NEC . 6 469% —
Railroad switchmen...........e.00. 1 713* --- =

146


COMMENTARY ON TABLE 1 (MALE MORTALITY, 1950-1979)

Airplane Mechanics and Repairmen
Occupation code 471
Total deaths 839

Cancers of kidney, urinary bladder, and brain, Hodgkin's disease,
asthma, multiple sclerosis, and aircraft accidents all have mortality
increases. Chronic rheumatic heart disease (1970-1979) also has a PMR
increase.

Auto Mechanics and Repairmen
Occupation code 472
Total deaths 3,445

Esophageal cancer, lung cancer, multiple sclerosis, chronic rheu-
matic heart disease, paralysis agitans, and hernia of the abdominal cavity
have increased deaths. The Registrar General's study also shows a slight
lung cancer increase.

Office Machine Mechanics and Repairmen
Occupation code 473
Total deaths 153

Tuberculosis, pancreatic cancer, chronic rheumatic heart disease, and
ulcerative colitis have PMR increases based on small numbers of deaths.
This pattern of mortality suggests possible self-selection into this occupa-
tion of chronically i11 men.

Radio/Television Mechanics and Repairmen
Occupation code 474
Total deaths 343

Acute leukemia, pneumonia, pulmonary emphysema, and suicide have
elevated PMRs.

Railroad/Car Shop Mechanics and Repairmen
Occupation code 475
Total deaths 818

Cancer of the kidney (1970-1979), paralysis agitans, cerebral embolism
and thrombosis, and unspecified falls have high PMRs. Cancer of the stomach
and rectum have elevated PMRs especially in deaths before 1960.

33


COMMENTARY ON TABLE 3
(MALE MORTALITY BY OCCUPATION WITHIN CAUSE-OF-DEATH GROUPS)

This tabie examines mortality by cause of death, showing occupations
with statistically significant elevations or reductions in PMR. The
commentary that follows is for selected causes of death. The commentary
and the table are in cause-of-death (Seventh Revision International Classi-
fication of Diseases) code number order. Organizing the mortality data in
this way allows common exposure patterns or other common denominators to
be seen which might explain an increase or decrease in mortality due to a
particular cause of death.

Infective and Parasitic Diseases (ICD 001-138)
Tuberculosis (total) (001-019)

Most of the deaths in this group are due to tuberculosis. The occupa~
tions with high PMRs are workers of low income and education; workers at
increased risk of occupational exposure to infectious diseases; and workers
exposed to siliceous dust and, therefore, to increased mortality from silico-
tuberculosis. In the first group are porters, newsboys, farm laborers,
laborers NEC, waiters, recreation and amusement attendants, and cooks. Medi-
cal and dental technicians and hospital and institution attendants are occupa—
tionally exposed to tuberculosis. As expected, men in the rubric 997
(institutionalized, retarded, disabled, ect.) have a high PMR from this cause
because they are institutionalized for tuberculosis. Men exposed to siliceous
dust are stonecutters, mine operatives and laborers, and boilermakers.

Malignant Neoplasm of the Buccal Cavity and Pharynx (ICD 140-148)
Malignant Neoplasm of the Tongue (ICD 141)
Malignant Neoplasm of the Oral Mesopharynx (ICD 145)

These cancers have been associated with the ingestion of alcoholic
beverages. Each occupational class represented with a high PMR from these
causes has, with rare exception, elevated mortality due to alcoholic
cirrhosis of the liver, The laundry and dry cleaning operatives, however,
are also occupationally exposed to solvents.

Malignant Neoplasm of the Esophagus (ICD 150)

Alcohol ingestion is also associated with cancers of the upper cervi-
cal esophagus. This could account for high PMRs in the sailors and cooks,
The printers however also have solvent exposures.

Malignant Neoplasm of the Stomach (ICD 151)

Carpenters, cabinetmakers, and plywood workers are exposed to wood
dusts. A national study of carpenters(4) supports the stomach cancer
excess. Brickmasons, plasterers, and metal molders are exposed to stone,

65


EXHIBIT 4 -- OCCUPATION GROUPINGS FOR MEN

Grouped Occupation
Code Code Occupation Title
405 405 Brickmasons, Stonemasons, and Tile Setters
602 Apprentice Bricklayers and Masons
406 406 Building and Construction Contractors and
Foremen
408 Railroad Contractors
429 Construction Foremen NEC
613 Apprentices, Building Trades NEC
407 407 Boatbuilders
410 410 Cabinetmakers
411 411 Carpenters
960 Carpenter Helpers, except Logging and Mining
412 412 Fabric Workers
652 Dyers
673 Textile Knitters, Loopers, and Toppers
705 Manufacturing Sewers, Stitchers, and Cutters
710 Textile Spinners
711 Ropemakers
720 Textile Weavers
413 413 Cement and Concrete Finishers
415 415 Cranemen, Derrickmen, and Hoistmen
416 416 Oil Well Drillers
420 420 Decorators and Window Dressers
421 421 Electricians
419 Electricians, Boeing or Airplane
604 Apprentice Electricians
425 425 Road Graders, Pavers, Machine Operators, and
Excavators
496 County/City Road Construction and Maintenance
Workers
676 Heavy Equipment Operators
426 426 Water Well Drillers
427 427 Railroad Foremen

102


MICROFICHE TABLES — TABLE 4, SIGNIFICANT MALE PMRS BY OCCUPATION

Grouped Microfiche

Code Occupation Page Row/Column
451 Jewelers, Watchmakers, Goldsmiths, Silver-

smiths, and Locksmiths............, D0 19 M10
453 Telegraph/Telephone/Power Linemen, 9 " All
454 Locomotive Engineers.... 90 D " Bll
459 Telephone Installers and Repairers... " cll
460 Locomotive Firemen......... " D1
462 Manufacturing Workers. " . Ell
465 Machinists NEC....... D " F1l
469 Railroad Workers NEC.. ©000S00000000000 " GlL
471 Airplane Mechanics and Repairmen........ 00 " H1L
472 Auto Mechanics and Repairmen... . " Ill
473 Office Machine Mechanics and Repairmen. q " J1l
474 Radio/Television Mechanics and Repairmen...... " K1l
475 Railroad/Car Shop Mechanics and Repairmen..... " Lil
477 Tire Recappers and Repairers, Rubber Welders... " Mil
479 Body/Fender Repairmen and Auto Painters O " Al2
480 Mechanics and Repairmen NEC.............. 0 " B12
490 Grain/Flour/Feed Mill Workers................. " C12
491 Millwrights....... " D12
492 Metal Molders.... " E12
493 Motion Picture Projectionists... " F12
500 Paper/Pulp Mill Workers................ 0 " G12-H12
501 Paperhangers and Decorators (Painters) " 112
505 Plasterers and Lathers.... ©000000000 " J12
507 Shipyard Workers, Shipwrights, and Shipfitters " K12
510 Plumbers and Pipefitters... 90000 " L12
512 Printing Pressmen, Plate Printers, and

Typesetters.......... 0000 " M12
514 Roofers and Slaters.... 90000 " A13-B13
515 Shoemakers, Shoe Repairers an eather Workers " C13
520 Stationary Engineers and Firemen.............. " D13
521 Stonecutters and Stonecarvers... " E13
523 Structural Metal Workers...... " F13
524 Tailors....... cece ee eee eee " G13
525 Tinsmiths, Coppersmiths, Sheet Metal Workers.. " H13
526 Aluminum Workers................ vee " 113
527 Cannery and Food Processing Workers........... " J13
528 Floor Workers (covering, hardwood, linoleum)... " K13

165


INDEX OF OCCUPATIONS FOR MEN

Number
of Occupation Grouped Commentary
Deaths Code Code Page

Lens grinders and polishers....... 99 494% -—- --
Librarians......... cece eee eee e eee 35 111* -
Library attendants and assistants. 11 302* cS
Lighthouse keepers................ 41 261* =
Linemen, telegraph/telephone/power 453 31
Linoleum floor workers............ 528 38
Lockkeepers, canal... «» 150 635* -
Locksmiths......... . 451 31
Locomotive engineers. gD 454 31
Locomotive firemen........ . 460 32
Lodge officials......... .- 275 19
Lodging housekeepers.............+ 15 821* -—- =
Log/lumber inspectors, scalers,

graders. 00 444 --- 30
Loggers......... 000 eoeee 970 -- 51
Logging engineers.........eeeeee-- 289 455 970 51
Logging machinists and mechanics... 227 464 970 51
Log truck drivers...... eee 755 718 --- 45
Longshoremen......... 900 965 --- 51
Loopers, textile.........eceeeeees 53 673 412 28
Lumber/logging maintenance and

WATCHMEN. ...ccceeecssccccccccees 363 855 970 51
Lumber camp cooks..........+2+2++. 150 827 825 47
Lumber company owners, managers,

and workers.........cseeeeeenees 292 --- 20
Lumberjacks (loggers).. 00000 970 — 51
Lumbermen (loggers)............... 970 --- 51
Lumber/plywood/veneer maintenance. 126 476 974 51
Lumber salesmen...........eeeeeeee 384 -— 25
Lumber truck drivers... sesseeee 755 718 -- 45
Lumberyard workers........cceeeees 974 --- 50

M

Machine operators, road - 1,069 425 --- 29
Machinery inspectors... . 60 445 450 31
Machinist apprentices... O 43 605 465 32
Machinists, Boeing..... +e 967 466 557 40
Machinists, logging. o 227 464 970 51
Machinists, military. 9 17 461 465 32
Machinists NEC......... - 5,739 465 --- 32
Machinists, shipyard.... . 573 467 507 36
Mail carriers.......... . 323 --- 22
Maintenance, Boeing.. » 199 468 557 40
Maintenance, highway.............. 425 — 29

124


COMMENTARY ON TABLE 1 (MALE MORTALITY, 1950-1979)

high PMRs (ICD 470-527). Silicosis has 50 deaths observed to less than

2 expected. Blows from falling objects and fire and explosion have elevated
PMRs. This pattern agrees well with the occupational literature on miners'
mortality (43-45).

Oilers and Greasers, except Auto
Occupation code 692
Total deaths 325

Lung cancer, machinery accidents, and electrocution have high PMRs.

Packers and Wrappers NEC
Occupation code 693
Total deaths 200

PMRs over 200 are seen for malignant neoplasms of the pancreas and
leukemia.

Painters
Occupation code 694
Total deaths 5,287

Significant mortality excess is seen for lung cancer, cirrhosis of the
liver, and accidental falls, especially from ladders. Elevated PMRs are
seen for cholelithiasis, acute pancreatitis, cancer of gallbladder, pulmonary
emphysema, and chronic interstitial pneumonia. Part of this pattern is prob-
ably related to alcohol intake. A very low PMR is seen for multiple sclerosis
(observed 1, expected 6, PMR = 18). The Registrar General's data support the
lung cancer increase.

Power Station Operators
Occupation code 701
Total deaths 385

Men in this category have increased deaths due to malignant lymphoma,
leukemia, and arteriosclerotic heart disease, including coronary artery
disease.

43


EXHIBIT 1 - Death Certificate

TYPE, OR PRINT IN

PERMANENT

<a

USUAL RESIDENCE

INSTITUTION, Give
ESIDENCE BEFORE
‘ADMISSION.

CAUSE

CERTIFIER

BURIAL

SES

REAU OF VITAL STATISTICS

WASHINGTON STATE DEPARTMENT OF SOCIAL AND HEALTH SERVICES

INK Local Fite NUMBER _ CERTIFICATE OF DEATH stave Pie wumaee
‘DECEASED —NAME RST MIDDLE tast TSEX |OATE OF DEATH (MONTH, DAY, VeaR)
1 2 a

RACE wHiTt, NEGRO, AMERICAN INDIAN, | AGE— Last JUNDER 1 YEAR [UNDER | DAY DATE OF BIRTH (month, Day, | COUNTY OF DEATH

etc. (SPECIFY) maTHDAY (YEARS) MOS. avs [| wouRs | min, | YEAR)

‘ [s. Se. s. re

CITY, TOWN, OR LOCATION OF DEATH INSIDE CiTY LUnITS | HOSPITAL OR OTHER INSTITUTION —NAME (1 MOT IN EITHER, GIVE STREET AND NUMBER)

SPECIFY YES O8 NO
a. 1.
STATE OF BIRTH (iF Nor in u.s.a., mame|CITIZEN OF WHAT COUNTRY MARRIED, NEVER MARRIED,
COUNTRY) | WIDOWED, DIVORCED « srecier )
‘ o Mn.
‘SOCIAL SECURITY NUMBER USUAL OCCUPATION (Give KIND OF WORK DONE DURING MOST. OF KIND OF BUSINESS OR INDUSTRY
‘WORKING LIFE, EVEN IF RETIRED }
2 30. 1m.
RESIDENCE — STATE COUNTY [ciTY, TOWN, OR LOCATION INBIDE city tuarta [STREET AND NUMBER
CMCIPY YES Of NO}

Mo. ul Me Ma. Me.

FATHER —NAME FIRST ‘MIDDLE ust MOTHER— MAIDEN NAME ‘MIDDLE wast
4s 16

TRFORMANT NAME MATING ADDRESS (SIMEET OF R.F.D. NOL, CIN O8 Town, STATE, iP)

176. [17

PART I. DEATH WAS CAUSED BY: mene aw po

ENTER ONLY ONE CAUSE PER LINE FOR (a), (b), AND (c])

i.
(@)

THMEDTATE CAUSE

DUETS, OF AS A CORSEOUERCE OF

CONDITIONS, IF ANT,
Seiew Gave
TMMEDIATE CAUSE (o),

{b)

STATING.
(vind cause Last

fe)

DUE TO, OF AS m CONSEGUENCE

PART Il. OTHER SIGNIFICANT CONDITIONS: CONDITIONS CONTRIBUTING TO DEATH BUT NOT RELATED TO CAUSE GIVEN IN PART 1 (a) ‘AUTOPSY IF YES WERe FINDINGS COM.
reson mor | Kotiee Wr bertaainsa Ste
ma i.
ACCIDENT, SUICIDE, HOMICIDE, [DATE OF INJURY (montn, pay, vear) [HOUR HOW INJURY OCCURRED (ENTER MATURE OF INJURY IM PART 1 OR PART II, ITEM 18)
(OR UNDETERMINED tarecrv
me. me, |. En
INJURY AT WORK [PLACE OF INJURY at vont, rams, fee, TACO, ] LOCATION CCCI LD
(irtai wenn) [omnce mow te vance)
200, 20. 2%.
‘CERTIFICATION— = MONTH bay eR MONT = DAY YEAR AND LAST SAW HUM/HEE ALIVE ON |1 DID/DID MOT VIEW THE] DEATH OCCURRED at THE PLACE, On
semua ay casero angers mon [1 vor aw ea SEES eh,
Tertenoeo me Se ny erence,
2ia,_pectaseD 180m mn ae ne. th. 10 me Cautetn Sante
CERTIFICATION— CORONER: ON THE BASIS OF THE OUR OF DEATH THE DECEDENT WAS PRONOUNCED DEAD
SEmtinavon Ov me Gabe aee/ Oe me meshoATON, MY OFMON, “one oar vee wou
SEAN" SccUts Ov Ie Bate nb DUE TO ne Cause) STAN
tte nlm, 4,
‘CERTFERRAME THe o8 Pan STGATURE eoRee on tme [DATE SIGNED (mont Bar, Team
Be, 28. te,
MAILING ADORESS—CERTIFIER ‘STREET OF A. CI ON TOWN ‘sare co
7,
BURIAL, CREMATION, REMOVAL ICEMETERY OR CREMATORY —NAME COCATION ‘cI 08 Town ‘stare
tireci
Ms. 0. .
Dae Tmo Ba, any | FUNERAL HOWE—NAME AND ADDRESS {stant OF &.0. WO., CIV O¥ TOWN, HATE HFT
4. 250.
(SSS ea REGISTRAR SIGNATURE TRIE RECETVED FY TOOT OTST
25. 260. Le

OSHS 0-181 (REV. 9/78)

85


RESULTS

The basic occupational mortality data are found in the accompanying
four sets of tables: Table 1, Male Mortality; Table 2, Female Mortality;
Table 3, Occupations Ranked by PMR within each Cause of Death (males
only); and Table 4, Causes of Death with Significantly (P < .05) Elevated
or Reduced PMRs by Occupation (males only).

The male and female mortality tables (Tables 1 and 2) are presented
in occupation code number order (see Exhibit 2) and the commentary is in
the same order. The listing in Exhibit 4 indicates how individual occupa-
tions are grouped for analysis. The commentary for Table 3 is in cause-
of-death order (7th ICD).

Table 4 [Causes of Death with Significantly (P < .05) Elevated or
Reduced PMRs by Occupation] is in occupation code number order (Exhibit 2).
No commentary is presented.

It is reassuring that all the intuitive or well-known occupational
mortality associations show up in this study: airplane pilots die in plane
crashes, loggers are struck by falling objects, roofers fall, telephone and
power linemen are electrocuted, etc.

The associations between cause of death and occupation seen in this
study are statistical associations. Some will, of course, be chance asso-
ciations but many will be real. These associations are clues or starting
points for more definitive studies.

The commentary reflects the author's biases, and it is possible that
different inferences may be drawn from the same data by others.


TABLE OF CONTENTS

ADSETACE. . oe eee cece cece eee e cece eee e cece ctcetetececececes
Introduction... ....sceec eee c eee c ec ee ce cecececectsecseseeeces
Method... cece c cece cece cece cece eee eres teaser estes eseeeence

RESULTS... 0. cee cece e cree cere cee cece eeeecceeceeccencceecees

Commentary on Table 1 (Male Mortality, 1950-1979)...........
Commentary on Table 2 (Female Mortality, 1974-1979).........
Commentary on Table 3 (Male Mortality by Cause).............
Commentary a Table 4 (Male Mortality by Occupation)........
DISCUSSION. «2... cece cece ccc cece cece ence eecccescecscesceece
Conclusion.......ecceeeeece cece cece nese eeceeceteececseseees
Acknowledgements.......... cc cee cccccccececccnccecscesceesces
References... ..scscsscsescccccccvcccccececesscscesesssences
Exhibits:
Exhibit 1—Death Certificate..........c sce c cece cece eens
Exhibit 2—Modified Occupation Codes............cccceee
Exhibit 3--PMR Calculation............. cece eeeeeececeee
Exhibit 4--Occupation Groupings:

LEE? 1:6 p9000000000000000000G0000000000000
For Women.....

Index of Occupations:

For Men... ececeee cocccccccccccenccccccas

Microfiche Table of Contents.........ecceccee cece eeececeeees

ili

65
70
71
79
80
81

85
86
96

97
110

113
135

150


INDEX OF OCCUPATIONS FOR WOMEN

Number
of Occupation Grouped Commentary
Deaths Code Code Page

Shoemakers and leather workers.... 16 515* --- --
Smelter workers... ..eeeeeceseeees 2 435% -—- --
Social science professors and

instructors NEC.........eeeeeees 4 053* a
Social scientists. 6 175% —
Social workers.. 140 171* -
Spinners, textile..........+.. 5 710 59
Sports instructors and officials 4 180* -
Stationary engineers.......... 1 520* —
Statisticians and actuaries 28 174% =
Statistics professors/instructors. 1 051* --
Stenographers.........eeeeeeeeeees 140 345 58
Stewards in private household 832 al 63
Stitchers, garment factory... 219 705 412 59
Stocks and bonds salesmen.. 12 395* --- --
Stock clerks and storekeepers 46 350° 343 58
Stonecutters and stonecarvers 2 521* —- --
Students.......... 196 56
Supervisors, Boeing.. 31 294 58
SULQEONS... eee eee eee eves 21 162* --
Surveying chainmen and rodmen 1 642% -
Switchmen, railroad........ 1 713* eee —

T

TALlOTs..ceccccesccccccccoves 53 524 60
Tavern owners/operators/workers. 816 61
Taxicab drivers.........+...-+ 10 714% --
Teachers, art..... 014 54
Teachers, dancing..........66. 10 070* --
Teachers, elementary/secondary 1,344 182 55
Teachers, high school......... 183 55
Technicians.......... . 195* --
Technicians, dental........ceeeeee 185 55
Technicains, electrical/electronic 30 190* --
Technicians, engineering.........+ 11 191* -- -
Technicians, laboratory. 54 192* -—- _-
Technicians, medical............6- 185 --- 55
Technicians, physical sciences 11 191% -—- =
Technicians, X-ray.........66 18 186* --- -
Telegraph messengers.... 1 351* --- al
Telegraph operators.......... 40 352% -_- —
Telephone installers/repairers 4 459% --- =
Telephone operators.......... 353 --- 58
Telephone/power linemen. 1 453* — --

148


COMMENTARY ON TABLE 1 (MALE MORTALITY, 1950-1979)

Boeing Workers NEC
Occupation code 557
Total deaths 3,718

This is a residual code for Boeing workers who do not fit a more
specific category. Coronary heart disease has a small but significant PMR
increase. Malignant neoplasms of the nasopharynx and benign neoplasms have
PMRs over 200.

Atomic Energy Workers NEC
Occupation code 558
Total deaths 1,480

These are men who worked at the Atomic Energy Commission Hanford
project at Richland, Washington. The project started in 1941 and, as the
work force ages, more deaths are being seen.

Malignant neoplasms of the digestive organs and peritoneum (age 20-64)
show a significant excess of deaths due to cancers of the stomach, large
intestine, and pancreas. Large intestinal cancer shows a PMR of 453 in
men age 45-49 based on 6 deaths.

PMRs over 200 are seen for bone cancer, hyperplasia of the prostate,
and amyotrophic lateral sclerosis.

Low PMRs are seen for leukemia, but multiple myeloma has a small PMR
excess. A population-based study in these workers(12) supports the pan-
cereatic cancer and multiple myeloma excess and, more importantly, links
the excess to low-dose occupational radiation exposure.

Asbestos and Insulation Workers
Occupation code 630
Total deaths 215

The total cancer PMR is 186 due to a lung cancer PMR of 351 (38 deaths
observed versus 11 expected). Asbestosis has 10 deaths observed to less
than .5 expected. These relationships are well known(42). Three deaths
were coded to benign neoplasm, all of which were pleural mesotheliomas.

40


MICROFICHE TABLES - TABLE 3, MALE OCCUPATIONAL MORTALITY BY CAUSE OF DEATH

Microfiche
IcD No. Cause of Death Page Row/Colum
193.0 MN Brain......eeeeeeeecee Come acc ew aneeerecrrces 17 M 5-A 6
195 MN Other Endocrine Glands. " B6
196 MN Bone.....-.eeeeee p00 " C6
197 MN Connective Tissue.....ceceeeeesee cece eeeeeees " D6
199 MN Other and Unspecified Sites........cceeeeeeeee " E6
200-205 MN Lymphatic and Hematopoietic Tissues. " F 6-H 6
200.0-200.1 Lymphosarcoma and Reticulosarcoma... " 16
200.0 Reticulum Cell Sarcoma...........+++ " 36
200.1 Lymphosarcoma......scscecececeerees 90000000000000 " K6
201 Hodgkin's Disease. " L 6-M 6
202,200.2 Other Lymphomas... " AZ.
203 Multiple Myeloma..... cece cece reece cece eee ceees " B7
204 Leukemia and Aleukemia.........eeeeeeeeeeseseeeee " Cc 7-D7
204.0 Lymphatic Leukemia..... " E7
204.1 Myeloid Leukemia. " F7
204.3 Acute Leukemla......cessccsccccccescoecs 900n00L00 " G7
204.4 Other and Unspecified Leukemia........ . " H7
210-229 Benign Neoplasms.............+- " 17
230-239 Neoplasms of Unspecified Nature " J7
241 Asthma... .cccccccccsccccccvccseres " K7
250-254 Diseases of Thyroid Gland............ cocoacD00K00 " L7
260 Diabetes Mellitus........sceeceee " M 7-A 8
270-277 Diseases of Other Endocrine Glands... " B8
280-289 Avitaminoses and Metabolic Diseases. " c 8
290-299 Diseases of Blood and Blood-forming Organs....... " D8
292 Other Anemias of Specified Type.......... ogac0 " E 8
292.4 Aplastic Anemia............0006 0 " F8
297 Agranulocytosis.......seeeeeeeeeneace 900000000000 " G8
300-309 PSyChoseS.. occcecccsccccccssnccccsccecscscccccce " H 8
320-326 Disorders of Character, Behavior and Intelligence " I 8-3 8
330-334 Vascular Lesions Affecting Central Nervous System " K 8-L 8
330 Subarachnoid Hemorrhage......seseeceeeeees 9000000 " M8
331,334 Cerebral Hemorrhage and Other Vascular Lesions... " A 9-B 9
332 Cerebral Embolism and Thrombosis............eeeee " c 9-D 9
340-345 Inflammatory Diseases of Central Nervous System.. " E9
345 PAM RIG, ATETCTEEI9000000000000000000D00000000000 " F9

159


DISCUSSION

This section consists of an examination of the mortality patterns
of groups of selected occupations which appear to have similar environ-
mental exposures. Finding similar mortality patterns in occupations with
similar exposures adds significance to the finding in the individual
occupation; however, misclassification of occupation can give the same
result.

1. Farmers

In Washington State the occupational exposures of farmers differ
markedly, depending on the type of farming. The cancer pattern seen in
these men seems to reflect these differences. Stomach cancer shows an
excess in farmers NEC, nurserymen, dairy farmers, and poultry farmers.
Lung cancer shows excess mortality only in orchardists and nurserymen,
with low PMRs in other types of farmers. The orchardist excess is
probably related to the use of arsenical-based pesticides before 1945.
Cancer of the pancreas shows a significant excess mortality in nursery-
men; kidney cancer in cattle ranchers and wheat farmers; and brain cancer
in wheat farmers and poultry farmers. Among the hypotheses to be con-
sidered in attempting to explain some of the specific cancer excesses in
farmers is animal to human transmission of disease. Dairy cattle and
chickens suffer endemic leukemia-like diseases. Case-control death record
studies in other states(29) support the leukemia-farming association.

PMRs AND CANCER DEATHS FOR FARM SUB-GROUPS

IcD number——+ 151 157 162.1,163 180 193.0 204
Malignant Neoplasm+ Stomach Pancreas Bronchus/Lung __Kidney Brain Leukemia
Code _ Occupationt PMR Deaths PMR Deaths PMR Deaths PMR Deaths PMR Deaths PMR Deaths
200 Farmers NEC 118** 573 109 323. 79** 646 89 89 111 69 107 225
201 Orchardists 69* 30113, 38 1308 154 114 14106 = 1k 9H
202 Nurserymen 134 9 222k 12 110 22 0 0 164 30079 3
203 Cattle Ranchers 82 45 89 35° 81k 106 «187*#* = 26115 12 96 a7
204 Dairy Farmers 137% 49° BL = 22 6O** 566 6 115 9 105 20
205 Wheat Farmers 97 58 92 38 «60** «78 «151 89224 9 144 43
206 Poultry Farmers 145 16 104 8 92 230071 2 175 4 241** 13

* P< 05; * P< LOL

2. Woodworkers

There are interesting similarities and differences in the mortality
patterns shown by men who work with wood and wood products. Exposures in
these trades are varied. Stomach cancer shows significant PMR elevations
in both carpenters and cabinetmakers and slight PMR elevations in all the

71


ACKNOWLEDGEMENTS

I gratefully acknowledge the assistance of the following
Washington State Department of Social and Health Services employees
who worked on this study.

Rita Klein
Elnora McGraw
Richard Lavorato
James Thomas

80


OCCUPATIONAL MORTALITY IN WASHINGTON STATE

1950-1979

Samuel Milham, Jr., M.D., M.P.H.
Washington State Department of Social and Health Services
Health Services Division, LB-15
Olympia, Washington 98504

Contract No. 210-80-0088

U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES
Public Health Service
Centers for Disease Control
National Institute for Occupational Safety and Health
Division of Surveillance, Hazard Evaluations and Field Studies
Cincinnati, Ohio

October 1983


EXHIBIT 4 -- OCCUPATION GROUPINGS FOR MEN

Grouped Occupation
Code Code Occupation Title
557 557 Boeing Workers
089 Draftsmen, Boeing
446 Inspectors, Boeing
466 Machinists, Boeing
468 Maintenance Workers, Boeing
657 Parts Finishers, Boeing
558 558 Atomic Energy Workers NEC
007 Atomic Energy Accountants
087 Engineers, Nuclear
088 Draftsmen, Atomic Energy
418 Electricians, Atomic Energy
509 Steamfitters/Pipefitters, Atomic Energy
559 Nuclear Workers, not Hanford
856 Watchmen and Guards, Atomic Energy Plants
630 630 Asbestos and Insulation Workers
634 634 Blasters and Powdermen
640 640 Railroad Brakemen
641 641 Bus Drivers
691 Street, Subway, Elevated Railway Motormen
650 650 Deliverymen and Routemen
655 655 Dairy Workers, Ice Cream and Cheesemakers
656 656 Milk Route Deliverymen
674 674 Laundry/Dry Cleaning Operatives
675 675 Meatcutters and Butchers
677 Slaughterhouse Butchers
685 685 Mine Operatives and Laborers NEC
692 692 Oilers and Greasers, except Auto
693 693 Packers and Wrappers NEC
694 694 Painters
495 Painters, Construction and Maintenance

106


INDEX OF OCCUPATIONS FOR MEN

Number
of Occupation Grouped Commentary
Deaths Code Code Page

PLESSMEN. . 1. cece ccccccceccevees 512 — 36
Printers, plate.. 9 9 512 36
Printing trade apprentices.... . 6 615 36
Produce brokers.........e.eecceeee 251 17
Produce/seed/grain company workers 966 51
Professional/technical workers NEC 195 — 15
Professors/instructors, agricul-

tural sciences..........eeeee eee 26 031 060 9
Professors/instructors, biological 4 032 060 9
Professors/instructors, chemistry. 12 034 060 9
Professors/instructors, economics. 7 035 060 9
Professors/instructors,

engineering..........ccceeeee eee 29 040 060 9
Professors/instructors, geology

and geophysics...........e.eee0e 5 041 060 9
Professors/instructors,

MathematicsS......... cc ceeee sees 16 042 060 9
Professors/instructors, medical

BCLENCES.. ec ceeeeccsccesccceees 15 043 060 9
Professors/instructors, natural

SCIENCES... cece cece cece ecccceene 20 052 060 9
Professors/instructors NEC 444 060 —- 9
Professors/instructors, non-

scientific subjects............6 81 054 060 9
Professors/instructors, physics... 11 045 060 9
Professors/instructors, psychology 10 050 060 9
Professors/instructors, social

sciences NEC........cceeeseeeoes 20 053 060 9
Programmers, computer........ oo 174 -—- 13
Projectionists, motion picture 493 -—- 35
Promoters....seseeeeeeeeeee 120 383 380 24
Proprietors NEC. 290 — 19
Psychiatrists. 74 173* --- --
Psychologists...... 74 173* --- --
Psychology professors......... 10 050 060 9
Public administration inspectors.. 479 260 -- 18
Public administration officials... 270 19
Publicity writers.. eneeae 175 163* -
Public relations men.............. 175 163* --- -
Public utility officials and

SUPETVISOTS... cece eee ree cecaes 364 24
Public utility workers. 000 363 24
Publishers, newspaper 000 076 9
Pulp mill workers.. 00 500 35
Purchasing agents. oo 285 19
Pursers, Ship....sssesececsevesces 265 — 18

129


MICROFICHE TABLES - TABLE 2, FEMALE MORTALITY

Grouped Microfiche

Code Occupation Page Row/Column
810 Hospital/Institution Attendants........ o 16 G 3-A 4
815 EER EFTo0060000000000000000000000Da00000000 " B 4-E 4
816 Cocktail Bar/Tavern Owners, Operators,

and Workers! ellelleletelleteleledetelteterteitelteeietelleistelels " F 4-3 4
817 Restaurant Owners, Managers, and Workers...... " K 4-D5
819 Hotel/Motel Owners and Managers............... " E 5-L 5
821 Hotel/Motel Maids and Housekeepers o " M 5-D 6
824 Charwomen and Cleaners......... o " E 6-I 6
825 Cooks, Candymakers, and Chefs...........eee005 " J 6-F7
832 Housekeepers and Stewards (in private

household)....... . O " G 7-M 7
834 Tan tors. .sccssccveccveccccccccccccce 00 " A 8-E 8
835 Kitchen Workers (not private household) 9 " F 8-K 8
843 Hairdressers and Cosmetologists.........sseee8 " L 8-E 9
875 at Eo 00000000000000000000000000000000000 " F 9-A10
909 Nuns. ..ceceecoee . " B10-E10
975 Fruit Warehousemen........eceeeeeecceccesceens " F10-J10

157




EXHIBIT 4 -- OCCUPATION GROUPINGS FOR MEN

Grouped Occupation
Code Code Occupation Title
701 701 Power Station Operators
703 703 Sailors, Deckhands, and Seamen NEC
553 Merchant Marines
706 706 Plywood Workers
713 713 Railroad Switchmen
714 714 Taxicab Drivers and Chauffeurs
715 715 Truck and Tractor Drivers
719 Moving, Transfer, and Storage Workers and
Truck Drivers
972 Truck Driver Helpers
716 716 Fuel Oil Truck Drivers
718 718 Lumber/Log/Sawmill Truck Drivers
717 Sawmill Truck Drivers
721 721 Welders and Flame Cutters
724 724 Tree Farmers, Forest Service and 'Parks:
Department Workers
726 726 Ordnance Plant Workers
810 810 Hospital/Institution Attendants
812 812 Recreation/Amusement Attendants (Cardroom,
Pool Hall, Carnival)
814 814 Barbers
815 815 Bartenders
816 Cocktail Bar/Tavern Owners, Operators and Workers
817 817 Restaurant Owners, Managers, and Workers
818 818 Brewery Workers
819 819 Hotel/Motel Owners and Managers

107


COMMENTARY ON TABLE 1 (MALE MORTALITY, 1950-1979)

Carpenters
Occupation code 411
Total deaths 16,843

Like the cabinetmakers, carpenters have a gastric cancer excess. Nasal
cancers (ICD 160) (1970-1979) have a significant mortality excess and naso-
pharyngeal cancers (ICD 146) show a slight PMR excess. This is consistent
with British reports of a nasal cancer excess in furniture workers(34). Lung
cancer has a PMR excess (age 20-64). Hodgkin's disease has a PMR excess
(1960-1969) and monocytic leukemia has a significant excess (age 20-64).
Emphysema without bronchitis and accidental falls have excess deaths. The
Registrar General's study supports the lung cancer and accidental fall excess.

Fabric Workers
Occupation code 412
Total deaths 333

Chronic rheumatic heart disease and lymphatic and hematopoietic tissue
cancers (1970-1979) have increased PMRs.

Cement and Concrete Finishers
Occupation code 413
Total deaths 1,246

Rectal ¢ancer, accidental falls and electrocutions have excess deaths.
The falls are also seen in the Registrar General's data.

Cranemen, Derrickmen, and Hoistmen
Occupation code 415
Total deaths 705

Asthma, pancreatitis, accidental falls, machinery accidents, and elec-
trocution have elevated PMRs.

Oil Well Drillers
Occupation code 416
Total deaths 149

These men have increased mortality from non-malignant respiratory
diseases, especially pulmonary emphysema.

28


EXHIBIT 2 - OCCUPATION CODES

PROFESSIONAL, TECHNICAL AND KINDRED WORKERS (continued)

095 Engineers, refrigeration
"

096 operating

097 " Boeing

099 " steam

093 " NEC, including aides

101 Entertainers NEC

102 Farm and home management advisers

103. Foresters and conservationists

104 Funeral directors and embalmers

105 Lawyers and judges

106 Court reporters

111 Librarians

120 Musicians and music teachers

130 Agricultural scientists

131 Biological scientists

134 Geologists and geophysicists

135 Mathematicians

140 Physicists

141 Meteorologists

145 Miscellaneous natural scientists

150 Nurses, professional

151 Nurses, student professional

152 Optometrists

153. Osteopaths

154 Personnel and labor relations workers
160 Pharmacists, druggists

161 Photographers

162 Physicians and surgeons

163 Public relations men and publicity writers
164 Radio operators

165 Recreation and group workers

170 ~=Religious workers

171 Social and welfare workers, except group
172 Economists

173 Psychologists, psychiatrists

174 Statisticians and actuaries, analysts
175 Miscellaneous social scientists

176 Sanitarians

180 Sports instructors and officials

181 =Surveyors

182 Teachers, elementary and secondary schools
183 " high school and NEC

184 Teachers and administrators NEC

185 Technicians, medical and dental

186 Technicians, X-ray, medical radiologists
190 Technicians, electrical and electronic
191 Technicians, other engineering and physical sciences
192 Technicians, laboratory NEC

193 Therapists and healers NEC

194 Veterinarians

195 Professional, technical and kindred workers NEC

196 Students
87


REFERENCES

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16.

17.

18.

19.

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21.

22.

23.

24.

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26.

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Kupper, L.L., McMichael, A.J., and Symons, M.J. On the Utility of
Proportional Mortality Analyses. Inst. of Statistics Mimeo Series
No. 988, School of Public Health, University of North Carolina, 1975.

The Registrar General's Dicennial Supplement for England and Wales,
1970-1972. Occupational Mortality, Series DS No. 1. London, Her
Majesty's Stationery Office, 1978.

Delahaye, R.P., Kaiser, R., and Pfister, A. Radiobiological Problems
Caused by Supersonic Transport. Aerospace Medicine 43(7): 782-784,
July 1972.

Li, F.P., Fraumeni, J.F., Mantel, N., and Miller, R.W. Cancer Mor-
tality among Chemists. J. Nat. Cancer Inst. 43(5): 1159-1164,
November 1969.

Olin, G.R. and Ahlbom, A. The Cancer Mortality among Swedish Chemists
Graduated during Three Decades. Env. Research 22, 154-161, 1980.

Hoar, S.K. and Pell, S. A Retrospective Cohort Study of Mortality
and Cancer Incidence among Chemists. J. of Occ. Med. 23(7): 485-494,
July 1981.

King, H. and Bailar, J.C. Mortality among Lutheran Clergymen.
Milbank Mem. Fund Quarterly 46: 527-548, 1968.

Michalek, A.M., Mettlin, C., and Priore, R.L. Prostate Cancer
Mortality among Catholic Priests. J. of Surg. Onc. 17:129-133,
1981.

Ross, R.K., Deapen, D.M., Casagrande, J.T., Paganini-Hill, A., and
Henderson, B.E. A Cohort Study of Mortality from Cancer of the
Prostate in Catholic Priests. Br. J. Cancer 43: 233-235, 1981.

Glass, F.L. Mortality of New England Dentists 1901-1960. PHS
Publication No. 999-R.H.-18, 1966.

Blachy, P.H., Osterud, H.T., and Joslin, R. Suicide in Professional
Groups. N. Engl. J. Med. 268: 1278-1282, 1963.

Bruce, D.L., Eide, K.A., and Smith, N.J. et al. A Prospective Survey
of Anesthesiologists Mortality 1967-71. Anesthesiology 41: 71-74,
1974.

Vianna, N.J. and Polan, A.K. Epidemiologic Evidence for Transmis-
sion of Hodgkin's Disease. N. Engl. J. Med. 289: 499-502, 1973.

82


COMMENTARY ON TABLE 1 (MALE MORTALITY, 1950-1979)

Aeronautical Engineers
Occupation code 080
Total deaths 1,003

Most of these men are employed by the Boeing Company in Seattle.
There were only 94 deaths in this occupational class in 1950-1959 versus
610 deaths 1970-1979. The age distribution of deaths is interesting in
that the peak frequency is at ages 55-59, reflecting that this occupation
is a comparatively new one.

There is a significant increase in the PMR for all malignant neoplasms
due to increased mortality from malignant neoplasms of the stomach, large
intestine, lymphosarcoma, multiple myeloma and leukemia. Subarachnoid
hemorrhage, multiple sclerosis, and amyotrophic lateral sclerosis also show

excess deaths. As might be expected, the PMR for deaths due to aircraft
accidents is increased.

Pulmonary emphysema and cirrhosis of the liver show low PMRs.

Civil Engineers
Occupation code 082
Total deaths 1,371

An elevated PMR is seen for cancer of the large intestine. This excess
is also seen in the Registrar General's data. Paralysis agitans, cerebral
embolism and thrombosis, and aircraft accidents also have elevated PMRs.

Electrical Engineers
Occupation code 083
Total deaths 783

Asthma and aircraft accidents show excess mortality. Asthma mortality
is mentioned in the Registrar General's analysis as being elevated in
electrical engineers. Small number PMR excesses are seen for malignant
melanoma, malignant neoplasms of the small intestine, brain cancer, and
lymphosarcoma.

Mechanical Engineers
Occupation code 085
Total deaths 365

Infective and parasitic diseases have an increased mortality due to
respiratory tuberculosis. Malignant brain tumors have a PMR of 422%** based
on 8 deaths. Vascular lesions affecting the central nervous system
(age 20-64) and suicide also have elevated PMRs.

10


COMMENTARY ON TABLE 1 (MALE MORTALITY, 1950-1979)

Fruit Warehousemen
Occupation code 975
Total deaths 567

Hypertensive disease, lung cancer, kidney cancer (age 20-64),
diseases of arteries, and unspecified falls have PMR increases.

Laborers NEC
Occupation code 980
Total deaths 18,251

Respiratory tuberculosis shows a PMR increase. Most cancer and
cardiovascular disease rubrics have low PMRs. The exceptions are malig-

nant neoplasms of the buccal cavity and pharynx, gallbladder, nose and
accessory sinuses.

Asthma, psychoses, disorders of character, intelligence and behavior,
other diseases of the heart, hypertensive disease, pneumonia, emphysema,
duodenal ulcer, intestinal obstruction, cirrhosis of the liver, senility,
railway accidents, accidental falls, death by fire and explosion, and
homicide all have significantly elevated PMRs.

Railroad Laborers NEC
Occupation code 981
Total deaths 5,164

Respiratory tuberculosis, avitaminosis and metabolic diseases,
psychoses, disorders of character, behavior and intelligence, pneumonia,
ulcer of stomach, cirrhosis of liver with alcoholism, and railway acci-
dents have increased deaths.

Construction Laborers NEC
Occupation code 982
Total deaths 4,519

Respiratory tuberculosis, malignant neoplasms of the larynx, lung,
urinary bladder, and connective tissue, disorders of character, behavior
and intelligence, diseases of the respiratory system, cirrhosis of the
liver, motor vehicle accidents, accidental falls, blows from falling objects,
and machinery-related accidents have PMR increases.

52




EXHIBIT 2 - OCCUPATION CODES

SERVICE WORKERS (continued)

819 Hotel, motel, resort, apartment house, dude ranch owners, Managers, etc.
820 Bootblacks and shoeshine operators

821 Boarding, lodging, hospital housekeepers; motel/hotel maids
822 Babysitters, preschool, nursery, day care

824 Charwomen and cleaners

825 Cooks, candymakers & chefs (except private household)
826 Dishwashers

827 Lumber camp cooks

830 Counter and fountain workers

831 Elevator operators

832 Housekeepers and stewards in private household (maids)
833 Window cleaners, wall washers

834 Janitors, maintenance men, sextons

835 Kitchen workers, restaurant employees NEC (not private household)
836 School custodians

840 Midwives

841 Porters

842 Practical nurses

843 Hairdressers and cosmetologists

849 Fumigation employees

850 Firemen and fire protection workers

851 Guards, watchmen and doorkeepers

852 Marshals and constables

853 Policemen and detectives

854 Sheriffs and bailiffs

855 Watchmen, lumber/logging

856 Watchmen and guards, atomic energy plants

860 Watchmen, crossing and bridge tenders

874 Ushers, recreation and amusement

875 Waiters and waitresses

890 Service workers NEC (except private household)

891 Garbage collectors

892 Junk dealers, secondhand store and salvage workers

LABORERS except farm and mine

960 Carpenter helpers, except logging and mining

962 Fishermen and oystermen

964 Gardeners (except farm), groundskeepers, greenskeepers, landscapers

965 Longshoremen and stevedores

966 Produce, seed, feed, grain company workers

967 Flour mill employees

970  Lumbermen, raftsmen, woodchoppers, lumberjacks, woodsmen, loggers

971 Teamsters

972 Truck driver helpers

973 Warehousemen NEC

974 Woodworkers (yardworkers): mill, pole, match, shingle weavers, sash-door,
furniture finishers 904




The mortality patterns seen in these groups suggest that respiratory
cancer may be induced in humans by inhalation of metals and metallic
compounds. Certain metals have been shown to be involved in respiratory
carcinogenesis, so the lung cancer excess seen in these occupational groups
is not surprising.

The urinary bladder cancer excess suggests that metals or metallic
urinary excretion products may be carcinogenic for urinary bladder mucosa.

OBSERVED AND EXPECTED DEATHS AND
PMRs FOR SELECTED CANCERS IN METAL-EXPOSURE OCCUPATIONS

IcD number-————- 157 160-165 181

Malignant Neoplasm—> Pancreas Respiratory Urinary Bladder
Code Occupationy Obs. Exp. PMR Obs. Exp. PMR Obs. Exp. PMR
403 Boilermakers 13 18 72 116 82 142** 17 12 «146
435 Smelter Workers 8 13 62 102 61 167%* 5 8 60
465 Machinists 64 65 99 313 302 104 41 41 99
492 Metal Molders 3 5 57 27 21 129 ) 4 83
510 Plumbers 42 50 84 300 236 127%* 39 31125

523 Structural Metal Wkrs. 26 25 105 151 124 122* 23 15 156*
525 Sheet Metal Workers 27 24 112 151 120 1264* 18 14 «129
526 Aluminum Siorkers 29 15 195** 92 86 106 10 8 126
530 Tool and Die Makers 2 6 360 (35 27 129 2 3) 60

721 Welders and Flame
Cutters 22 25 87 177 140 126%* 16 12 128

TOTAL 236 ©=246 96 1464 1199 122% 174 148 118
* P< .05; ** P< O01

4. Petroleum Products Workers

Men who work around garages and gas stations and men who deliver fuel
oil and gasoline show an excess of urinary bladder cancer. This suggests
that a volatile constituent of gasoline and fuel oil or its urinary excre-
tion product may be carcinogenic for urinary bladder mucosa. Since vehicle
drivers also have a bladder cancer excess, it may be automotive exhaust
rather than gasoline which is the critical variable.

URINARY BLADDER CANCER DEATHS (ICD 181)

Code Occupation Observed Expected PMR
291 Gas Station and Garage Owners
and Attendants 26 18 144
295 Fuel Oil Dealers alis} 12 129
472 Auto Mechanics 28 24 119
716 Fuel Oil and Gasoline Truck Drivers 3 2 138
TOTAL 72 56 129*
* P< .05

73


COMMENTARY ON TABLE 1 (MALE MORTALITY, 1950-1979)

Tire Recappers and Repairers, Rubber Welders
Occupation code 477
Total deaths 359

Elevations of PMR are seen for lung cancer, other diseases of the
heart, and pulmonary emphysema.

Body/Fender Repairmen and Auto Painters
Occupation code 479
Total deaths 428

Gastric cancer, lung cancer (especially ages 20-64), chronic respira-
tory disease, cerebral hemorrhage, and suicide show increased deaths.
Coach painters (occupational unit 101) have an SMR of 140 for lung cancer
in the Registrar General's data.

Mechanics and Repairmen NEC
Occupation code 480
Total deaths 4,266

Tumors of the nose and nasopharynx, lung cancer, myeloid leukemia,
subarachnoid hemorrhage, and accidents caused by machinery have increased
PMRs.

Grain/Flour/Feed Mill Workers
Occupation code 490
Total deaths 596

Rectal and kidney cancer, chronic rheumatic heart disease, other

diseases of the heart (age 20-64), and unspecified falls show elevated
PMRs.

Millwrights
Occupation code 491
Total deaths 1,207

Hodgkin's disease, chronic rheumatic heart disease, accidental falls
from one level to another, and machinery accidents have elevated PMRs.

34


COMMENTARY ON TABLE 1 (MALE MORTALITY, 1950-1979)

Hospital/Institution Attendants
Occupation code 810
Total deaths 537

Respiratory tuberculosis, non-malignant respiratory diseases, diabetes
mellitus, and chronic rheumatic heart disease have PMR elevations.

Recreation/Amusement Attendants (cardroom, pool hall, carmival)
Occupation code 812
Total deaths 528

Respiratory tuberculosis, malignant neoplasms of urinary bladder,
cirrhosis of the liver, and other diseases of the urinary system have signi-
ficant mortality increases. Causes with elevated PMRs are multiple myeloma,
pulmonary embolism, and hyperplasia of prostate.

Barbers
Occupation code 814
Total deaths 3,014

Multiple myeloma, asthma, cirrhosis of the liver, chronic enteritis
(1970-1979), chronic nephritis (age 20-64), and suicide have increased PMRs.

Bartenders
Occupation code 815
Total deaths 2,676

Causes of death usually associated with alcoholism show excess deaths.
Malignant neoplasms of the buccal cavity, tongue and larynx have signifi-
cantly elevated PMRs. Diabetes mellitus, duodenal and gastric ulcers,
cirrhosis of the liver, acute pancreatitis, and homicide all have increased
deaths.

Restaurant Owners, Managers, and Workers
Occupation code 817
Total deaths 1,973

A pattern of mortality quite similar to that of the bartenders is seen
with excess deaths due to diabetes mellitus, cirrhosis of the liver, and
homicide. In addition, cancer of the stomach and large intestine have
significant PMR increases.

46


INDEX OF OCCUPATIONS FOR MEN

Number
of Occupation Grouped Commentary

Deaths Code Code Page

Attendants, physicians' and
dentists’ offices............008 6 303* --- -
Attendants, recreation and
AMUSEMENE. . 6. ee eee e eee eeeeenes 812 46
Auctioneers......... 53 381* -
Auditors.......... 000 --- “7
AULHOTS... csc ceecceeoeeee 93 020* — =
291 -—- 20
Auto mechanic apprentices... 6 601 472 33
Auto mechanics...... 472 --- 33
Auto painters....... 0000 479 --- 34
Auto service attendants........... 291 --- 20
Awning sales and service workers.. 412 --- 28
Axmen, surveying.......seceeseceee 21 642 181 14
B

Baggagemen, transportation. o 304 -- 21
Bailiffs and sheriffs.... . 470 854 853 49
Bakers. reesccccccccccccevcce eee 401 -— 26
Bankers, bank clerks, managers.... 305 -- 21
Barbers...ccccccrccvccee eee 814 _ 46
Bartenders.. 600000 815 --- 46
Beekeepers...... ccc e eee eeereeeee 64 207* -— _-
Biological science professors..... 4 032 060 9
Biological scientists..........+6. 81 131* -—- -
Blacksmiths.............. 800000 402 -—_ 26
Blasters and powdermen............ 634 --- 41
Boarding/lodging housekeepers..... 15 821* --- -
Boatbuilders..........sseceeecceee . 407 — 27
BoatmMen... sess eeeeeeeeeeeeesesses 150 635* --
Boat workers, fiberglass.... 27 436% --
Body/fender repairmen.... 5 479 34
Boeing clerks....... D0 362 -_- 24
Boeing draftsmen........ 9000 51 089 557 40
Boeing electricians...... sees 186 419 421 29
Boeing engineers.... a0 736 097 080 10
Boeing inspectors..... «. 273 446 557 40
Boeing machinists.......... +s 967 466 557 40
Boeing maintenance workers........ 199 468 557 40
Boeing managers.......... 294 -_ 20
Boeing officials. 294 --- 20
Boeing parts finishers O00 145 657 557 40
Boeing supervisors....... O 294 --- 20
Boeing workers NEC. . 2,083 557 --- 40
Boilermakers......... : 403 = 27
Bonds salesmen............0eeeees 395 --- 26

115


COMMENTARY ON TABLE 1 (MALE MORTALITY, 1950-1979)

Longshoremen and Stevedores
Occupation code 965
Total deaths 3,735

Psychoses, disorders of character, behavior and intelligence, pneu-
monia (age 20-64), cirrhosis of the liver, ulcer of the stomach (age 20-64),
senility and ill-defined diseases, and unspecified falls (age 20-64) show
high PMRs.

Produce/Seed/Feed/Grain Company Workers
Occupation code 966
Total deaths 650

Motor vehicle accidents (1970-1979) and aplastic anemia have raised
PMRs.

Loggers
Occupation code 970
Total deaths 16,625

Malignant neoplasms of the stomach and prostate and respiratory tuber-
culosis have small but significant PMR elevations. Very high PMRs are seen
for logging-related accidents, i.e., blows from falling objects (logs) has 448
deaths observed compared to 42 expected. Disorders of character, behavior
and intelligence and bronchiectasis have elevated PMRs. The bronchiectasis
excess is not seen in deaths after 1970.

Warehousemen
Occupation code 973
Total deaths 2,066

Increased mortality due to suicide is seen in these men. Small number
PMR elevations are seen for laryngeal cancer, aplastic anemia, intestinal
obstruction, cholecystitis, and accidental electrocution.

Wood/Lumber/Sawmill Workers
Occupation code 974
Total deaths 15,067

Malignant neoplasms show a small but significant deficit of deaths.
Pancreatic cancer (age 20-64) and cancer of the testis show PMR excesses.
Other causes with significant PMR excesses are asthma, aplastic anemia
(1970-1979), senility and ill-defined diseases, and work-related accidents.

51


INDEX OF OCCUPATIONS FOR WOMEN

Number
of Occupation Grouped Commentary
Deaths Code Code Page
Art teachers........ g0900000000060 014 54
Assemblers, factory workers.. 30 631* —_
ASSESSOTS.. cece essen cnscvecee 000 54
Athletes... cece cscs cesses secs 6 O1L5* —
Attendants, flight..............66 10 009% =
Attendants, gas station/garage.... 13 291% --
Attendants, hospital/institution.. 810 --- 61
Attendants, library.............6- 34 302 111 54
Attendants, physicians' and
dentists’ offices.........+..40- 64 303% oo
Attendants, recreation/amusement.. 27 812* —
Atomic energy accountants......... 5 007* —
Atomic energy workers... on 51 558* —
AttorneyS..........04- 0 G 13 105* =
Auditors. . 000 54
Authors.... . 28 020* —
Auto mechanics.... D 6 472% =o
Auto painters... o 2 479% —
Auto salesmen..........+4. 6 386* =
Awning sales and service workers.. 5 412 -—- 59
B
Babysitters, preschool/day care
WOrKeTs)yelel-l-)-}-lelelelelolelolelslerelelel=) 62 822% -—- ——
Baggagemen.... 900000 1 304% --- =
Bailiffs. seen 9 854% a
Bakers... seeeee 85 400% =5
305 57
305 57
19 814% --
Bartenders... os eee c eee eeeeee 815 61
Beekeepers. .....eeeeeeee 1 207* =
Bill collectors...... 22 313* _
Biological scientists............. 10 131* —
Biology professors/instructors.... 1 032* =
Blacksmiths.......+..0-- al 402% _
Body/fender repairmen... 2 479% =
Boeing clerks..... 121 362 58
Boeing draftsmen.. 10 089 60
Boeing electricians. 16 419 60
Boeing engineers. 7 097* _
Boeing inspectors.... 9 446 60
Boeing machinists..........+e+eeee 7 466 60
Boeing maintenance workers........ 14 468 60

136


COMMENTARY ON TABLE 1 (MALE MORTALITY, 1950-1979)

Brewery Workers
Occupation code 818
Total deaths 437

The infective and parasitic diseases rubric has a PMR elevation as
does malignant neoplasm of the prostate. Malignant neoplasms of digestive
organs and peritoneum are in excess because of cancer of stomach and large
intestine. A large PMR excess is also seen for primary neoplasms of the
biliary passages and liver. A study of Danish brewery workers supports the
iiver cancer excess(46).

Hotel/Motel Owners and Managers
Occupation code 819
Total deaths 3,109

Tuberculosis of the respiratory system, malignant neoplasms of unspecified
sites (1970-1979) (age 20-64), multiple myeloma, and cirrhosis of the liver
have significant PMR increases. Causes with PMRs >200 are malignant neoplasms
of the testis, malignant melanoma of the skin, cholelithiasis, acute pan-
creatitis, and homicide.

Cooks, Candymakers, and Chefs
Occupation code 825
Total deaths 5,034

Respiratory tuberculosis, malignant neoplasms of the buccal cavity and
pharynx, and esophagus, avitaminosis and metabolic diseases, disorders of
character, behavior and intelligence, pneumonia, pulmonary emphysema, acute
pancreatitis, homicide, accidental falls, ulcer of the stomach, and cirrhosis
of the liver have increased PMRs. The Registrar General's data agree quite
well.

Dishwashers
Occupation code 826
Total deaths 285

Diseases of the respiratory system, cirrhosis of the liver, disorders
of character, behavior and intelligence, accidental falls, and homicide have
PMR increases. The pattern of mortality seen in dishwashers is quite
similar to that seen in cooks.

47


9. Workers Exposed to Phenoxy Herbicides and Chlorophenols

Swedish investigators(52,53), using case-control interview studies,
have shown increased mortality and incidence of soft tissue tumors and
lymphomas in workers exposed to phenoxy herbicides and chlorophenols.

There is considerable exposure in this State to these agents in agricul-
ture and forestry and the wood products industry. 2,4-D is used extensively
in wheat farming, roadside brush and weed control, management of unwanted
forest growth, and in paper mills and sawmills for control of bluestaining
fungi.

Table A shows mortality due to soft tissue cancers, Hodgkin's disease,
and the non-Hodgkin's lymphomas for men in occupations which have exposure
to phenoxy herbicides and chlorophenols.

Only farmers (NOS) have a significant excess of soft tissue cancers,
but the total PMR for these occupations is not significantly elevated.
Similarly, papermakers have a significant excess of Hodgkin's disease while
the overall PMR for Hodgkin's disease in these occupations is only 102.

Table B shows the 15 occupations (of 219) with the highest PMRs for
soft tissue cancers. None of them have an intuitive exposure to the phenoxy
herbicides or chlorophenols. The dry cleaners, printers, and mechanics have
solvent exposure.

The mortality patterns seen here do not offer convincing support for
the phenoxy herbicide and chlorophenol link to soft tissue tumors, Hodgkin's
disease, and non-Hodgkin's lymphomas.

TABLE A
OBSERVED AND EXPECTED DEATHS AND PMRs FOR
SELECTED CANCERS IN OCCUPATIONS WITH EXPOSURE TO PHENOXY HERBICIDES AND CHLOROPHENOLS

IcD Nunber————> 197 201 200.0-200.1 202-202.2
Malignant Neoplasm—> Soft Tissue Hodgkin's Disease Bee, Other Lymphomas
Gode Occupation. Obs Exp PMR ~ Obs Exp PNR Obs Exp PUR Obs Emp Pun
103. Foresters 5s oo Dp oO Gc 1 1 20 So Go
200 Farmers (NOS) 25 16 152% 38 -36.-:107 2 7 Ll 41 40 103
201 orchardists - 30 2 14s 9 5 196 2 9 136 305 (5B
202 Nurserymen Do Oo Sa o toi 7n Sa o
203 Ranchers 1 2 43 2 5 38 9 1 O81 6 6 102
205 Wheat Farmers 1 2 40 5 6 90 130 1a 9 6 18
983 Orchard Laborers 1 1 99 2 3° «67 2 & 46 0 2 0
964 Landscapers, Gardeners 1 2 56 44 89 4 8 52 5 4 16
500 Paperworkers 3.3 91 79 194k asa 33 7 8 9
704 Sawnill Workers 10 10 98 26, 27 88 42 45 96 23 2496
724 Tree Farners oo Go 33 1b 3 4 B 32 154
981 Railroad Laborers 4 310 _5 _9 58 42 15 88 2 7 169
TOTAL 49 41 120 109 107 102 +188: 192 98 109 104 105

* P< .05 76


EXHIBIT 2 - OCCUPATION CODES
PROFESSIONAL, TECHNICAL AND KINDRED WORKERS

000 Accountants, auditors, assessors

007 Atomic energy accountants

009 Flight attendants, airline

010 Actors, actresses, radio announcers

011 Air tratfic controllers

012 Airplane pilots and navigators

013 Architects

014 Artists and art teachers

015 Athletes, athletic coaches

016 Chiropodists

020 Authors

021 Chemists

022 Chiropractors

023 Clergymen

030 College presidents and deans

031 Professors/instructors, agricultural sciences
" "

032 biological

034 " " chemistry

035 " " economics

040 " " engineering

G41 " " geology and geophysics
042 " " mathematics

043 " " medical sciences

045 " " physics

050 " " psychology

051 " " statistics

052 " " natural sciences NEC
053 " " social sciences NEC
054 " " non-scientific subjects
055 " " forestry

060 " " subject not specified

070 Dancers and dancing teachers
071 Dentists
072 Designers
073 Dietitians and nutritionists
074 Draftsmen
088 Draftsmen, atomic energy
089 Draftsmen, Boeing
075 Editors and reporters
076 Newspaper owners, publishers, managers, etc.
080 Engineers, aeronautical

"

081 chemical

082 " civil

083 " electrical
084 " industrial
085 " mechanical
086 " marine

087 " nuclear

090 " metallurgical
091 " mining

092 " sales

094 " construction 86


COMMENTARY ON TABLE 1 (MALE MORTALITY, 1950-1979)

Blasters and Powdermen
Occupation code 634
Total deaths 235

The other accident rubric (ICD 910-936) has a PMR of 606 based on
35 deaths observed to 6 expected. PMRs are elevated for blows from
falling objects and explosion-related deaths.

Railroad Brakemen
Occupation code 640
Total deaths 1,410

Diseases of arteries (age 20-64) and railway accidents have signifi-
cant death increases. PMRs are also elevated for malignant neoplasms of
tongue and testis, emphysema without bronchitis, and unspecified falls.

Bus Drivers
Occupation code 641
Total deaths 1,494

Fatal anemias and agranulocytosis show PMR elevations. Multiple
myeloma and myeloid and acute leukemia have slightly elevated PMRs also.

Deliverymen and Routemen
Occupation code 650
Total deaths 754

Malignant neoplasms of the esophagus, rectum, and Pancreas show high
PMRs. Acute pancreatitis also has a PMR elevation.

Dairy Workers, Ice Cream and Cheesemakers
Occupation code 655
Total deaths 882

Malignant neoplasms of the kidney, lymphatic and hematopoietic tissues.
and leukemia have high PMRs.

As noted in the 1950-1971 study, chronic rheumatic heart disease,

leukemia, and chronic enteritis have elevated PMRs in this group and in
dairy farmers. The similar mortality patterns could be explained by

41


INDEX OF OCCUPATIONS FOR MEN

Number
of Occupation Grouped Commentary
Deaths Code Code Page
Nuclear engineers......... 0 115 087 40
Nurserymen....... 00 202 16
Nurses, practical.. . 30 842% -
Nurses, professional..... D 97 150* —- -
Nurses, student professional. . 11 151* --
Nursing home managers..... » 169 811* --
Nutritionists.................0005 23 073% --- _
ie}
Office bOYS...... cece cece cece eee 47 324% -- --
Office machine operators.. 56 325* --- -
Office machine repairmen... 473 33
Officers, ships........ 265 18
Officials, Boeing.. 294 20
Officials, lodge........ qg000 275 -—- 19
Officials, public administration.. 270 --- 19
Officials, public utility......... 364 --- 24
Officials NEC............. . 290 _ 19
Officials, society. 0 275 — 19
Officials, sports.... G 48 180* --- --
Officials, union.... 275 <— 19
Oilers, except auto..... 692 _—- 43
Qil well drillers.... 416 — 28
Operating engineers. 096 -— 11
Operatives NEC.......... 109 722% -—- --
Operators, heavy equipment 1,944 676 425 29
Operators, power station.. 701 - 43
Operators, radio.. 128 164 352 23
Operators, telegraph. 352 — 23
Operators, telephone. 44 353% -- --
Opticians................ 99 494% -- --
Optometrists... 152 -- 12
Orchardists.... 201 16
Orchard laborers....... 1,138 983 53
Ordnance plant workers. 726 45
Organ tuners and repairmen 100 504* --
Osteopaths............... 79 153 13
Owners, furniture store 297 21
Owners, garage....... 291 20
Owners, lumber company. 292 20
Owners, newspaper... 076 9
Owners, pet shop. 73 296% io
Oystermen...... 962 = 50

127


EXHIBIT 4 -- OCCUPATION GROUPINGS FOR WOMEN

Grouped

Code

310

340

342

343

353

362

363

370

385
393
396
412

500

507

Occupation

——Code__

310
312
333

340
280

342
345

343
350
973

353

362
294

363
364

370
320
321
325
341
360
361

385
393
396

412
652
673
705
710
711
720

500
507

422
467

Occupation Title

Bookkeepers, Cashiers, and Payroll Clerks
Cashiers
Payroll and Timekeeping Clerks

Postal Workers
Postmasters

Secretaries
Stenographers

Shipping and Receiving Clerks
Stock Clerks
Warehousemen

Telephone Operators

Boeing Clerks
Boeing Officials, Managers, and Supervisors

Public Utility Workers
Public Utility Supervisors

Clerks NEC

File Clerks

Adjusters and Examiners
Office Machine Operators
Receptionists

Typists, Data Entry Operators
Railroad Clerks

Insurance Agents, Brokers, Underwriters, Appraisers
Real Estate Agents, Brokers, Developers, Appraisers
Sales Clerks NEC

Fabric Workers

Dyers

Knitters, Loopers, and Toppers, Textile
Sewers, Stitchers, and Cutters, Manufacturing
Spinners, Textile

Rope Makers

Weavers, Textile

Paper/Pulp Mill Workers

Shipyard Workers and Shipfitters
Shipyard Electricians
Shipyard Machinists

111


INDEX OF OCCUPATIONS FOR MEN

Engineers, mining..............006
Engineers NEC (including aides)...
Engineers, nuclear.............006
Engineers, operating...... .
Engineers, railroad...............
Engineers, refrigeration..
Engineers, sales........
Engineers, ship....
Engineers, stationary
Engineers, steam.....
Engravers.....
Entertainers.
Examiners..............
Examiners, manufacturing...
Excavating machine operators......
Express agents..........e..eece0e0

F

Fabric workers............eeeeeeee
Factory motormen..
Farm caretakers.
Farmers, bee....
Farmers, cattle...
Farmers, dairy..
Farmers, egg...
Farmers, grain.
Farmers,
Farmers,
Farmers,
Farmers,
Farmers,

laborers, itinerant.
laborers, orchard....
managers............
Management advisers.
owners NEC....... cece eeeeee
products buyers and shippers.
service (self-employed)......
Farm workers, family......
Feed/grain company workers
Feed mill workers........
Fender/body repairmen
Fiberglass workers...
File clerks..........

Number
of Occupation Grouped Commentary

Deaths Code Code Page
241 091 093 11
093 --- ll

115 087 558 40
096 -—- 11

454 -- 31

160 095 093 11
65 092 093 11
265 --- 18

520 --- 37

374 099 11
100 424% —
68 101* =
321 --- 22

67 643 450 31
425 _— 29

354 --- 23

412 --- 28

21 690% -- =
11 904 902 50
64 207* — --
203 -_ 16

204 _ 16

206 l7

205 7

266 387% -
202 16

206 <> 17

203 16

724 45

205 -—- 7

70 901 902 50
902 =-- 50

46 906 50
983 53

60 222 50
37 102* a
200 15

251 17

51 905 50
4 903 50
966 sl

490 34

479 34

27 436% =
22 320% -

120



INDEX OF OCCUPATIONS FOR MEN

Number
of Occupation Grouped Commentary
Deaths Code Code Page

Maintenance, lumber/plywood/veneer 126 476 974 51
Maintenance, lumber and logging... 363 855 970 51
Maintenance men, janitors.... 834 --- 48
Maintenance, railroad.... 9 469 --- 32
Managers, bank...... 305 -— 21
Managers, Boeing 294 -—- 20
Managers, building......... 00 262 -—- 18
Managers, cocktail bars/tavern. 1,188" * 816 815 46
Managers, farm.........eseee 60 222 902 50
Managers, furniture store....... Oo 297 -—-- 21
Managers, hospitals/nursing homes. 169 811* —_ --
Managers, hotel/motel/resort/

apartment house..........++ 00000 819 -- 47
Managers, lumber company 292 -—- 20
Managers NEC....... 00000 o 290 = 19
Managers, newspaper........- 0 076 — 9
Managers, restaurant and cafe O 817 = 46
Managers, sales. 00000000 285 19
Managers, traffic... po0d00000 314 22
Manufacturing workers......... 0000 462 --- 32
Manufacturing checkers, examiners,

and inspectors..... o0000000G0cG000 67 643 450 31
Marine Corps officers/enlisted men 185 549 555 39
Marine engineers.......+..-- o00000 086 = 11
Markers, manufacturing. 67 643 450 31
Markers, store..... 43 254% --- —
Marshals and constables. 106 852 853 49
Masons, brick and stone. 405 - 27
Mathematicians.......... 3 135 174 13
Mathematics professors.. oa 16 042 060 9
Meatcutters, except slaughterhouse 675 --- 42
Mechanical engineers........+++-++- 085 -—- 42
Mechanics/repairmen, air condi-

tioning, heating, refrigeration. 470 —- 32
Mechanics/repairmen, airplane..... 471 --- 33
Mechanics/repairmen, auto......... 472 — 33
Mechanics/repairmen NEC........... 480 --- 34
Mechanics/repairmen, office

machines.........+0-- 90000900000 473 — 33
Mechanics/repairmen, radio and

television.....ceceeeceeceeeeree 474 -—- 33
Mechanics/repairmen, railroad and

CAL SHOPe eee ee eee ee ces receeeeees 475 -- 33
Mechanic apprentices, auto...+..-- 6 601 472 33
Mechanic apprentices, except auto. 3) 610 480 34

125


INDEX OF OCCUPATIONS FOR WOMEN

Number
of Occupation Grouped Commentary

Deaths Code Code Page
Television repairmen.............. 1 474% --- --
Textile knitters/loopers/toppers.. 24 673 412 59
Textile spinners............. a 5 710 412 59
Textile weavers... o 8 720 412 59
Therapists.......... O 48 193% --- --
Ticket agents........ 5 27 354% --- -

Tile setters/brickmasons. 2 405* --- -
Timekeeping clerks..............0. 32 333 310 57
Tinsmiths/coppersmiths/sheet metal

WOLKETS. cess eee eee ccc enscsace 17 525* =
Tire recappers and rubber welders. 6 477% oS
Tool and die makers............... 3 530* =
Toppers, textile. 500 24 673 59
Traffic managers. o 33 314* -
Travel agents...... D 27 354% -
Travelling salesmen. . 65 380* -
Truck drivers......... o 10 715* _
Tuners, piano and organ.. o a 504* --
Typesetters and compositors. O 10 414* -- --
Typists and keypunchers O 91 360 59
Underwriters, insurance . 385 59
Unemployable........ » 137 997% --
Unemployed.... a 37 998% --
Union officials. O 44 275% --
Unknown....... - 564 999% --
Upholsterers............... a 20 535* --
Ushers, recreation/amusement...... 1 874% --- -
Veterinarians.............. sees 6 194* -—- --
Waitresses... o eee 875 -—- 63°
Warehousemen....... goo 14 973 343 58
Warehousemen, fruit... 21 975 -—- 64
Watchmakers and jewelers. O 25 451* --- --
Watchmen and guards......... 0 18 851* --- ad
Watchmen, lumber and logging 0 2 855* --- --
Weavers, textile............ D 8 720 412 59
Welders......... Q 4 721* --- --
Welfare workers. ~ 140 171% -— -
Wheat farmers.... »- 205 200 56
Woodworkers... . 72 974% -—- -
Wrappers, meat..... o 675 --- 61
Writers, publicity... o 27 163* --- --

x

X-ray technicians................. 18 186* --- --

149


MICROFICHE TABLES - TABLE 1, MALE MORTALITY

Grouped Microfiche

Code Occupation ___Page Column
435 Smelter Workers and Heat Treaters.............. 7 13
444 Log/Lumber Inspectors, Scalers and Graders,

and Timber Cruisers.........cccsecceeeeeeseee 7 14
447 Railroad Inspectors.. 7 15
450 Inspectors NEC........ cece ccc cece cece ecececsees Ft 16
451 Jewelers, Watchmakers, Goldsmiths, Silversmiths,

and Locksmiths...........ccceecccceeeeeeecrees 8 1
453 Telegraph/Telephone/Power Linemen, 8 2
454 Locomotive Engineers............ 8 3
459 Telephone Installers and Repairers............. 8 4
460 Locomotive Firemen........cseeeeeeeeceeceeeeees 8 5
462 Manufacturing Workers 8 6
465 Machinists NEC....... - 8 7
469 Railroad Workers NEC............eeeeeeee 8 8
470 Air Conditioning/Heating/Refrigeration

Mechanics and Repairmen................2+202- 8 9
471 Airplane Mechanics and Repairmen,.... . 8 10
472 Auto Mechanics and Repairmen......... 8 i
473 Office Machine Mechanics and Repairmen,,....... 8 12
474 Radio/Television Mechanics and Repairmen,...... 8 13
475 Railroad/Car Shop Mechanics and Repairmen,, . 8 14
477 Tire Recappers and Repairers, Rubber Welders... 8 15
479 Body/Fender Repairmen and Auto Painters........ 8 16
480 Mechanics and Repairmen NEC.............00cee0e 9 1
490 Grain/Flour/Feed Mill Workers...... . 9 2
491 Millwrights..............0. o 3
492 Metal Molders............cceseesceeceeceeeseeee 9 4
493 Motion Picture Projectionists.................. 9 5
500 Paper/Pulp Mill Workers,............. . 9 6
501 Paperhangers and Decorators (Painters) . 9 7
502 Pattern and Model Makers, except Paper, wees 9 8
505 Plasterers and Lathers,.........cccccececcccees 9 9
507 Shipyard Workers, Shipwrights, and Shipfitters, 9 10
510 Plumbers and Pipefitters................ 9 i
512 Printing Pressmen, Plate Printers, and ©

Typesetters,....... 2. cece cece cence ceeee aeeeee 9 122
514 Roofers and Slaters,...........eeceeeeeeseeeees 9 13
515 Shoemakers, Shoe Repairers, and Leather Workers 9 14
520 Stationary Engineers and Firemen,,,,.,......... 9 15
521 Stonecutters and Stonecarvers,............. boop a 16

153


ABSTRACT

The occupational and cause-of-death information on 429,926 Washington
State male deaths for 1950-1979 and 25,066 female deaths for 1974-1979
was analyzed using an age and year-of-death standardized proportionate
mortality ratio program. A detailed cause-of-death analysis (160 causes)
is published for each of 219 occupational categories for males and for
each of 51 occupational categories for females.

The occupational mortality findings are compared with those of the
Registrar General and with the published occupational mortality literature.
The Washington State mortality pattern is, in general, consistent with both
the Registrar General's results and with the published literature. Some of
the new occupational mortality findings published in the 1950-1971 report
and in this updated version have been confirmed. Others warrant follow-up.
These include a lung cancer excess in workers at the ASARCO Tacoma copper
smelter, increased mortality due to miltiple myeloma and pancreatic cancer
in workers at the Hanford atomic energy facility, and excess mortality due

to cancer of the pancreas, lymphoma, leukemia, and emphysema in aluminum
workers.

New findings in this report are a leukemia increase in workers exposed
to electric and magnetic fields and a deficit of multiple sclerosis deaths
among outdoor workers,

itt


INDEX OF OCCUPATIONS FOR WOMEN

Number
of Occupation Grouped Commentary
M Deaths Code Code Page

Machinery inspectors.............. 2 445% --- --
Machinists, Boeing D 7 466 557 60
Machinists NEC.... Q 20 465% -— --
Machinists, shipyard . 1 467 507 60
Maids, hotel/motel. 0 821 --- 62
Mail carriers...... . 20 323* =
Maintenance, Boeing........ 5 14 468 60
Maintenance, lumber company. 0 4 476% -
Maintenance, railroad.... 0 6 469% —
Managers, aircraft... . 3 289% --
Managers, bank.. a 305 57
Managers/floor men, store 16 254% -
Managers, furniture store 55 297% -
Managers, hotel/motel.... 819 62
Managers, lumber company... o 51 292% -
Managers NEC.......... 5 290 57
Managers, newspaper.............2. 27 076% --- --
Managers/owners, nursing home and

hospital... 80 811* --
Managers, sales............ccceeee 30 285* --
Managers/superintendents, building 8 262% -
Managers, traffic.........eeeee eee 33 314* --- --
Manufacturing checkers/inspectors/

MATKETS.. 6... cece esses ee cc eens 6 643% --
Manufacturing workers... ceeee 32 462% --
Marine Corps officers/enlisted men 1 549% -
Markers/inspectors, manufacturing. 6 643% -
Masons, brick and stone........... 2 405* --
Mathematicians............. 2 135* _ a
Meatcutters, packers/wrappers..... 63 675 --- 61
Mechanics/repairmen, air condi-

tioning, heating, refrigeration. 2 470% -—- -
Mechanics/repairmen, airplane.... 15 471% — --
Mechanics/repairmen, auto.... 6 472% --- --
Mechanics/repairmen NEC........... 5 480% --+ -_-
Mechanics/repairmen, office

MAChineS........ eee eeeeeeeeeeee 1 473% -— —
Mechanics/repairmen, radio and

television............e eee eee ee ah 474% -—- -~
Mechanics/repairmen, railroad and

CAY SHOP... ss. eee cece ccccceceee 4 475* — =
Medical radiologists............05 18 186* --- --
Medical sciences professors and

Anstructors.......... ec cece eee 3 043% -—- -
Medical technicians............... 185 --- 55

143


EXHIBIT 4 -- OCCUPATION GROUPINGS FOR MEN

Auto Mechanics and Repairmen

Office Machine Mechanics and Repairmen
Radio/Television Mechanics and Repairmen
Railroad/Car Shop Mechanics and Repairmen
Tire Recappers and Repairers, Rubber Welders
Body/Fender Repairmen and Auto Painters

Mechanics and Repairmen NEC
Apprentice Mechanics, except Auto

Grain/Flour/Feed Mill Workers

Motion Picture Projectionists

Paperhangers and Decorators (Painters)

Pattern and Model Makers, except Paper

Shipyard Workers, Shipwrights, and Shipfitters

Grouped Occupation
Code Code Occupation Title
472 472
601 Apprentice Auto Mechanics
473 473
474 474
475 475
477 477
479 479
480 480
610
490 490
967 Flour Mill Workers
491 491 Millwrights
492 492 Metal Molders
493 493
500 500 Paper/Pulp Mill Workers
501 501
502 502
505 505 Plasterers and Lathers
507 507
409 Shipwrights
422 Shipyard Electricians
467 Shipyard Machinists
510 510 Plumbers and Pipefitters
508 Steamfitters
612

Apprentice Plumbers and Pipefitters

104


COMMENTARY ON TABLE 2 (FEMALE MORTALITY, 1974-1979)

Nuns
Occupation code 909
Total deaths 109

These women have a very interesting pattern of mortality. Cancers
of digestive organs and peritoneum have a PMR of only 15 (1 death observed
to 7 expected). Lung cancer also has a low PMR (38) probably due to the
fact that most nuns do not smoke cigarettes; however, ovarian cancers have
a very high PMR (480 based on 6 deaths) and breast cancer also has a PMR
increase. The ovarian and breast cancer increases are probably related to
the fact that very few nuns have pregnancies.

Fruit Warehousemen
Occupation code 975
Total deaths 130

These women show a slight and statistically insignificant PMR increase
for malignant neoplasm of the bronchus and lung. Chronic rheumatic heart
disease has a PMR of 276 based on 3 deaths.

64


COMMENTARY ON TABLE 1 (MALE MORTALITY, 1950-1979)

Junk Dealers, Secondhand Store and Salvage Workers
Occupation code 892
Total deaths 457

Malignant neoplasms of the urinary bladder, Hodgkin's disease, cere-
bral embolism and thrombosis (age 20-64), chronic bronchitis, blows from
falling objects, and homicide show elevated PMRs.

Farm Laborers
Occupation code 902
Total deaths 4,438

Respiratory tuberculosis, disorders of character, behavior and intel-
ligence, other diseases of the heart, pneumonia, senility and ill-defined
diseases, railway accidents, motor vehicle accidents, machinery accidents,
accidents due to fire and explosion, and homicide all show significant
mortality excesses. Low social class, poor quality of medical certification
of causes of death, and dangerous work may account for much of the mortality
pattern seen in these men.

Sheepherders and Wool Workers
Occupation code 907
Total deaths 377

High PMRs are seen for senility and ill-defined diseases, motor vehicle
accidents, and suicide.

Fishermen and Oystermen
Occupation code 962
Total deaths 4,675

Malignant neoplasms of the stomach, disorders of character, behavior
and intelligence, cirrhosis of the liver, accidental drowning, and accidents
due to fire and explosion have increased mortality. The Registrar General's
data agree for cirrhosis and accidental deaths.

Landscape Gardeners, Groundskeepers, and Greenskeepers
Occupation code 964
Total deaths 2,677

Malignant neoplasms of the stomach and other and unspecified sites,
subarachnoid hemorrhage, inflammatory diseases of the central nervous system,
and accidental electrocution show PMR increases.

50


EXHIBIT 4 — OCCUPATION GROUPINGS FOR MEN

Grouped” Occupation . . _
Code Code Occupation Title
181 181 Surveyors
642 Chainmen, Rodmen, and Axmen, Surveying
184 184 School Teachers
182 Teachers, Elementary and Secondary Schools
183 Teachers, High School NEC
185. 185 Medical and Dental Technicians
190 190 Electrical and Electronic Technicians
194 194 Veterinarians
195 195 Professional and Technical Workers NEC
196 196 Students (18 and over)
200 200 Farmers NEC
201 201 Orchardists
202 202 Nurserymen
203 203 Ranchers (cattle, sheep, etc.)
204 204 Dairy Farmers
205 205 Wheat and Grain Farmers
206 206 Egg/Poultry Farmers and Distributors
249 249 Florists
250 250 Store Buyers and Department Heads
251 251 Buyers and Shippers of Farm Products and
Produce Brokers
252 252 Railroad Conductors:
253 253 Credit Men
255 255 City and Civil Service Employees
260 260 Public Administration Inspectors
262 262 Building Managers and Superintendents

99


COMMENTARY ON TABLE 1 (MALE MORTALITY, 1950-1979)

Boeing Clerks
Occupation code 362
Total deaths 226

Diabetes mellitus and cerebral embolism and thrombosis show PMR
elevations.

Public Utility Workers
Occupation code 363
Total deaths 1,585

Accidental electrocution has increased mortality in these men
presumably due to occupational exposure to electric current.

Public Utility Supervisors and Officials
Occupation code 364
Total deaths 988

These men also suffer an accidental electrocution increase. In addi-
tion, they have increased mortality due to coronary heart disease, brain,
and rectal cancer (age 20-64).

Clerks NEC
Occupation code 370
Total deaths 1,173

Malignant tumors of the buccal cavity and pharynx, cancer of the
rectum, Hodgkin's disease, myeloid leukemia, and emphysema without bronchi-
tis have more deaths than expected. The Hodgkin's disease excess is also
seen in the Registrar General's analysis.

Travelling Salesmen and Sales Representatives
Occupation code 380
Total deaths 4,618

The rubric for total malignant neoplasms has a significant excess
mortality due to elevated PMRs for malignant neoplasms of the buccal cavity
and pharynx, testis, kidney (1950-1959, 1970-1979), brain (age 20-64), and
lymphatic and hematopoietic malignancies. Benign neoplasms (age 20-64)
and diabetes mellitus also show PMR elevations.

24


COMMENTARY ON TABLE 1 (MALE MORTALITY, 1950-1979)

Gas Station/Garage Owners and Attendants
Occupation code 291
Total deaths 2,786

Diabetes mellitus, diseases of circulatory system, and duodenal
ulcer show statistically significant PMR elevations. PMRs over 200 are
seen for malignant neoplasms of other parts of the mouth, thoracic
organs (secondary), monocytic leukemia, and aplastic anemia. Asthma has
a significantly elevated PMR in men age 20-64.

Lumber Company Managers, Owners, and Workers
Occupation code 292
Total deaths 1,036

Cancer of the pancreas and liver (secondary and unspecified) have
elevated PMRs. Malignant melanoma of the skin has a PMR of 317 based on 4
deaths. Coronary heart disease and cerebral hemorrhage have excess deaths.

Boeing Officials, Managers, and Supervisors
Occupation code 294
Total deaths 726

The total malignant neoplasms rubric has an elevated PMR due to
malignant neoplasms of the esophagus, lymphatic and hematopoietic tissues,
lymphosarcoma, other lymphomas, and myeloid and acute leukemia. All show
small-number PMR excesses. Subarachnoid hemorrhage and aircraft accidents
have elevated PMRs. The mortality pattern in this group is similar to that
of Boeing engineers. Some of the similarity may be due to occupational
misclassification.

Fuel Oil Dealers and Workers
Occupation code 295
Total deaths 1,554

Malignant neoplasms of lymphatic and hematopoietic tissues (1970-1979)
have a significant excess of deaths due to increased mortality from lympho-
sarcoma and the non-Hodgkin's lymphomas. Excess deaths are also seen for
psychoses and paralysis agitans. Asthma has a PMR increase (1950-1969),
put other non-malignant respiratory diseases have a deficit.

20


EXHIBIT 4 -- OCCUPATION GROUPINGS FOR MEN

Grouped Occupation
Code Code Occupation Title
430 430 Foremen NEC z
434 434 Glaziers
435 435 Smelter Workers
431 Forgemen and Hammermen
670 Furnacemen and Pourers
671 Metal Heaters
672 Smelter Workers NEC
444 444 Log/Lumber Inspectors, Scalers, Graders, and
Timber Cruisers
447 447 Railroad Inspectors
450 450 Inspectors NEC
445 Inspectors, Machinery
448 Inspectors, Construction
643 Manufacturing Checkers, Examiners, and Inspectors
451 451 Jewelers, Watchmakers, Goldsmiths, Silversmiths,
and Locksmiths
453 453 Telegraph/Telephone/Power Linemen
454 454 Locomotive Engineers
459 459 Telephone Installers and Repairers
460 460 Locomotive Firemen
462 462 Manufacturing Workers
465 465 Machinists NEC
461 Military Machinists
605 Apprentice Machinists and Toolmakers
469 469 Railroad Workers NEC
470 470 Air Conditioning/Heating/Refrigeration Mechanics
and Repairmen 0
471 471 Airplane Mechanics and Repairmen

103


MICROFICHE TABLES - TABLE 3, MALE OCCUPATIONAL MORTALITY BY CAUSE OF DEATH

Microfiche

IcD. No. Cause of Death Page Row/Column
350 Paralysis Agitans.............006 17 G9
356.1 Amyotrophic Lateral Sclerosis " HO
400-468 Diseases of Circulatory System. a " I9-K 9
410-416 Chronic Rheumatic Heart Disease.......ee eee eee eee " L 9-M 9
420 Arteriosclerotic Heart Disease, including

Coronary Disease... ee cece eee cece ence rece eens " A10-D10
430-434 Other Diseases of Heart...... O " E10-F10
440-447 Hypertensive Disease... O " G10-H10
450-456 Diseases of Arteries.........seeeee 9 " 110
460-468 Diseases of Veins,-etc..........008 " J10
465 Pulmonary Embolism and Infarction. " K10
470-527 Diseases of Respiratory System.... " L10-C11
490-493 Pneumonia.....eeeeeeeeeeees D0 900 " D11-F11
502 Chronic Bronchitis.......... 000000000000000000000 " G11
502.0 Bronchitis with Emphysema.......... 9 " HIL
510-527 Other Diseases of Respiratory System. o 5 " 1T11-K11
523.0 ERG etes¥ 1350000000000 00000000000000000000000000000 " L11
523.1 Anthracosilicosis..... 600000000000000000000000000 " M11
523.2 Asbestosis.........++s--05 o " A12
523.3 Other Pneumoconiosis..........++4- G " B12
525 Other Chronic Interstitial Pneumonia............. " c12
526 Bronchlectasis...csccsccccccssccccceccccece S00000 " D12
527 Other Diseases of Lung and Pleural Cavity. D " E12-G12
527.1 Emphysema without Bronchitis.......... . " H12-J12
540 Ulcer of Stomach.......... o " K12
541 Ulcer of Duodenum................ " L12
550-553 Appendicitis........ a a M12
560-561 Hernia of Abdominal Cavity, 0q0000 ou AL3
570-578 Other Diseases of Intestine and Peritoneum...... " B13
570 Intestinal Obstruction, without Hernia........... " C13
572 Chronic Enteritis, Ulcerative Colitis. ; " D13
581 Cirrhosis of Liver.......secseeeeeeeee 0 " E13-H13
581.0 Cirrhosis of Liver without Alcoholism............ " 113-313
581.1 Cirrhosis of Liver with Alcoholism. Q " K13-L13
584 Cholelithiasis....... " M13
587 Diseases of Pancreas. " A14
587.0 Acute Pancreatitis............ - " Bl4

160


MICROFICHE TABLES - TABLE 4, SIGNIFICANT MALE PMRS BY OCCUPATION

Grouped Microfiche
Code Occupation Page Row/Column
202 De 19 HG
203 Ranchers (cattle, sheep, etc.). " I 4-3 4
204 Dairy Farmers...............0.. " K 4-L 4
205 Wheat and Grain Farmers.......... " M 4-A 5
206 Egg/Poultry Farmers and Distributors.......... " BS5
249 Florists... ee cece cece cee ee cee eee 90G0000 " c5
250 Store Buyers and Department Heads " D5
252 Railroad Conductors................ . " E5
253 Credit Men...... eee eee eee cee eeeeee cece cece " F5
255 City and Civil Service Employees........... 000 " G5
265 Ships' Officers, Pilots, Pursers, Engineers... " HS
270 Public Administrators and Officials NEC....... " I5
275 Lodge/Society/Union Officials...... " J5
280 Postmasters..............0.00, o " K5
285 Purchasing Agents and Buyers NEC, and
Sales Managers............ 00... cee eeceeee " L5
290 Managers, Officials, and Proprietors NEC... " M 5-C 6
291 Gas Station/Garage Owners and Attendants.... 00 " D6
292 Lumber Company Managers, Owners, and Workers.. " E6
294 Boeing Officials, Managers, and Supervisors... " F6
295 Fuel 0il Dealers and Workers.................. " G6
297 Furniture Store Owners, Managers, and Clerks.. " H6
298 Grocers and Grocery Clerks.............0.045., " 16
305 Bankers, Bank Clerks, and Managers....., Q " J 6-K 6
310 Bookkeepers, Cashiers, and Payroll clerks..... " L6
314 Vehicle Dispatchers, Starters » and Traffic
Managers................ 0000000 " M6
321 Adjusters and Examiners... o " A7
323 Mail Carriers....... . " B7
340 Postal Clerks....... 000 900000 " c7
343 Shipping and Receiving Clerks...............05 " D7
350 Stock Clerks and Storekeepers... dee eeeee " E7
352 Telegraph and Radio Operators................. " F7
354 Ticket, Station, Express, and Travel Agents... " G7
361 Railroad Clerks..............ccccceeeeee . " H7
362 Boeing Clerks.......... 0. cece ceceeeeeee " 17
364 Public Utility Supervisors and Officials o " J7
370 Clerks NEC........ Decree anew eereenene . " K7



MICROFICHE TABLES - TABLE 4, SIGNIFICANT MALE PMRS BY OCCUPATION

Grouped Microfiche

Code Occupation Page Row/Column
826 Dishwashers...........eeeeeeee on 20 Gl
833 Window Cleaners and Wall Washers.... o0 " H1
834 Janitors, Maintenance Men, and Sextons 55 a Il
836 School Custodians...........cccceceeecececeees " J1
841 POTLETS. cee cece cececc ences ccencscceecccerces " Kl
843 Hairdressers and Cosmetologists.. 5 " Li
850 Firemen and Fire Protection Workers Do " M1
851 Guards, Watchmen, and Doorkeepers............. " A2
853 Policemen, Sheriffs, and Marshals............. " B2
860 Bridge Tenders and Crossing Watchmen ° " c2
875 Walters. ....scceceeceenee ee D " D2
891 Garbage Collectors.........ceceececees " E2
892 Junk Dealers, Secondhand Store and

Salvage Workers NEC. 900 " F2
902 Farm Laborers..........esee08 . " G 2-1 2
907 Sheepherders and Wool Workers. " J2
962 Fishermen and Oystermen.............. " K 2-L 2
964 Landscape Gardeners, Groundskeepers, and

Greenskeepers..... cece cece cece cece ceeeeeeens " M2
965 Longshoremen and Stevedores........ o " A3
966 Produce/Seed/Feed/Grain Company Workers. 0 " B3
970 LOQRETS. ccc ccccccccccceccccsrecccnencccscccens " C 3-E 3
973 Warehousemen.......ceeeeeeccecesccecceceecees " F3
974 Wood/Lumber/Sawmill Workers " G 3-H 3
975 Fruit Warehousemen......... " 13
980 Laborers NEC... ce cece cece eee e eee e eee eee eee " J 3-A 4
981 Railroad Laborers NEC.. D " B4-c 4
982 Construction Laborers NEC. D " D 4-F 4
983 Orchard Laborers.......... a D " G4
985 Chemical Company Workers........... . " H4
997 Institutionalized, Retarded, Disabled,

and Unemployable Men............eeecececeees " IT 4K 4
999 Not Stated or Unknown.......... " L 4-B 5

167


COMMENTARY ON TABLE 1 (MALE MORTALITY, 1950-1979)

Locomotive Firemen
Occupation code 460
Total deaths 339

Railway accidents have an elevated PMR. Infective and parasitic
diseases and multiple sclerosis have small number PMR excesses.

Manufacturing Workers
Occupation code 462
Total deaths 426

Malignant neoplasms of the digestive organs and peritoneum have a
significantly elevated PMR due to a slightly increased mortality in all
the causes in this group (malignant neoplasms of esophagus, stomach,
large intestine, rectum, etc.). Malignant neoplasms of other and
unspecified sites also have a mortality increase.

Machinists NEC
Occupation code 465
Total deaths 5,799

Subarachnoid hemorrhage and chronic nephritis have increased deaths
in the period 1970-1979. Myeloid leukemia has an elevated PMR especially
in men under age 65.

Railroad Workers NEC
Occupation code 469
Total deaths 332

Stomach cancer (1970-1979) and cancer of the prostate have increased
deaths in this residual railroad workers group.

Air Conditioning/Heating/Refrigeration Mechanics and Repairmen
Occupation code 470
Total deaths 657

PMR increases based on small numbers of deaths are seen for malignant

melanoma of the skin, lymphosarcoma, reticulosarcoma, and amyotrophic
lateral sclerosis.

32


INDEX OF OCCUPATIONS FOR MEN

Number of deaths is given if no occupation mortality table is
printed or when the occupation is analyzed with others in a
group. Grouped Code (Column 3) supersedes Occupation Code
(Colum 2) when listed. An asterisk (*) indicates that no
occupation mortality table is printed (data available on request).

Number
of Occupation Grouped Commentary
A Deaths Code_- Code Page

AccOUNtANES.....ceeceeccccreeccccs 000 7
Accountants, atomic energy 00 22 007 40
ACLOTS ce secesccccccccccs 00 92 010* --
Actuaries.... o 174 13
Adjusters... O90 321 22
Administrators, public...... O00 270 19
Administrators, school. 00 184 14
Advertising agents.. G000000 380 24
Advisers, farm and home management 37 102* --
Aeronautical engineers............ 267 080 10
Agents, advertising... 380 -—- 24
Agents, express... 354 -- 23
Agents, insurance. 385 --- 25
Agents NEC........ 301* -_- -
Agents, purchasing..... 285 -— 19
Agents, real estate..... 393 - 25
Agents, station and ticket oe 354 _— 23
Agents, travel... .ccccecescceceeae 354 -—- 23
Agricultural science professors... 26 031 060 9
Agricultural scientists..... 90 94 130* -—- -
Air conditioning repairmen 470 -—- 32
Aircraft managers.............0005 51 289% -_ --
Air Force officers & enlisted men. 1,183 550 555 39
Airplane electricians............. 186 419 421 29
Airplane mechanics and repairmen.. 471 — 33
Airplane navigators.......... 012 -- 7
Airplane pilots...... O 012 —_ 7
Air traffic controllers D 37 011* _— --
Aluminum workers..........0eeeeeee 526 -- 38
Amusement attendants (cardroom,

pool hall, carnival)............ 812 --- 46

113


INDEX OF OCCUPATIONS FOR MEN

Number
of Occupation Grouped Commentary
Deaths Code Code Page
Truck drivers, moving/transfer/

GHePEEV 30 000 000000000000000000000 616 719 715 44
Truck drivers, sawmill. q 15 717 718 45
Tuners, piano and organ a0 100 504% --- --
Typesetters.......... a0 471 414 512 36
GR PE IEXEIo on 0GgadDODN0DD0DEG00G090R00 11 360% --- --

U
Underwriters, insurance........... 385 -—- 25
Unemployable......... a0 997 --- 53
Unemployed... ° 409 998 999 53
Union officials o 275 -— 19
Unknown...... oe oe 60 -» 8,517 999 —> 53
Upholsterers.....eeeeeeeeeeee o0 535 -— 39
Ushers, recreation/amusement...... 10 874% — —

Vv
Vegetable graders/packers... 89 654 975 52
Vehicle dispatchers.... O 314 --- 22
Veterinarians.........eee eee e ee eee 194 -—- 15

Ww
Waiters...ccc cece eee ence eee gaoop 875 -—- 49
Wall washers......... 833 --- 48
Warehousemen, fruit.. 422 975 --- 52
Warehousemen NEC..... 973 --- 51
Watchmakers........-seeeee0- 451 -—- 31
Watchmen, atomic energy plant 122 856 558 40
Watchmen, crossing........... 329 860 --- 49
Watchmen, guards/doorkeepers. 851 --- 49
Watchmen, lumber/logging.... 363 855 970 51
Water well drillers......... 426 --- 29
Weavers, textile.. 37 720 412 28
Welders........ 721 --- 45
Welders, rubber 477 -—~ 34
Welfare workers. 209 171* — =>
Well drillers, oil..... 416 --- 28
Well drillers, water. 426 — 29
Wheat farmers..... 205 -- 17
Window cleaners. 833 --- 48
Window dressers........+-eeeee- 420 --- 29
Woodchoppers/woodsmen (loggers) 970 -~- 51
Woodworkers... .sseeeessccececcvece 974 -—- 51
Wool workers. 907 --- 50
Wrappers NEC.... 693 --- 43

Writers, publicity.........ssseeee 175 163* --- --


COMMENTARY ON TABLE 2 (FEMALE MORTALITY, 1974-1979)

Students
Occupation code 196
Total deaths 137

Hodgkin's disease and brain tumors show small number excesses of
deaths similar to the excesses seen in male students.

Farmers
Occupation code 200
Total deaths 212

Lung cancer shows a PMR of 141 based on 7 deaths. Male farmers show
a deficit of lung cancer. Subarachnoid hemorrhage has a PMR of 284 based
on 4 deaths.

Florists
Occupation code 249
Total deaths 65

Diabetes mellitus has a PMR of 399 based on 5 deaths (4 over age 75).

Store Buyers and Department Heads
Occupation code 250
Total deaths 126

Cancer of the rectum, lymphatic and hematopoietic tissues, cirrhosis
of the liver, and suicide have elevated PMRs.

City and Civil Service Employees
Occupation code 255
Total deaths 409

Cancer of the breast shows a significant excess mortality (PMR=157)
based on 39 deaths. Cervical cancer and cancer of the corpus of the uterus
show low PMRs. Cancer of the buccal cavity and pharynx, brain, and lymph-
atic and hematopoietic tissues also show increased deaths.

56


EXHIBIT 4 -- OCCUPATION GROUPINGS FOR WOMEN

Grouped Occupation
Code Code Occupation Title
000 000 Accountants, Auditors, and Assessors
014 014 Artists and Art Teachers
073 073 Dietitians and Nutritionists
iil 111 Librarians
302 Library Assistants
120 120 Musicians and Music Teachers
150 150 Nurses
151 Nurses, Student Professional
842 Nurses, Practical
170 170 Religious Workers
023 Clergymen
184 184 School Teachers
182 Elementary School Teachers
183 High School Teachers
185 185 Medical and Dental Technicians
196 196 Students
200 200 Farmers
201 Orchardists
202 Nurserymen
203 Ranchers (cattle, sheep, etc.)
204 Dairy Farmers
205 Wheat and Grain Farmers
206 Egg/Poultry Farmers and Distributors
249 249 Florists
250 250 Store Buyers and Department Heads
285 Purchasing Agents
255 255 City and Civil Service Employees
290 290 Managers, Officials, and Proprietors NEC
298 298 Grocers and Grocery Clerks
305 305 Bankers, Bank Clerks, and Managers

110


5. Motor Vehicle Drivers

Of the 8 occupational groups engaged in driving cars and trucks,
6 show a slight elevation of urinary bladder cancer PMR.

URINARY BLADDER CANCER DEATHS (ICD 181)

Code Occupation Observed Expected PMR
380 Travelling Salesmen 40 31 129
641 Bus Drivers 9 11 83
650 Deliverymen and Routemen 8 5 165
656 Milk Route Deliverymen 2 2 80
714 Taxicab Drivers 11 6 177
715 Truck Drivers 55 49 112
716 Fuel 011 Truck Drivers 3 2 138
718 Log and Lumber Truck Drivers 5 4 130

TOTAL 133 110 121*
* P< .05

6. Painters and Decorators

Men working as painters, paperhangers, decorators, etc. show excess
deaths due to lung cancer, suggesting that volatile constituents of certain
paints may be carcinogenic.

DEATHS DUE TO PRIMARY CANCER OF TRACHEA, BRONCHUS, AND LUNG (ICD 162)

Code Occupation Observed Expected PMR
420 Decorators, Window Dressers 13 7 196*
479 Body and Fender Men, Car Painters 38 27 139%
501 Paperhangers, Interior Painters 41 30 138*
694 Painters 251 208 121**
TOTAL 343 272 126*

* P< .05; ** P< .01
7. Fabric Workers

Men working with fabrics show increased mortality from urinary bladder
cancer, presumably due to exposures to dyes. Dry cleaning workers are also
exposed to solvents.

URINARY BLADDER CANCER DEATHS (ICD 181)

Code Occupation Observed Expected PMR
412 Canvas Makers, Fabric Workers 4 3 154
524 Tailors 10 6 180
535 Upholsterers 7 3) 214*
674 Laundry and Dry Cleaning Workers 11 9 119

TOTAL 32 21 152*
* P< .05

74


COMMENTARY ON TABLE 1 (MALE MORTALITY, 1950-1979)

Stocks and Borids Salesmen
Occupation code 395
Total deaths 379

A curious excess mortality is seen for deaths due to paralysis agitans
(7 deaths observed, 1 expected, PMR = 697). Coronary heart disease also
has a slight PMR excess.

Sales Clerks NEC
Occupation code 396
Total deaths 5,279

This is the miscellaneous sales clerk category. Malignant neoplasms of
the buccal cavity and pharynx, larynx, acute leukemia, and chronic rheumatic
heart disease show high PMRs. The buccal cavity and laryngeal tumors may
be due to alcohol ingestion.

Carpet Makers and Layers
Occupation code 400
Total deaths 148

Cerebral embolism and thrombosis has a PMR increase in these men.

Bakers
Occupation code 401
Total deaths 1,370

Most of the mortality excesses seen in the 1950-1971 study have not
persisted in the 1970-1979 deaths. PMRs over 200 are seen for cancer of
the tongue, acute leukemia, psychoses, abdominal hernias, senility, and
falls on the same level.

Blacksmiths
Occupation code 402
Total deaths 1,304

Nearly half the deaths in this group of men occurred at age 80+, with
fewer deaths occurring in recent years. Elevated PMRs are seen for cancers
of the large intestine and esophagus, other diseases of the heart, hyper-
tensive disease, and homicide.

26


EXHIBIT 2 - OCCUPATION CODE3

CRAFTSMEN, FOREMEN AND KINDRED WORKERS (continued)

548 Officers and enlisted men, Coast Guard
" 0 "

549 Marine Corps
550 " " "Air Force
sl avy

552 Army

555 " " “Armed Forces NEC

553 Merchant Marines

554 Civilian employees of the Armed Forces
557 Boeing workers NEC

558 Atomic energy workers NEC

559 Nuclear workers, not Hanford

OPERATIVES
601 Apprentice, auto mechanics
602 " bricklayers and masons
604 " electricians
605 " machinists and toolmakers
610 " mechanics, except auto
612 " plumbers and pipefitters
613 " building trades NEC
614 " metalworking trades NEC
615 " printing trades
620 " other specified trades
621 " trade not specified

630 Asbestos and insulation workers

631 Assemblers, factory workers

634 Blasters and powdermen

635 Boatmen, canalmen and lock keepers

640 Railroad brakemen, carmen

641 Bus drivers

642 Chainmen, rodmen and axmen, surveying

643 Checkers, examiners and inspectors, manufacturing

645 Conductors, bus and street railway

650 Deliverymen and routemen

651 Dressmakers and seamstresses, except factory

652 Dyers

653 Metal filers, grinders, and polishers

654 Graders and packers (except factory) fruit, nut, vegetable
655 Creamery, ice cream and cheesemakers, and dairy workers
656 Milk route deliverymen

657 Parts finishers, Boeing

670 Furnacemen, smeltermen and pourers

671 Heaters, metal

672 Other smelter workers

92


COMMENTARY ON TABLE 1 (MALE MORTALITY, 1950-1979)

This commentary consists of a description of the mortality pattern
seen in each of the occupation groupings and compares this pattern to what
has been published by the Registrar General(16) for the same occupation
group. Frequently, comparison is impossible because of lack of occupation
code comparability or because of difference in cause-of-death groupings.
Where other published work is applicable it is cited. Occupation groups
with less than 200 deaths are not described unless an interesting mortality
pattern or known occupational hazard exists. A few groups with more than
200 deaths are not described, if the mortality pattern is not unusual and
no known occupational hazard exists. Unless specified, the PMRs described
are for the entire study period (1950-1979).

Accountants, Auditors, and Assessors
Occupation code 000
Total deaths 3,732

Cancer of the esophagus has a significant mortality increase due to
excess deaths in 1950-1969. Since 1970, the PMR is only 122. Other statis—
tically significant increases in PMR are seen for cancers of stomach, biliary
passages and liver, lymphatic and hematopoietic tissues (1970-1979), acute
leukemia (1950-1979), asthma (1950-1959), cerebral embolism and thrombosis
(1950-1979), arteriosclerotic heart disease (age 20-64), bronchiectasis, and
aircraft accidents (1970-1979). The Registrar General's study showed non-
significant increases in SMR for brain cancer, lung cancer, and ischemic
heart disease. The brain cancer and ischemic heart disease excesses are
supported in the Washington State data but the lung cancer excess is not.

Airplane Pilots and Navigators
Occupation code 012
Total deaths 362

Statistically significant excess deaths are seen for cancer of the rec-
tum and for deaths due to aircraft accidents (observed 171, expected 7, PMR
over 2,000*%*). This excess is seen in the Registrar General's data (SMR=2,948).
Kidney, brain, and connective tissue cancers also show non-significant PMR
increases based on small numbers of deaths. There is a slight PMR elevation due
to leukemia. Pilots and plane crews are exposed to cosmic radiation, especially
at high altitudes and latitudes in the northern hemisphere(17).

Architects
Occupation code 013
Total deaths 387

Multiple myeloma, chronic rheumatic heart disease and accidental falls
show mortality increases based on small numbers of deaths. Architects show
a leukemia excess in the Registrar General's data.



8. Workers in Magnetic and/or Electrical Fields

Men exposed to electricity or magnetic fields produced by electric
current have excess mortality due to leukemia. Aluminum workers are
exposed to strong magnetic fields induced by the high amperage direct cur-
rent used in the pots in the aluminum reduction process. The other workers
are exposed to electrical fields associated with alternating current flowing
in wires and power lines. Some of these workers have other exposures which
might explain some of the leukemia excess. Among the few studies available
(48,49), there is no evidence to support the hypothesis that occupational
exposures to electric or magnetic fields is carcinogenic. One study, however,
has associated the incidence of juvenile cancers with proximity of residence
to electrical distribution wires(50) and another associates power-frequency
magnetic fields with suicide(51).

Leukemia Mortality
In Men Occupationally Exposed to Electric and Magnetic Fields
Washington State White Male Deaths, 1950-1979

IcD Number—————> 204 204.3
Malignant Neoplasm———> All Leukemia Acute Leukemia

Code Occupation Obs Exp PMR Obs Exp PMR
083 Electrical Engineers 7 6 114 2 2 97
190 Electronic Technicians 6 4 149 3 2 162
352 Radio and Telegraph

Operators 5 4 111 3 1 239
421 Electricians 51 37 138% 23° 13° 178**
453 Power and Telephone

Linemen 15 9 159 6 3 183
474 Television and Radio

Repairmen 5 3 157 4 1 291
493 Motion Picture

Projectionists 4 2 234 1 1111
526 Aluminum Workers 20 11 189*%* 11 4 258%*
691 Streetcar and Subway

Motormen é} 2 = 175 0) i) i)
701 Power Station Operators 8 3 259% 3 1 282
721 Welders and Flame Cutters 12 _18 _67 4 7 _56

TOTAL 136 99 137% 60 35 160*

*P < .05; ** P< .O1

75


REFERENCES

ths

10.

11.

12.

13.

14.

Milham, S. Occupational Mortality in Washington State, 1950-1971.
DHEW Publication No. (NIOSH) 76-175-A,B,C, 1976.

Milham, S. and Hesser, J.E. Hodgkin's Disease in Woodworkers. The
Lancet No. 7507 (v. II): 136-137, July 1967.

Petersen, G.R. and Milham, S. Hodgkin's Disease Mortality and Occu-
pational Exposure to Wood. J. Nat. Cancer Inst. 53: 957-958, 1974.

Milham, S. Mortality Experience of the AFL-CIO United Brotherhood
of Carpenters and Joiners of America, 1969-1970. H.E.W. Publication
No. (NIOSH) 74-129.

Cole, P., Hoover, R., and Friedell, G.H. Occupation and Cances of
the Lower Urinary Tract. Cancer 29: 1250-1260, 1972.

Anthony, H.M. and Thomas, G.M. Tumors of the Urinary Bladder: An
Analysis of the Occupations of 1,030 Patients in Leeds, England. J.
Nat. Cancer Inst. 45: 879-895, 1970.

Dunham, L.J., Rabson, A.S., Stewart, H.L., Frank, A.S., and Young,
J.L. Rates, Interview, and Pathology Study of Cancer of the Urinary
Bladder in New Orleans, Louisiana. J. Nat. Cancer Inst. 41: 683-709,
1968.

Wynder, E.L., Onderdonk, J., and Mantel, N. An Epidemiological
Investigation of Cancer of the Bladder. Cancer 16: 1388-1406, 1963.

Milham, S. Leukemia and Multiple Myeloma in Farmers. Am. J. Epide-
miology 94: 307-310, 1971.

Fasal, E., Jackson, E.W., and Klauber, M.R. Leukemia and Lymphoma
Mortality and Farm Residence. Amer. J. Epidem. 87: 267-274, 1968.

Milham, S. and Strong, T.R. Human Arsenic Exposure in Relation to a
Copper Smelter. Env. Res. 7: 176-182, 1974.

Gilbert, E.S. and Marks, S. An Analysis of Mortality in Workers in
a Nuclear Facility. Radiation Res. 79: 122-148, 1979.

Milham, S. Mortality in Aluminum Reduction Plant Workers. Journal
of Occupational Medicine 21(7): 475-480, July 1979.

Pinto, S.S., Enterline, P.E., Henderson, V., and Varner, M.0. Mor-
tality Experience in Relation to a Measured Arsenic Trioxide Exposure.
Environmental Health Perspectives 19: 127-130, 1977.

81


This report is made up of four sets of tables:

Table 1: Male mortality by occupation

Table 2: Female mortality by occupation

Table 3: Occupations ranked by PMR within each cause of
death (males only)

Table 4: Causes of death with significantly (P < .05) elevated
or reduced PMRs by occupation (males only)

The tabular format has been changed in that mortality is now shown
for three 10-year periods: 1950-1959, 1960-1969, and 1970-1979.


EXHIBIT 4 ~~ OCCUPATION GROUPINGS FOR MEN

Grouped Occupation
Code Code Occupation Title
965 965 Longshoremen and Stevedores
966 966 Produce/Seed/Feed/Grain Company Workers
970 970 Loggers
455 Logging Engineers
464 Logging Machinists and Mechanics
855 Lumber/Logging Watchmen
973 973 Warehousemen
974 974 Wood/Lumber/Sawmill Workers
476 Lumber/Plywood/Veneer Maintenance Men
704 Sawyers, Sawmill Workers, Saw Filers
975 975 Fruit Warehousemen
654 Fruit/Nut/Vegetable Graders and Packers
976 Fruit Inspectors
980 980 Laborers NEC
981 981 Railroad Laborers NEC
982 982 Construction Laborers NEC
984 Hod Carriers
983 983 Orchard Laborers
985 985 Chemical Company Workers
997 997 Institutionalized, Retarded, Disabled, and
Unemployable Men ;
999 999 Not Stated or Unknown
998 Unemployed

109


CONCLUSION

In the interval since the publication of the 1950-1971 analysis of
this data set, a number of new occupational mortality associations
demonstrated in that study have been substantiated by independent study
results. Increased mortality due to pancreatic cancer and multiple myeloma
in workers at the Hanford atomic energy facility has been substantiated by
a population-based study(12) and, more importantly, has been shown to be
associated with low-level radiation.

Similarly, the lung cancer excess seen in workers at the ASARCO Tacoma
smelter has been confirmed by a population-based study(14) in that work-
force. Additionally, this lung cancer excess has been related to occupa—
tional arsenic exposures. Partly as a result of this work, a lowered
federal workplace standard for arsenic has been promulgated.

Aluminum workers showed elevated PMRs for cancer of the pancreas,
leukemia, lymphoma, and emphysema. These excesses have been confirmed in
a population-based study done at a Washington State aluminum reduction
plant(13) and in a recently-concluded multiplant study done in the United
States(41).

It is hoped that the new findings of the 1950-1979 analysis presented
here will provide a rational basis for future studies.

As this type of information becomes available for other populations,
comparisons will indicate which occupational mortality findings warrant
followup. The pattern of mortality within an occupational group should
also assist in the study of morbidity in that group.

An inescapable conclusion of the previous study and the current analysis

is that the proportionate mortality ratio method is appropriate for this
type of analysis.

79


EXHIBIT 4 -- OCCUPATION GROUPINGS FOR MEN

Printing Pressmen, Plate Printers, and Typesetters
Compositors and Typesetters
Electrotypers and Stereotypers

Shoemakers, Shoe Repairers, and Leather Workers

Stationary Engineers and Firemen

Stonecutters and Stonecarvers

Metal Working Trades Apprentices NEC
Metal Filers, Grinders, and Polishers

Tinsmiths, Coppersmiths, and Sheet Metal Workers
Metal Rollers and Roll Hands

Cannery and Food Processing Workers
Floor Workers (Covering, Hardwood, Linoleum)

Tool and Die Makers and Setters

Craftsmen and Kindred Workers NEC

Navy/Coast Guard Officers and Enlisted Men
Coast Guard Officers and Enlisted Men

Army/Air Force/Marine Corps Officers and

Marine Corps Officers and Enlisted Men
Air Force Officers and Enlisted Men

Grouped Occupation
Code Code Occupation Title
512 512
414
423
615 Apprentice Printing Trades
514 514 Roofers and Slaters
515 515
520 520
712 Stationary Firemen
521 521
523 523 Structural Metal Workers
452 Metal Jobsetters
614
653
524 524 Tailors
525 525
513
526 526 Aluminum Workers
527 527
528 528
530 530
535 535 Upholsterers
545 545
551 551
548
555 555
Enlisted Men
549
550
552

Army Officers and Enlisted Men

105


EXHIBIT 2 - OCCUPATION CODES

400
401
402
403
404
405
406
407
408
409
410
41L
412
413
414
415
416
417
420
421
418
419
422
423
424
425
426
427
429
430
431
434
435
436
444
445
446
447
448
450
976
260
451
452
453
454
455
459
460
461
462
464

CRAFTSMEN, FOREMEN AND KINDRED

Carpet makers, carpet layers

Bakers

Blacksmiths

Boilermakers

Bookbinders

Brickmasons, stonemasons, tile setters

Building contractors, construction contractors
Boatbuildérs

Railroad contractors

Shipwrights

Cabinetmakers

Carpenters

Canvas makers, sailmakers, awning sales and service and fabric workers
Cement and concrete finishers

Compositors and typesetters

Cranemen, derrickmen and hoistmen

Oilwell drillers

Oil refinery workers

Decorators and window dressers

Electricians

Electricians, atomic energy

Electricians, Boeing or airplane

Electricians, shipyard

Electrotypers and stereotypers

Engravers, except photoengravers

Excavating, grading, road machinery operators, pavers, highway maintenance
Water well drillers

Railroad foremen

Construction foremen NEC

Foremen NEC

Forgemen and hammermen

Glaziers

Smelter workers, heat treaters, annealers, temperers (ASARCO)
Fiberglass, bathtub and boat workers

Inspectors, scalers, graders--log and lumber; timber cruisers
Inspectors, machinery

Inspectors, Boeing

Inspectors, railroad

Inspectors, construction

Inspectors, NEC

Inspectors, fruit

Inspectors, public administration

Jewelers, watchmakers, goldsmiths, silversmiths, locksmiths
Jobsetters, metal

Linemen and servicemen, telegraph, telephone, power
Locomotive engineers, railroad

Logging engineers

Telephone installers, repairmen

Locomotive firemen, railroad

Military machinists

Manufacturing workers

Logging machinists and mechanics

90


COMMENTARY ON TABLE 2 (FEMALE MORTALITY, 1974-1979)

Secretaries
Occupation code 342
Total deaths 1,654

The total malignant neoplasms rubric has increased mortality due
to cancers of the breast, body of uterus and brain. Multiple myeloma
also shows a PMR increase. Diseases of the circulatory system show a
significant deficit of deaths. Deaths due to accidental falls are
increased. Multiple sclerosis and cirrhosis of the liver also have PMR
increases.

Shipping and Receiving Clerks
Occupation code 343
Total deaths 122

Breast cancer (age 20-64) shows a PMR increase. Cancer of the cervix
also shows a small PMR excess as does hypertensive disease.

Telephone Operators
Occupation code 353
Total deaths 427

Cancer of the cervix and homicide show elevated PMRs.

Boeing Clerks
Occupation code 362
Total deaths 152

Cancers of the large intestine (age 20-64) and lung show significant
excesses in these women.

Public Utility Workers
Occupation code 363
Total deaths 159

Malignant neoplasms of the breast and ovary show elevated PMRs.

58


COMMENTARY ON TABLE 2 (FEMALE MORTALITY, 1974-1979)

As in the commentary on Table 1 (Male Mortality) this section con-
sists of a description of the mortality pattern seen in each of the
occupational groupings in Table 2. The numbers of deaths available for
analysis are small because only 6 years of data are available for females

(vs. 30 for males) and nearly two-thirds are in the single non-specific
group coded "housewife."

Accountants, Auditors, and Assessors
Occupation code 000
Total deaths 296

The PMR for all malignant neoplasms is slightly elevated (PMR=108).
Cancer of the body of the uterus has a PMR of 349 based on 5 deaths.

Artists and Art Teachers
Occupation code 014
Total deaths 87

Women in this occupation show 3 deaths in the other lymphoma category
compared to 0 expected. Breast cancer has a PMR of 171 based on 10 deaths.

Dietitians and Nutritionists
Occupation code 073
Total deaths 104

These women show a significant excess of malignant neoplasms of the
digestive organs (PMR=254 based on 7 deaths) in the 20-64 age class.
This is due to 4 deaths observed due to cancer of the pancreas to less
than 2 expected. Malignant neoplasms of lymphatic and hematopoietic
tissues (age 20-64) show a PMR of 476 based on 5 deaths, 3 of which were
in the other lymphoma category. Diabetes mellitus had a PMR of 225
based on 5 deaths.

Librarians
Occupation code 111
Total deaths 201

Elevated PMRs are seen for cancers of the large intestine and rectum.

54


COMMENTARY ON TABLE 1, (MALE MORTALITY, 1950-1979)

Orchardists
Occupation code 201
Total deaths 3,215

Orchard farmers show a significant lung cancer excess which is
especially interesting since the other farming rubrics show a significant
deficit of lung cancer deaths. The lung cancer excess seems to be increas-
ing in that the PMR for 1950-1959 deaths was 102; 1960-1969, PMR = 121; and
1970-1979, PMR = 143**, The non-malignant respiratory disease rubric shows
a deficit, suggesting that the lung cancer excess is not due to cigarette
smoking. Lead arsenate insecticide was used heavily in the orchard areas
of the State until 1940. Men who manufacture arsenical-based pesticides
have increased mortality from lung cancer(31, 32).

Hodgkin's disease, cerebral embolism and thrombosis, and cholelithiasis
have elevated PMRs. Cirrhosis of the liver shows a deficit of deaths in
these men while aircraft accidents show an excess.

Nurserymen
Occupation code 202
Total deaths 503

Respiratory tuberculosis and cancer of the pancreas show significantly
elevated PMRs.

Ranchers (cattle, sheep, etc.)
Occupation code 203
Total deaths 3,913

These men show a deficit of lung cancer deaths; however, prostate and
kidney cancer, lymphatic leukemia (age 20-64), chronic bronchitis, machinery
accidents, and accidental electrocutions had elevated PMRs.

Dairy Farmers
Occupation code 204
Total deaths 2,629

Lung cancers show a deficit of deaths. The stomach and brain cancer
excesses seen in the 1950-1971 study are not seen in 1970-1979 deaths.

Chronic rheumatic heart disease and coronary heart disease had excess
deaths as did amyotrophic lateral sclerosis and machinery accidents.

16


COMMENTARY ON TABLE 1 (MALE MORTALITY, 1950-1979)

Fuel Oil Truck Drivers
Occupation code 716
Total deaths 334

The same general pattern of mortality is seen in these men as in the
truck and tractor drivers group. Motor vehicle accidents and diseases of
arteries have increased deaths.

Lumber/Log/Sawmill Truck Drivers
Occupation code 718
Total deaths 770

Asthma and logging-related accidents have PMR elevations. Motor ve-
hicle accidents and blows from falling objects (logs) show excess deaths.

Welders and Flame Cutters
Occupation code 721
Total deaths 2,124

Malignant neoplasms of the lung and kidney have significant PMR excesses
as do bronchitis with emphysema and deaths due to fire and explosion.
The Registrar General's data agree with the lung cancer increase.

Tree Farmers, Forest Service and Parks Department Workers
Occupation code 724
Total deaths 1,114

Lymphatic leukemia, other anemias, diseases of arteries (1970-1979),
and the other accidents category have increased deaths.

Sandblasters
Occupation code 725
Total deaths 82

No table is published since there were only 82 deaths in sandblasters.
These men have very high PMRs due to malignant and non-malignant respira-
tory diseases. As expected, there were 2 deaths from pneumoconiosis, 1 due
to silicosis, and 1 due to other pneumoconiosis.

Ordnance Plant Workers
Occupation code 726
Total deaths 377

Other diseases of the respiratory system and motor vehicle accidents
show increased deaths in this group.

45


COMMENTARY ON TABLE 1 (MALE MORTALITY, 1950-1979)

Firemen and Fire Protection Workers
Occupation code 850
Total deaths 1,636

Malignant neoplasms of the brain, bronchiectasis, and deaths caused
by fire and explosion have significantly elevated PMRs. Small number PMR
elevations are seen for malignant neoplasms of the gallbladder and bile
ducts, malignant melanoma, leukemia, and psychosis.

Guards, Watchmen, and Doorkeepers
Occupation code 851
Total deaths 2,042

Cirrhosis of the liver without alcoholism, cholelithiasis, and suicide
(age 20-64) have significant PMR elevations.

Policemen, Sheriffs, and Marshals
Occupation code 853
Total deaths 2,253

Malignant neoplasms of the large intestine and liver, diseases of
veins (age 20-64), pulmonary embolism and infarction, diabetes mellitus,
and deaths due to homicide show high PMRs. The intestinal cancer excess
is seen in the Registrar General's data.

Bridge Tenders and Crossing Watchmen
Occupation code 860
Total deaths 329

Men in this category show significantly increased mortality due to
diabetes mellitus and hyperplasia of the prostate.

Waiters
Occupation code 875
Total deaths 329

Men in this group have increased mortality due to respiratory tuber-
culosis and homicide.

Garbage Collectors
Occupation code 891
Total deaths 283

Esophageal and rectal cancers and cirrhosis of the liver have increased

49


MORTALITY IN INDOOR VERSUS OUTDOOR WORKERS

IcD Number 345
Multiple

Cause of Death————>

Sclerosis
Occupation Obs Exp PMR

Chronic Rheumatic
Heart Disease

410-416

Obs

Exp

PMR

722.0

Obs

Exp

Rheumatoid
Arthritis

PMR

Outdoor blue collar 70 100

Indoor white collar 117

Indoor blue collar 112 110
All other occupations 126 134

* P< .05; ** P< .OL

Outdoor blue collar occupation codes:
405, 406, 413, 416, 425,426, 444, 447,

962, 964, 965, 970, 981, 982, 983.

Indoor white collar occupation codes:

075, 076, 080, 082, 083, 085, 086, 093,
184, 185, 190, 194, 195, 249, 250, 252,
297, 298, 305, 310, 314, 321, 340, 350,

Indoor blue collar occupation codes:

451, 459, 462, 465, 470, 471, 472, 473,
501, 502, 505, 510, 512, 515, 520, 521,
630, 655, 674, 675, 693, 701, 706, 810,

All other occupations: 161, 196, 206,
411, 415, 427, 430, 434, 450, 454, 460,
694, 714, 715, 716, 718, 721, 726, 812,

975, 980, 985, 986, 997, 999.

70**

142%*

102
94

103,
453,

000,
094,
253,
352,

400,
474,
524,
814,

251,

469,
833,

78

789
723
881

938

181,
507,

012,
096,
255,
354,

401,
475,
525,
815,

265,
523,
834,

200,
514,

013,
104,
262,
361,

402,
477,
526,
817,

291,
551,
836,

853
618
849

1010

201,
634,

014,
105,
270,
362,

403,
479,
527,
818,

295,
555,
841,

92%

56

117**% 45

104

93%

202,
703,

021,
120,
275,
370,

407,
480,
528,
819,

304,
640,
850,

52
57

203, 204,
713, 724,

022, 023,
152, 154,
280, 285,
385, 386,

410, 412,
490, 491,
530, 535,
825, 826,

343, 363,
641, 650,
851, 853,

56
39
53
60

205,
891,

060,
160,
290,
393,

420,
492,
545,
843,

364,
656,
875,

100
115
98
95

323,
902,

o71,
162,
292,
395,

421,
493,
557,
973,

380,
685,
892,

390,
907,

074,
174,
294,
396.

435,
500,
558,
974,

384,
692,
966,


INDEX OF OCCUPATIONS FOR WOMEN

Number
of Occupation Grouped Commentary

Deaths Code Code Page

Examiners....scesescccccssecccees . 14 321 370 59
F

Fabric workers. ..... esses eeeeeeeee 5 412 — 59
Farm advisers.. 8 102* -— -
Farmers, cattle 20 203 200 56
Farmers, dairy.. 20 204 200 56
Farmers, egg... 28 206 200 56
Farmers, grain. 7 205 200 56
Farmers NEC.. eee 71 200 —_— 56
Farmers, nursery 0 28 202 200 56
Farmers, orchard.. O 28 201 200 56
Farmers, poultry 28 206 200 56
Farmers, sheep.. 20 203 200 56
Farmers, wheat. 17 205 200 56
Farm foremen... soeee 2 901* - --
Farm laborers.......... 900 24 902* --

Farm laborers, itinerant..... 5 906* --
Farm products buyers/shippers 2 251* —
Farm service (self-employed). 2 905* —
Farm workers, unpaid family 2 903* i
Feed/grain company workers.... 7 966* =
Fiberglass and plastics workers... 5 436* =
File clerks.....ccccssccsscvceesee 35 320 59
Finishers, cement and concrete. 1 413% =
Firemen/fire protection.... 2 850* =
Fishermen......sseseeceeees 13 962* =
Flight attendants, airline. 10 o09* =
Floor/linoleum workers....... 1 528* =
Floor men and managers, store. 16 254% =5
FLOTAstS...sccceeceerscenes 249 56
Flour mill workers... 3 967* —
Food processing workers. 527 60
Foremen, farm 000 2 901* -- =
Foremen NEC ae 12 430* -—- --
FOresters.evecscscescccccecoee 4 103* --- =
Forest service/Parks/Game depart-

ment workers..... socccccees 13 724% --- --
Foundry workers. 2 670* —- --
Fruit inspectors... 1 976 975 64
Fruit/nut/vegetable graders and

packers....... ©00000000000000000 108 654 64
Fruit warehousemen.... . 21 975 64
Fuel oil dealers/workers gO 20 295* --
Fuel oil truck drivers...........- 1 716* --- --

140


INDEX OF OCCUPATIONS FOR MEN

Number
of Occupation Grouped Commentary
Deaths Code Code Page

Tavern owners and operators....... 1,188 816 815 46
Taxicab drivers........... D 714 --- 44
Teachers and administrators. . 184 -_— 14
Teachers, art.......-..00- o 014 -—- 8
Teachers, dancing. D 20 070* -— _
Teachers, elementary.......... ° 571 182 184 14
Teachers, high school and NEC..... 1,139 183 184 14
Teachers, MUSic.... see eecseeence 120 -—- 12
Teachers, secondary... 571 182 184 14
Technical workers NEC..........60. 195 - 15
Technicians, electrical/electronic 190 -— 14
Technicians, engineering and

physical sciences........seeeeee 75 191* --- -
Technicians, medical/dental. 185 --- 14
Technicians NEC.......... 126 192* --- --
Telegraph linemen. O 453 --- 31
Telegraph messengers 0 22 351* —- -
Telegraph operators. o 352 23
Telephone installers/repairers.... 459 31
Telephone linemen........... 453 31
Telephone operators. . 44 353% --- _
Television repairmen o 474 --- 33
TeMperersS.... cee c eee e enc eceeenene 435 --- 30
Textile knitters/loopers/toppers.. 53 673 412 28
Textile spinners........ccceeeeees 26 710 412 28
Textile weavers 37 720 412 28
Therapists..... Q 187 193% --- —
Ticket agents.. D 354 -—- 23
Tile setters... 9 405 --- 27
Timber cruisers........ . 444 --- 30
Timekeeping clerks. 0 o0 142 333 310 21
Tinsmiths.............. D 525 --- 38
Tire recappers/repairers. . 477 -- 34
Tool and die makers/setters....... 530 — 39
Toppers, textile manufacturing 9 53 673 412 28
Traders, fur...... cece ee eee 266 387* — =
Traffic managers. 2000000 ° 314 22
Transfer workers/truck drivers 0 616 719 44
Transportation baggagemen... O 304 21
Travel agents....... o 354 23
Travelling salesmen. D 380 24
Tree farmers........ o 724 45
Truck/tractor drivers. 0 715 44
Truck drivers, fuel oil. . 716 --- 45
Truck driver helpers... D 40 972 715 44
Truck drivers, lumber/log......... 718 — 45

133


COMMENTARY ON TABLE 1 (MALE MORTALITY, 1950-1979)

Marine Engineers
Occupation code 086
Total deaths 628

Cancers of lung, liver, and brain have excess deaths. Lymphosarcoma
has a PMR of 310 based on 4 deaths.

Engineers NEC
Occupation code 093
Total deaths 3,593

Cancer of the large intestine and brain, leukemia, Hodgkin's disease,
benign neoplasms, multiple sclerosis, and duodenal ulcer show excess
deaths. The Registrar General's tables for engineers NEC show mortality
excesses due to cancer of the large intestine and benign neoplasms.

Construction Engineers
Occupation code 094
Total deaths 351

Lung cancer, chronic rheumatic heart disease and hypertensive disease
show elevated PMRs.

Operating Engineers
Occupation code 096
Total deaths 913

Lung cancer and motor vehicle accidents show significant PMR elevations.

Foresters and Conservationists
Occupation code 103
Total deaths 217

Men in this group show a 32% excess of total malignant neoplasms;
however, this excess is limited to deaths before 1970. Cancers of the
rectum, pancreas, nose and sinuses, and asthma show PMR elevations.

11


INDEX OF OCCUPATIONS FOR WOMEN

Number of deaths is given if no cccupation mortality table is
printed or when the occupation is analyzed with others in a
group. Grouped Code (Column 3) supersedes Occupation Code
(Column 2) when listed. An asterisk (*) indicates that no
occupation mortality table is printed (data available on request).

Number
of Occupation Grouped Commentary
A Deaths Code Code Page

Accountants............. 000 54
Accountants, atomic energy. 5 007* --
ActresseS......... ec. cece ee 10 010* -- --
Actuaries and statisticians 28 174% --- --
Adjusters.......... 14 321 370 59
Administrators, public 61 270* --- --
Administrators, school 28 184 -——- 55
Advertising agents........ og 65 380* a
Advisers, farm and home management: 8 102* --
Agents, advertising............... 65 380* --
Agents, insurance. 385 59
Agents NEC........ 5 301* — --
Agents, purchasing................ 30 285 250 56
Agents, travel/ticket/station/

OXPLESS. eee eee ee eee cece eenns 27 354% --- --

Agricultural science professors... 1 031* --- --
Agricultural scientists....... 3000 5 130* -- --
Air conditioning repairmen 00 2 470* --- --
3
7
5

Aircraft managers............ 289% -- -—
Air Force officers/enlisted men... 550%
Airplane mechanics........... D0 1 471*

Air traffic controllers 1 o11* --
Aluminum workers....... 12 526* -
Analysts....... o 28 174* -
Announcers, radio, 5 O 10 010* -—
Appraisers, insurance.......... 385 59
Apprentices, metal working trades. 1 614% --
Apprentices, other specified trade 1 620* aed
Apprentices, trade not specified.. 1 621% --
Architects....... ce ccce eee e ee eae 2 013* --
Armed Forces NEC.............00.08 3 555* --
Army officers and enlisted men.... 21 552* --
ALtisSts. cee eee cee cece eee ee eevee 014 => 54

135


COMMENTARY ON TABLE 1 (MALE MORTALITY, 1950-1979)

Orchard Laborers
Occupation code 983
Total deaths 1,138

PMRs over 200 are seen for urinary bladder cancer (age 20-64),
lymphatic leukemia, psychoses, disorders of character, behavior and
intelligence, ulcer of stomach and duodenum (age 20-64), senility,
accidental death due to electric current, fire and explosion, homicide,
and railway accidents. Motor vehicle accidents also show increased
deaths.

Chemical Company Workers
Occupation code 985
Total deaths 379

PMRs over 200 are seen for leukemia, amyotrophic lateral sclerosis,
and infections of the kidney.

Institutionalized, Retarded, Disabled, and Unemployable Persons
Occupation code 997
Total deaths 1,506

Tuberculosis, psychoses, disorders of character, behavior and intel-
ligence, cerebral hemorrhage, multiple sclerosis, pneumonia, other diseases
of respiratory system, ulcer of the stomach, intestinal obstruction, urinary
disease, and infections of the kidney have high PMRs. Very low PMRs are
seen for motor vehicle and work-related accidents presumably because these
men do not drive or work.

The pattern of mortality reflects causes of death common in bedridden
men and the diseases which cause institutionalization.

Not Stated or Unknown
Occupation code 999
Total deaths 8,926

Respiratory tuberculosis, diabetes mellitus, avitaminosis and meta-
bolic diseases, psychoses, disorders of character, behavior and intelligence,
other diseases of heart, pneumonia, other diseases of intestine, cirrhosis
of liver, infections of kidney, senility, railway accidents, unspecified
falls, and deaths due to fire and explosion have increased PMRs. This
pattern of mortality is similar to that of laborers (code 980).

53




MICROFICHE TABLES - TABLE 3, MALE OCCUPATIONAL MORTALITY BY CAUSE OF DEATH

Microfiche

ICD No. Cause of Death Page Row/Column
590-594 Nephritis and Nephrosis...........eeeeeesscceuece 17 C14
592 Chronic Nephritis.............. 90 " D14
600-609 Other Diseases of Urinary System. 0 900 " E14

600 Infections of Kidney........... ccc eee ces eccceeee " F1l4
602 Calculi of Kidney and Ureter..... " G14
610-617 Diseases of Male Genital Organs " H14

610 Hyperplasia of Prostate........ " 114
690-716 Diseases of Skin, Cellular Tissue................ " J14
722.0 Rheumatoid Arthritis..........ecece cee ee eee eeeees " K14
730-738 Osteomyelitis, Diseases of Bone and Joint.. os " L14
790-795 Senility and Ill-defined Diseases........... OD " M14
800-999 Accidents, Poisonings and Violence..............- " A15-E15
800-802 Railway Accidents.........eeeeeeeees ° " FS
810-835 Motor Vehicle Accidents (Total). . " G15-I15
860-866 Aircraft Accidents............ o " J15-K15
900-904 Accidental Falls......... cc cccceeeeeee cence oe " L15-M15
901 Falls from Ladders.........ccsseecceeccscccccuece " Al6
902 Other Falls from One Level to Another. O " B16-C16
903 Falls on Same Level........sceeseecesceee 0 " D16
904 Unspecified Falls........ ccc cece eee eec cee nscecnes " E16
910-936 Other AccidentsS....... cece ce eccceeescecenssccees " F16-J16
910 Blows from Falling Object.. 5 " K16

912 Accidents caused by Machinery.... o " L16-M16
914 18 Al

916 " B1-cl
970-979 " D1-F1
980-985 " G1-H1

161


COMMENTARY ON TABLE 4
(MALE MORTALITY BY CAUSE-OF-DEATH GROUPS WITHIN OCCUPATION)

Table 4 presents, for each occupational class, those causes of
death with significantly elevated or reduced PMRs. Significance testing
is done only in the grouped year-of-death column (1950-1979), so signi-

ficant differences seen in the other grouped year-of-death or age~at-
death columns will be missed.

The commentary on Table 1 applies to Table 4 since it is a subset
of Table 1.

70


COMMENTARY ON TABLE 1 (MALE MORTALITY, 1950-1979)

Lumber Salesmen
Occupation code 384
Total deaths 442

Malignant neoplasms of the large intestine, cerebral hemorrhage, and
other vascular lesions affecting central nervous system show a mortality
excess.

Insurance Agents, Brokers, Underwriters, Appraisers
Occupation code 385
Total deaths 2,595

Cancers of the small intestine, large intestine, prostate, brain, and
bone have excess deaths. Leukemia (acute and myeloid) show elevated PMRs
in 1970-1979. Multiple sclerosis and accidental falls also have mortality
excesses.

Car Salesmen
Occupation code 386
Total deaths 1,877

Reticulosarcoma, diabetes mellitus, coronary heart disease, and air-
craft accidents have significant mortality excesses.

Newsboys
Occupation code 390
Total deaths 227

Infective and parasitic diseases, cancer of the stomach, hypertensive
disease, and auto accidents have PMR elevations in these men.

Real Estate Agents, Brokers, Developers, Appraisers
Occupation code 393
Total deaths 3,700

Lung cancer and non-malignant respiratory diseases show low PMRs.
Elevated PMRs are seen for cancer of the tongue, lymphosarcoma (age 20-64),
coronary heart disease, aircraft accidents, and suicide.

25


COMMENTARY ON TABLE 3
(MALE MORTALITY BY OCCUPATION WITHIN CAUSE-OF-DEATH GROUPS)

Subarachnoid Hemorrhage (ICD 330)

Two occupational classes employed at a large aircraft manufac-
turing facility (Boeing) have elevated PMRs due to subarachnoid hemorrhage.

Diseases of the Respiratory System (ICD 470-527)

Cigarette smoking and exposure to asbestos, silica, metal fumes,
and other toxic inhalants can cause these diseases. The occupations with
high PMRs reflect this.

Silicosis (ICD 523.0)

Metal molders, stonecutters and stonecarvers, and miners are .all
exposed to free crystalline silica.

Asbestosis (523.2)

Shipyard workers and asbestos and insulation workers are exposed to
asbestos fibers.

Cirrhosis of the Liver without Alcoholism (ICD 581.0)
Cirrhosis of the Liver with Alcoholism (ICD 581.1)
Ulcer of the Stomach (ICD 540)

Acute Pancreatitis (ICD 587.0)

These causes of death are all related to excessive ingestion of alcohol.
Alcoholism is probably an occupational hazard of bartenders and restaurant
and cafe workers. Men in the other occupations with high PMRs due to these
causes probably suffer alcoholism due to lifestyle, not occupation.

Aircraft Accidents (ICD 860-866)

Airplane pilots and navigators, aeronautical engineers, and airplane
mechanics and repairmen are, of course, at increased risk of dying in plane
crashes. The other occupational classes with high PMRs due to aircraft
accidents may represent those men with enough money to own or fly in small
aircraft.

68


INDEX OF OCCUPATIONS FOR WOMEN

Number
of Occupation Grouped Commentary
Deaths Code Code Page
Merchant MarineS......+sssseeeeeee 2 553* =
Messengers, express. o 1 314* --
Messengers, telegraph. . 1 350* --
Milliners.......+++- . 41 680* -
Millwrights......+sseseseee . 1 491* -—
Moving/storage truck drivers C 4 719% -
Musicians.....--seeeeeeeeee sees 120 — 54
Music teacherS....sseeeeeeceereees 120 — 54
N

Natural sciences professors......- 3 052* --
Navy officers and enlisted men. 11 551* --
NewsboyS....e.seeeeeeeeeereces 3 390% --- --
Newspaper owners/publishers/

MANAQETS.. ee eeesereeereccccrecce 27 076% — --
Nuns......-- . 909 — 64
Nurserymen.....-. . 28 202 200 56
Nurses, practical. 666 842 150 55
Nurses, professional........- «- 1,429 150 -—- 55
Nurses, student professional...... 1 151 150 55
Nursing home/hospital managers and

OWNETS se eee eee cece eee eeeeeeees 80 811* --- --
Nutritionists.....seeeeeeeeeeeeeee 073 — 54

i)
Office machine operators........+- 42 325 59
Office machine repairmen.. 00 1 473* --
Officers, ship.......sseeeeee 0a 7 265* -—-
Officials, lodge/society/union.... 44 275% --
Officials NEC.........eeeeeeeeeeee 290 57
Officials, public administration.. 61 270* --
Officials, SPpOrtsS.....sseeeeeeeeee 4 180* --
Oilers and greasers, except auto.. 1 692% --
Operatives NEC.....-seeeeeeeeeeeee 3 722% --
Operators, elevator.. 90500000 22 831* --
Operators, heavy equipment.... 4 676% --
Operators, office machine. oO 42 325 59
Operators, radio........+- oe 1 164* --
Operators, road machinery. 1 425% --
Operators, telegraph...... 40 352% -
Operators, telephone....... 00 353 58
Opticians and lens grinders 00 4 494% --
OptometristS.....eseeeeeees sees 2 152* --- -

144


COMMENTARY ON TABLE 2 (FEMALE MORTALITY, 1974-1979)

Laundry/Dry Cleaning Operatives
Occupation code 674
Total deaths 398

Arteriosclerotic heart disease (age 20-64) has an elevated PMR.

Meatcutters and Wrappers
Occupation code 675
Total deaths 65

Pulmonary emphysema, cirrhosis of the liver, and motor vehicle
accidents have increased mortality.

Hospital/Institution Attendants
Occupation code 810
Total deaths 438

Cancers of the buccal cavity and pharynx, large intestine, gallbladder
and bile ducts, uterine cervix, and kidney show increased PMRs. Pulmon-
ary emphysema also shows excess deaths.

Bartenders
Occupation code 815
Total deaths 79

Female bartenders show PMR increases based on small numbers for
respiratory and ovarian cancer, pulmonary emphysema, cirrhosis of the
liver, motor vehicle accidents, and homicide. This pattern is similar to
that of male bartenders.

Cocktail Bar/Tavern Owners, Operators, and Workers
Occupation code 816
Total deaths 90

Respiratory cancer, cirrhosis of the liver, motor vehicle accidents,
and homicide show increased deaths.

61


COMMENTARY ON TABLE 1 (MALE MORTALITY, 1950-1979)

Railroad Conductors
Occupation code 252
Total deaths 1,080

PMR elevations are seen for tumors of the buccal cavity and pharynx,
and cancers of the lung, prostate and kidney. Diabetes mellitus and, as
expected, deaths from railway accidents show increased PMRs.

Credit Men
Occupation code 253
Total deaths 366

Brain cancer, malignant lymphoma, and cerebral embolism and thrombo-
sis show PMR elevations.

City and Civil Service Employees
Occupation code 255
Total deaths 2,719

Men in this group show a deficit of deaths due to tuberculosis. Cancer
of the pancreas has elevated PMRs in 1950-1969, but not in the 1970-1979
period. There is a very high PMR (>700) in age class 45-49 due to cancer of
the pancreas (observe 7 deaths, expect less than 1). Appendicitis also has
an elevated PMR limited to the years 1950-1969.

Public Administration Inspectors
Occupation code 260
Total Deaths 479

Malignant neoplasms of the stomach (1970-1979) and lymphatic and hema—
topoietic tissues. (1970-1979) have significant PMR increases. Cerebral
hemorrhage has a PMR increase limited to 1950-1959.

Building Managers and Superintendents
Occupation code 262
Total deaths 253

The mortality pattern in this group is unremarkable.

Ships' Officers, Pilots, Pursers, and Engineers
Occupation code 265
Total deaths 1,153

Cancer of the stomach, hypertensive disease, and intestinal obstruction
show mortality excesses.

18


COMMENTARY ON TABLE 1 (MALE MORTALITY, 1950-1979)

Metal Molders
Occupation code 492
Total deaths 486

Respiratory tuberculosis, stomach cancer, silicosis, chronic bron-
chitis with emphysema, cirrhosis of the liver, and lung cancer show
excess deaths. These men inhale siliceous and metallic dusts.

Motion Picture Projectionists
Occupation code 493
Total deaths 210

Cancer of pancreas and appendicitis have PMR elevations.

Paper/Pulp Mill Workers
Occupation code 500
Total deaths 3,711

Cancer of small intestine, gallbladder (age 20-64), lymphatic and
hematopoietic tissues, Hodgkin's disease, multiple myeloma, fatal anemias
including aplastic anemia, coronary heart disease, and machinery acci-
dents all have more deaths than expected. The Hodgkin's disease excess
is supported by a New York State study(2).

Paperhangers and Decorators (Painters)
Occupation code 501
Total deaths 832

Lung cancer, cancer of the urinary bladder, reticulosarcoma, hyper-
tensive heart disease, and gastric ulcer have increased deaths.

Pattern and Model Makers, except Paper
Occupation code 502
Total deaths 161

Stomach cancer and chronic rheumatic heart disease have small number
excesses.

35


MICROFICHE TABLES - TABLE 1, MALE MORTALITY

Grouped Microfiche

Code Occupation Page Column
726 Ordnance Plant Workers.........eceeceeeeeecevee 12 5
810 Hospital/Institution Attendants............-+6. 12 6
812 Recreation/Amusement Attendants (cardroon,

Pool hall, carnival).....seccccccesecceeceees 12 7
814 Barbers... ..csecccecescceccavccsccsescesccscees 12 8
815 Bartenders... ccsscccccccccccsecccssascosessece 12 9
817 Restaurant Owners, Managers, and Workers... 12 10
818 Brewery Workers...........06- 0000 12 11
819 Hotel/Motel Owners and Managers..........+0+... 12 12
825 Cooks, Candymakers, and Chefs. 12 13
826 Dishwashers......e.seeseeeces a0000 12 14
833 Window Cleaners and Wall Washers..... 12 15
834 Janitors, Maintenance Men, and Sextons......... 12 16
836 School Custodians. 13 1
841 POLLELS. sees eseereserccecccce eeee 13 2
843 Hairdressers and Cosmetologists... sevens 13 3
850 Firemen and Fire Protection Workers.. veee 13 4
851 Guards, Watchmen, and Doorkeepers.............. 13 5
853 Policemen, Sheriffs, and Marshals... -- 13 6
860 Bridge Tenders and Crossing Watchmen. -- 13 7
875 Waiters... cccsesecccccrecccceccccsccessssreces 13 8
891 Garbage Collectors ....-.eecceceeeescscccscscees 13 9
892 Junk Dealers, Secondhand Store and

Salvage Workers NEC.........46 woeceeseee 13 10
902 Farm Laborers ........e.seee05 13 11
907 Sheepherders and Wool Workers........... +. 13 12
962 Fishermen and Oystermen.......sesseeeeseceeeses 13 13
964 Landscape Gardeners, Groundskeepers, and

Greenskeepers »...ccesecenccccccccrcsssssesees 13 14
965 Longshoremen and Stevedores........+- . 13 15
966 Produce/Seed/Feed/Grain Company Workers........ 13 16
970 LOQQETS wee seccrcscccrccsccsccesseccccvecsccces 1G 1
973 Warehousemen . 14 2
974 Wood/Lumber/Sawmill Workers . eee 14 3
975 Fruit Warehousemen ......ssesesscccecccccceseses 14 4
980 Laborers NEC........ on 14 5
981 Railroad Laborers NEC..... 14 6
982 Construction Laborers NEC. vee 16 7
983 Orchard Laborers ....sseescerecccccecvcccccsscce 14 8
985 Chemical Company Workers ......eeeeeecscceeseeee 1G 9
997 Institutionalized, Retarded, Disabled,

and Unemployable Men.....seseeesececceseseces 14 10
999 Not Stated or Unknown ....seseeeeeccsccceeeseees 14 11

155


COMMENTARY ON TABLE 2 (FEMALE MORTALITY, 1974-1979)

Musicians and Music Teachers
Occupation code 120
Total deaths 236

Cancer of the breast has a PMR of 150 based on 14 deaths. Rectal
cancer has a PMR of 226 based on 3 deaths.

Nurses
Occupation code 150
Total deaths 2,105

Stomach cancer has a PMR of 212 based on 10 deaths in nurses dying in
the age group 20-64. Deaths due to avitaminosis and other metabolic diseases
show significant excess deaths. The PMR for suicide is slightly elevated
(PMR=121) agreeing with the Registrar General's findings.

Religious Workers
Occupation code 170
Total deaths 130

Elevated PMRs are seen for uterine cancer and other diseases of the heart.

School Teachers
Occupation code 184
Total deaths 2,448

Women in this class show a 10 percent increase in cancer mortality
(28 percent under age 65). Cancers of the digestive organs and peritoneum
show a significant excess due to cancers of the esophagus, stomach, large
intestine, and pancreas... Breast cancer, malignant melanoma, and malignant
neoplasms of the brain (age 20-64) all show significant excess deaths, while
respiratory cancers show a significant deficit. The other lymphoma category
has excess deaths in the age 20-64 category. Circulatory diseases and cirrho-
sis of the liver show a significant deficit of deaths, while the chronic
interstitial pneumonia category has an excess. Multiple sclerosis, paralysis
agitans, and rheumatoid arthritis also have excess deaths.

Medical and Dental Technicians
Occupation code 185
Total deaths 114

Breast, ovarian, and uterine (corpus and unspecified) cancer have elevated
PMRs. Cerebral embolism and thrombosis and subarachnoid hemorrhage also show
small number PMR elevations.

55


COMMENTARY ON TABLE 1 (MALE MORTALITY, 1950-1979)

Furniture Store Owners, Managers, and Clerks
Occupation code 297
Total deaths 740

Cancer of the pancreas (age 20-64) and chronic rheumatic heart disease
have high PMRs.

Grocers and Grocery Clerks
Occupation code 298
Total deaths 4,203

Bone cancer and diabetes mellitus (age 20-64) have increased PMRs.
Tumors of the floor of the mouth and nose also show PMR elevations based
on small numbers of deaths. Cerebral hemorrhage and coronary heart disease
also have slightly elevated PMRs. The homicide excess seen in the 1960s is
not as apparent in the 1970s deaths.

Transportation Baggagemen
Occupation code 304
Total deaths 156

Only cirrhosis of the liver without alcoholism shows a PMR above 200.

Bankers, Bank Clerks, and Managers
Occupation code 305
Total deaths 1,407

All malignant neoplasms, cancers of the large intestine, larynx,
brain and connective tissue, Hodgkin's disease (age 20-64), lymphatic and
acute leukemia, and coronary heart disease have excess deaths. The PMR for
connective tissue tumors was 465 based on 5 deaths.

Bookkeepers, Cashiers, and Payroll Clerks
Occupation code 310
Total deaths 1,308

Lung cancer shows a significant deficit in these men, while non-
malignant respiratory diseases show an excess. The urinary bladder cancer
excess seen in deaths before 1960 is not seen since. Cancer of the tongue,
lymphosarcoma, intestinal obstruction without hernia, and cholecystitis
without calculi have PMR elevations.

21


INDEX OF OCCUPATIONS FOR WOMEN

Number
of Occupation Grouped Commentary
Deaths Code Code Page
Institutionalized..... . , 137 997% “+ --
Instructors, sports... 0 4 180* --~ -
Insurance agents /brokers /under—
writers, and appraisers......... 385 --- 59
J
TANLtors..csccccccseseseee sogoa000 GI} 834 --- 63
Janitors, school...... a 22 836 834 63
Jewelers and watchmakers. . 25 451% --- --
TUdges..cceseccccsecvcscccccccccens 13 105* --- --
Junk dealers/secondhand store
Visa 144300 ga00000000000000000 sae 8 892% --- --
K
Keypunchers and typists........... 91 360 370 59
Kitchen workers, not private
household..........cececcceccsee 835 = 63
Knitters, textile...........eeeeee 24 673 412 59
L
Laboratory technicians.. D 54 192* --
Laborers, construction D 4 982* —
Laborers NEC........ o 48 980* —-
Laborers, orchard... O 20 983% =
Laborers, railroad NEC............ 11 981* —
Labor relations/personnel workers. 50 154% =
Landscapers and gardeners......... 9 964% =
Laundry operatives..... 674 61
Lawyers..... 13 105* --
Leather workers D 16 515* --
Librarians.......... C 167 111 54
Library attendants/assistants..... 34 302 54
Linemen, telegraph/telephone/power 1 453% -_
Lodge officials..............ee eee 44 275% --
Loggers........ O 9 970* --
Logging engineers... 1 455% --
Longshoremen..... 2 965* -- --
Loopers, textile. 24 673 412 59
Lumber camp cooks............e0005 6 827% --- --
Lumber company maintenance workers 4 476% -—- --
Lumber company owners, managers,
and workers...........0.. waceees 51 292* --
Lumber inspectors/scalers/graders. 3 444x --
Lumber/logging watchmen. a 2 855* --
Lumber salesmen...............0005 5 384% -- --

142


EXHIBIT 2 - OCCUPATION CODES

200
201
202
203

205
206
207
222
387
901
902
903
904
905
906
907

249
250
251
252
253
254
255
260
261
262
265
270
275
280
285
289
290
291
292
294
295
296
297
298

FARMERS AND FARM MANAGERS

Farmers, owners and tenants
Orchardists

Nurserymen

Ranchers

Dairy farmers

Wheat and grain farmers
Egg and poultry farmers, distributors
Bee keepers

Farm managers

Mink ranchers, fur traders
Farm foremen

Farm laborers, wage workers
Unpaid family farm workers
Farm caretakers
Self-employed farm service
Itinerant laborers
Sheepherders, wool workers

MANAGERS, OFFICIALS, PROPRIETERS except farm

Florists

Buyers and department heads, store

Buyers and shippers, farm products, produce brokers
Conductors, railroad

Credit men

Floor men and floor managers, store

City, civil service employees

Inspectors, public administration

Lighthouse keepers

Managers and superintendents, building

Officers, pilots, pursers, engineers, ship
Officials and administrators NEC, public administration
Officials, lodge, society, union, etc.

Postmasters

Purchasing agents and buyers NEC, sales managers
Aircraft managers, etc.

Managers, officials and proprietors NEC

Owners, attendants, gas station/garage; ‘car wash, parking
Lumber company managers, owners, and workers
Boeing officials, managers, supervisors

Fuel oil dealers, workers

Pet shop owners, workers

Furniture store owners, managers, clerks

Grocers, grocery clerks

88




COMMENTARY ON TABLE 1 (MALE MORTALITY, 1950-1979)

misclassification of occupation; however, both groups are exposed to
milk and to streptococcal and enteric diseases associated with dairy
cattle and raw milk. This may explain the rheumatic and enteric disease
excess.

Milk Route Deliverymen
Occupation code 656
Total deaths 353

Lymphosarcoma shows a non-significant PMR elevation based on 3 deaths
observed to less than 1 expected.

Laundry/Dry Cleaning Operatives
Occupation cede 674
Total deaths 1,268

Malignant neoplasms of the buccal cavity and pharynx, liver, and connective
tissue have elevated PMRs. Subarachnoid hemorrhage (age 20-64) has a PMR
of 227 based on 7 deaths. Acute pancreatitis has a PMR of 279 based on 5
deaths. The dry cleaning workers are exposed to solvents, but this mortality
pattern could also be due to excessive drinking. Cirrhosis of the liver has
a small PMR increase.

Meatcutters and Butchers
Occupation code 675
Total deaths 2,907

Malignant neoplasms of the hypopharynx, esophagus, and liver (age 20-64),
and pneumonia (age 20-64) have high PMRs. The pharyngeal cancers are prob-
ably related to alcoholism since cirrhosis of the liver also shows a 40%
increase. Inflammatory diseases of the central nervous system, hypertensive
disease, and the other chronic interstitial pneumonia rubric show elevated
PMRs.

Mine Operatives and Laborers NEC
Occupation code 685
Total deaths 4,050

Respiratory tuberculosis has a PMR of 506 (observed 79 deaths, expected
16). Lung cancer and all the non-malignant respiratory disease rubrics have

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83


COMMENTARY ON TABLE 2 (FEMALE MORTALITY, 1974-1979)

Paper/Pulp Mill Workers
Occupation code 500
Total deaths 101

Women who work in these mills have a 19 percent increase in total
cancers due to cancers of large intestine, rectum, and breast.

Shipyard Workers and Shipfitters
Occupation code 507
Total deaths 123

Cancers of digestive organs have a significant PMR elevation due to
cancers of large intestine and biliary passages and liver. Lung cancer,
hypertensive disease, and emphysema also have PMR elevations.

Cannery/Food Processing Workers
Occupation code 527
Total deaths 314

Cancer of the esophagus and chronic rheumatic heart disease have PMR
increases. Lung cancer has a deficit of deaths.

Boeing Workers NEC
Occupation code 557
Total deaths 198

Malignant neoplasms of digestive organs and peritoneum have a signi-
ficant excess mortality due to cancers of esophagus (2 cases), stomach
(3 cases), and large intestine (10 cases). Multiple myeloma and chronic
rheumatic heart disease also have increased PMRs.

Dressmakers and Seamstresses, except Factory
Occupation code 651
Total deaths 530

Cancers of the urinary bladder and lymphatic and hematopoietic tissues,
infections of the kidney, and cirrhosis of the liver show PMR increases.

60


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84


INDEX OF OCCUPATIONS FOR MEN

Number
of Occupation Grouped Commentary
Deaths Code Code Page
DAVETS.. cece eee cece cee c cece eeacene 32 702% -—- --
Doorkeepers, guards, watchmen. 0 851 -_ 49
Draftsmen........eeeeeeeeee . 074 -—- 9
Draftsmen, atomic energy. D 10 088 558 40
Draftsmen, Boeing........ : 51 089 557 40
Dressmakers, except factory. . 10 651* = =
Drillers, oil well....... 416 -- 28
Drillers, water.... o 426 -- 29
Drivers, a 641 - 41
Drivers, fuel oil trucks.... o 716 -- 45
Drivers, lumber and log trucks a 755 718 --- 45
Drivers, moving/transfer trucks... 616 719 715 44
Drivers, sawmill trucks....... O 15 717 718 45
Drivers, taxicab......... 714 -—-- 44
Drivers, truck and tractor.. 715 44
Druggists............ . 160 13
Dry cleaning operatives........... 674 --- 42
E
Economics professors.............. 7 035 9
Economists......... 9 11 172* —
Editors... seecee . 075 9
Egg farmers.........eceeeeecceeees 206 17
Electrical/electronic technicians. 190 14
Electrical engineers.............. 083 -- 10
Electricians......... 421 -— 29
Electrician apprentices.. O 13 604 421 29
Electricians,. atomic energy.. 0 55 418 558 40
Electricians, Boeing/airplane. » 186 419 421 29
Electricians, shipyard..... o 316 422 507 36
Electrotypers........ O 100 423 512 36
Elevator operators. a 175 831* -—- —
Embalmers.............008 00 104 --- 12
Engineering professors... 9 040 060 9
Engineers, aeronautical. 9 080 093 11
Engineers, Boeing........ . 097 093 11
Engineers, chemical....... O 081 093 11
Engineers, civil...:.. oe 082 --- 10
Engineers, construction. 90 092 093 11
Engineers, electrical. 0000 083 --- 10
Engineers, industrial. a0 084 093 11
Engineers, locomotive D 454 -—- 31
Engineers, logging... O 455 970 51
Engineers, marine.... 9 086 093 11
Engineers, mechanical. 990 085 --- 10
Engineers, metallurgical.......... 090 093 11

119


INDEX OF OCCUPATIONS FOR MEN

Number
of Occupation Grouped Commentary

Deaths Code Code Page
Geology/geophysics professors..... 5 041 9
Glaziers.......ceccceesscccceneece 434 30
Goldsmiths.......... 0000000 451 31
Grader operators, road.. eee 425 29
Graders, log and lumber. oe 444 30
Graders/packers, fruit/vegetables. 89 654 52
Grain/feed company workers........ 966 51
Grain farmers......seeeeeeeeeeeeee 205 17
Grain, flour/feed mill workers.... 490 34
Greasers, auto.......... a 291 20
Greasers, except auto. DooDod 692 43
Greenskeepers......... 0000 964 -- 50
Grinders, metal......... eoee = 153 653 523 37
Grocers.......6. 000000 298 --- 21
Groundskeepers..... eee 964 50
Group WOTKETS....eeeeeeeeereeceees 74 165* -— _-
Guards, atomic energy plant....... 122 856 558 40
Guards, watchmen/doorkeepers...... 851 --- 49

H

Hairdressers......cceccccececceecs 843 --- 48
Hammermen.....ssscsccccccccecceees 17 431 435 30
Hardwood floor workers........+..- 528 --- 38
Healers, therapists........... 9 187 193% -_—- oss)
Heaters, metal...... . 25 671 435 38
Heating repairmen.. . 470 --- 32
Heat treaters........... . 435 30
Heavy equipment operators + 1,944 676 29
Highway maintenancemen... o 425 29
Hod carriers...... 9 422 984 52
Hoistmen....... ccs e eee eene . 415 28
Home management advisers... . 37 102* a
Hospital attendants........... O 810 46
Hospital managers..... . 169 811* pant

Hotel owners and managers......... 819 --- 47
Housekeepers and stewards (private

household)..........ceeeeeee Fy 204 832* --- --

Housekeepers, lodging. . D 15 821* —- —_

Hucksters.....sseseecsccevcevveees 17 383 380 24
I

Ice cream manufacturers.. 655 -_— 41

Industrial engineers.............. 102 084 093 11

122


COMMENTARY ON TABLE 1 (MALE MORTALITY, 1950-1979)

Decorators and Window Dressers
Occupation code 420
Total deaths 247

Tumors of the buccal cavity and pharynx, larynx, and lung, and
accidental falls have elevated PMRs.

Electricians
Occupation code 421
Total deaths 4,549

The lung cancer excess seen in deaths in 1950-1959 is not seen in deaths
after 1960. Malignant melanoma (age 20-64), malignant brain tumors, acute

leukemia, silicosis, bronchitis, emphysema, and accidental electrocution have
more deaths than expected.

Road Graders and Pavers, Machine Operators, and Excavators
Occupation code 425
Total deaths 4,629

Lung cancer, appendicitis, motor vehicle accidents, blows from falling
objects, machinery accidents, and electrocution have increased deaths.

Water Well Drillers
Occupation code 426
Total deaths 279

Elevated PMRs are seen for malignant neoplasms of the brain, for other
diseases of the urinary system, and for work-related accidents.

Railroad Foremen
Occupation code 427
Total deaths 847

Multiple myeloma shows a small number increase. Railway accidents,
as expected, are more common in these men. Diseases of the circulatory
system show a small but significant increase in deaths.

29


MICROFICHE TABLES - TABLE 1, MALE MORTALITY

Grouped Microfiche

Code Occupation Page Column
523 Structural Metal Workers.......... teeeeeeeeeee. 10 1
524 Tailors..... see eeeeee tect e cence cesseeceeesecee 10 2
525 Tinsmiths, Coppersmiths » Sheet Metal Workers... 10 3)
526 Aluminum Workers............e00.e005 geaccaoccn0 alii) 4
527 Cannery and Food Processing Workers............ 10 5
528 Floor Workers (covering, hardwood, linoleum)... 10 6
530 Tool and Die Makers and Setters seceee 10 7
535 Upholsterers......... G9R9C0000d0a0qn000000 HmOK0c0 10 8
545 Craftsmen and Kindred Workers NEC.............. 10 9
551 Navy/Coast Guard Officers and Enlisted Men,,.,, 10 10
555 Army/Air Force/Marine Corps Officers

and Enlisted Men...... Co0000G0D00000000000000 Et) 11
557 Boeing Workers........ cscs eceeceeesseeccccees LO 12
558 Atomic Energy Workers NEC...........- O500G00000_~«—} 13
630 Asbestos and Insulation Workers » 10 14
634 Blasters and Powdermen...... 10 15
640 Railroad Brakemen-.......+..- 10 16
641 Bus Drivers....-... eee eee eee nee wee eeeeeeee IL 1
650 Deliverymen and Routemen........seeeeeeeeeeeees Il 2
655 Dairy Workers, Ice Cream and

Cheesemakers,.....3......20550505 11 3
656 Milk Route Deliverymen---+.......4 11 4
674 Laundry/Dry Cleaning Operatives. » 1 5
675 Meatcutters and Butchers-.-..... 11 6
685 Mine Operatives and Laborers NEC. 11 7
692 Oilers and Greasers, except Auto. 11 8
693 Packers and Wrappers NEC..................006.. LL 9
694 LIEBE VEFF 5 po 0000000000000 11 10
701 Power Station Operators.... 11 11
703 Sailors, Deckhands, and Seamen NW! GT 11 12
706 Plywood Workers..........cccceeeeeeseceeecenee. LL 13
713 Railroad Switchmen,........... . il 14
714 Taxicab Drivers and Chauffeurs . i 15
715 Truck and Tractor Drivers,..................... ll 16
716 Fuel Oil Truck Drivers........ . 12 1
718 Log/Lumber/Sawmill Truck Drivers, . 12 2
721 Welders and Flame Cutters,........... seeeverece 12 3
724 Tree Farmers, Forest Service and Parks

Department Workers................cceeeeceees 12 4

154


The occupation code used in the 1950-1971 study was refined to
eliminate as much misclassification as possible. For example, tele-
phone installers and repairmen were separated from telephone linemen,
and body and fender repairmen were separated from automobile mechanics
and repairmen.

In generating the female mortality tables, female specific causes
of death were added. Since the housewives rubric (908) is so large
(52,307 deaths), female PMRs were run without the housewives rubric.
A mortality table for housewives is available on request.

The major flaw of the proportionate mortality ratio (PMR) is that
it says nothing about total force of mortality for a given occupation
(see Exhibit 3 for PMR calculation). All occupations have a total PMR
of 100. Also, since the cause-of-death specific PMRs must sum to 100,
a very high or low PMR in a common cause-of-death group will affect the
other PMRs for that occupation. Although the method has had numerous
critics, I know of no body of data which has been able to discredit the
PMR method by systematic comparison with denominator-based statistics.
In one case in which such testing was done(15), the PMR seemed to
accurately reflect the mortality pattern derived using a population-
based statistic [standardized mortality ratio (SMR)]..


INDEX OF OCCUPATIONS FOR WOMEN

Number
of Occupation Grouped Commentary
Deaths Code Code Page

Boeing officials/managers/

supervisors....... . 31 294 362 58
Boeing parts finishers. . 2 657 557 60
Boeing workers NEC.. » 140 557 60
Bookbinders...... . 34 404% =
Bookkeepers..... 0 879 310 57
Brakemen, railroad a 2 640% -
Brewery workers.. . 3). 818* _
Brickmasons...... . 2 405* -
Brokers, insurance.. 9 385 59
Building contractors......eeeeeeee 4 406* -
Building managers/superintendents. 8 262* --
Bus drivers..ccccccecccscccccccves 22 641* --
Butchers, slaughterhouse.... D 2 677 61
Buyers/shippers, farm products.... 2 251* --
Buyers, StOre..cessccccccceccceees 96 250 -- 56

c

Cabinetmakers... ..eseeeeceeeeeee 2 410% --- --
Candymakers... . 825 --- 62
Cannery workers a 527 60
Canvasmakers..... . 5 412 59
Carpenter helpers . 1 960* -
Carpenters..... o 8 411* -
Cashiers...........000. « 148 312 57
Cement/concrete finishers... . 1 413* ~~
Charwomen.......eeeeeeeeeene . 824 62
Cheese and ice cream makers. a 20 655* =>
Chefs...ccsseeccsccavceoes o 825 62
Chemical company workers. O 12 985* -
Chemical salesmen...... O 2 388% —
Chemistry professors o 2 034% =
Chemists........... . 2 021% =
Chiropodists p00 D 1 016* —
Chiropractors.....eseeeeee o 15 022% -—-- ad
City/civil service employees 5 255 = 56
Civil engineers..............00005 3 082* --- -
Civilian employees of armed forces 26 554% --- -
Civil service employees........... 255 -—- 56
Cleaners and charwomen..... D 824 -- 62
Cleaners, windows and walls. . 2 833* --- —
Clergymen......ccccccrccccccccenes 28 023 170 55
Clerical NEC sees 486 370* -— —
Clerks, bank... 0000 305 -_— 57
Clerks, Boeing........eseeeeeeeees 121 362 --- 58

137


INDEX OF OCCUPATIONS FOR WOMEN

Number
of Occupation Grouped Commentary
Deaths Code Code Page
Orchardists........cceeeeececesene 28 201 209 56
Ordnance plant workers. o 6 726% -- --

Osteopaths..... 000000000 O 4 153*

Owners, cocktail bar/tavern 0 816 61
Owners, furniture store... 55 297% —
Owners, gas station/garage 13 291* --
Owners, hotel/motel..... 819 62
Owners, lumber company. 51 292% =
Owners, newspapers... 27 076* _—
Owners, pet shop..... 17 296% —
Owners, restaurant 817 --- 62
Oystermen.....cccccccccccccscccoes 13 962% --- =
P
Packers, fruit/nut/vegetables..... 108 654 64
Packers/wrappers NEC....... 00 40 693% =
Packers, meat..... 00 675 61
Painters, auto..... cece e cece es cane 2 479* —
Painters, construction/maintenance 10 495% =
Painters, sign......ccccsssccececs 7 694* _—
Paperhangers/decorators (painters) 16 501* —
Paper mill workers...........02005 500 -—- 60
Parts finishers, Boeing...... 00 2 657 557 60
Pattern/model makers, not paper... 1 502* -_—- oo
Pavers, road.... 00 1 425* —
Payroll clerks..... 00 32 333 57
Peddlers and promoters............ 5 383% 5
Personnel/labor relations workers. 50 154* =
Pet shop owners 17 296% =
Pharmacists.... oe 34 160* -_
PhotographersS.........+.0+ c0 34 161* =
Photographic process workers...... 25 695* _—
Physiclans....ccccscccsccescsceces 21 162* ——
Physicians' office attendants..... 64 303* =
Piano and organ tuners....... o 1 504* —
Pilots, ship........ 00000 . 7 265* -
Plastics/fiberglass workers O 5 436% =
Plywood workers......... 29 706* _
Policemen...... 16 853* =
Postal clerks D 116 340 57
Postmasters......eeseeeeee . 76 280 59
Poultry farmers/distributors. 0 28 206 56
Power/telephone linemen.... 00 1 453% =
Pressmen and plate printers....... 26 512* =

145


MICROFICHE TABLES - TABLE 1, MALE MORTALITY

Grouped Microfiche

Code Occupation Page Colum
196 Students (18 and over).....ecseeeecseeseeee eee 3 5
200 Farmers NEC..+.eeeseeen eves : 3 6
201 Orchardists 3 7
202 NUTSETYMEN.. cece eee cece reece een ccccce 3 8
203 Ranchers (cattle, sheep, etc.)......+.0+ dese 3 9
204 Dairy Farmers........ . 3 10
205 Wheat and Grain Farmers........... see 3 11
206 Egg/Poultry Farmers and Distributors.......... 3 12
249 Florists......se+- g0G00000000000 0 3 13
250 Store Buyers and Department Heads..........+.- 3 14
251 Buyers and Shippers of Farm Products and

Produce Brokers..... 3) 15
252 Railroad Conductors..... 3 16
253 @yerbKs W40000000000000000 poD00000000000 90000 4 1
255 City and Civil Services Employees. . 4 2
260 Public Administration Inspectors... . 4 3
262 Building Managers and Superintendents....... on 4 4
265 Ships' Officers, Pilots, Pursers, Engineers... 4 5
270 Public Administrators and Officials NEC. 4 6
275 Lodge/Society/Union Officials......... 4 7
280 Postmaster .ccccsccccccccuseavesecveses 4 8
285 Purchasing Agents and Buyers, NEC, and

Sales Managers .......seeeccncceeenerercecves 4 9
290 Managers, Officials, and Proprietors NEC.. 0 4 10
291 Gas Station/Garage Owners and Attendants...... 4 11
292 Lumber Company Managers, Owners, and Workers.. 4 12
294 Boeing Officials, Managers, and Supervisors... 4 13
295 Fuel Oil Dealers and Workers..........0005 4 14
297 Furniture Store Owners, Managers, and Clerks.. 4 15
298 Grocers and Grocery Clerks............. o000cc0 4 16
304 Transportation Baggagemen .....+..eeeeeeeeeeene 5 1
305 Bankers, Bank Clerks, and Managers...... 5 2
310 Bookkeepers, Cashiers, and Payroll Clerks..... 5 3
314 Vehicle Dispatchers and Starters, and Traffic

Managers .rcrscccrccrccccsccercceccsccces wees 5 4
321 Adjusters and Examiners........eeeeeeeeeneenee 5 5
323 Mail Carriers........... . 5 6
340 Postal Clerks..........-065 ae 5 7
343 Shipping and Receiving Clerks .............0005 5 8

151


COMMENTARY ON TABLE 1 (MALE MORTALITY, 1950-1979)

Sailors, Deckhands, and Seamen NEC
Occupation code 703
Total deaths 3,149

Respiratory tuberculosis, multiple myeloma, and malignant neoplasms
of the esophagus and lung have increased mortality. Other causes of death
with PMR increases are disorders of character, behavior and intelligence;
pneumonia, alcoholic cirrhosis of the liver; acute pancreatitis; accidental
falls, and homicide.

Plywood Workers
Occupation code 706
Total deaths 2,256

Malignant neoplasms of the stomach (age 20-64), multiple sclerosis,
arteriosclerotic heart disease, and suicide have excess deaths. Leukemia
had high PMRs before 1970, but not afterward, suggesting that the leukemo-
genic agents formerly involved are no longer present in the work environment.

Railroad Switchmen
Occupation code 713
Total deaths 637

Respiratory and urinary bladder cancer, cirrhosis of the liver, and
railroad accidents have significant mortality increases.

Taxicab Drivers and Chauffeurs
Occupation code 714
Total deaths 989

Diseases of the arteries, pneumonia, pulmonary emphysema, cirrhosis of
the liver, ulcer of the stomach and duodenum, and homicide have high PMRs.
Urinary bladder cancer shows a slight elevation.

Truck and Tractor Drivers
Occupation code 715
Total deaths 8,048

Malignant neoplasms of the pharynx, larynx, lung, and skin, chronic
bronchitis, bronchitis with emphysema, other diseases of the lung and pleural
cavity, cirrhosis of the liver, and motor vehicle accidents have increased
deaths.

44


METHOD

Punch cards containing death record information were available for the
years 1950-1971. Death certificate numbers of all male resident deaths in
Washington State, age 20+, for the years 1950-1971 were listed in certifi-
cate number order within year of death. The death record occupation state-
ments were abstracted and coded using a modification of the U. S. Census
Bureau code (Exhibit 2). The death certificate numbers and the occupation
codes were key punched into a deck of cards and these cards were then matched
to the original death cards on year and death certificate number. For match—
ing cards, the occupation code was punched into the initial death card. Non-
matches were resolved clerically. The completed cards were read onto magnetic
tape.

For male deaths 1972-1979 and female deaths 1974-1979, occupation was
coded routinely on a monthly basis and added to the ordinarily prepared
computer record of death. These records were added to the existing 1950-
1971 file.

Since the study period included two International Classification of
Diseases code changes, ninth and eighth revision codes were translated to
seventh revision codes with a translation table. The causes of death given
in this study are according to the seventh revision ICD codes.

Since non-white deaths made up less than 3% of the total file, they
were omitted from the basic tables of this study, for the sake of homogeneity.
All tables presented are for white deaths only. Out-of-state resident deaths
were also eliminated from the file.

A computer program which performed an age and year of death standard-
ized PMR analysis was written and run (see Exhibit 3). For each occupation,
observed and expected deaths and a PMR are presented by detailed cause of
death, grouped years of death, and age. Expected deaths are generated for
each year of the study based on that year's mortality experience. Expectations
are then summed over years of death into the appropriate cells of the table.
Expected deaths are therefore specific for five-year age classes as well as
year of death.

Expected death frequencies are rounded to the nearest whole number
before printing; however, exact fractional expected frequencies are totaled
into grouped years and grouped ages, so that these totals may be slightly
different than the sum of the expected frequencies by five-year age classes.
A minus sign (-) is printed for PMR values generated by division by an
expected value less than one (to avoid large meaningless PMRs). An asterisk
(*) after a PMR value indicates that the observed and expected values for
that PMR are significantly different at the 5% level (x? > 3. 84; P < .05).

A double asterisk (**) indicates that the observed and expected deaths are
significantly different at the 1% level (xj > 6.64; P < .01). PMRs are
calculated using exact expected values. Statistical testing was done only
on observed values of six or greater and in the grouped years of death and
age 20-64 colums. Cause-of-death lines are printed only if there is an
observed or expected death.

4


COMMENTARY ON TABLE 1 (MALE MORTALITY, 1950-1979)

Tailors
Occupation code 524
Total deaths 713

Hypertensive disease, intestinal obstruction, hyperplasia of prostate,
cancer of urinary bladder, cirrhosis of the liver, and cholelithiasis show
increased deaths. The urinary bladder cancer increase has been reported
elsewhere (6).

Tinsmiths, Coppersmiths, and Sheet Metal Workers
Occupation code 525
Total deaths 2,102

Respiratory cancers and accidental falls have significantly elevated
PMRs. Lung cancer has an SMR of 145 in sheet metal workers (occupational
unit 33) in the Registrar General's data set. Elevated PMRs are also seen
for cerebral embolism and thrombosis and chronic interstitial pneumonia.

Aluminum Workers
Occupation code 526
Total deaths 1,238

The all malignant neoplasms (grouped) rubric has a significant PMR
elevation. Statistically significant PMR increases are seen for cancers of
the pancreas, other lymphomas, and leukemia.. These findings are supported
by a retrospective cohort (SMR) study in a Spokane aluminum reduction
mil1(13) and by a multiplant study of U. S. aluminum reduction mills(41).

Cannery and Food Processing Workers
Occupation code 527
Total deaths 1,489

Cancer of urinary bladder, avitaminosis and metabolic diseases, gastric
and duodenal ulcer (20-64), and motor vehicle accidents have significantly
elevated PMRs.

Floor Workers (covering, hardwood, linoleum, etc.)
Occupation code 528
Total deaths 263

Hypertensive disease has a PMR increase.

38


INDEX OF OCCUPATIONS FOR MEN

Number
of Occupation Grouped Commentary
Deaths Code Code Page

Construction inspectors........... 139 448 450 31
Construction laborers NEC « 4,097 982 --- 52
Construction ,painters............. 4,802 495 43
Contractors, building/construction 406 27
Contractors, railroad............- 31 408 27
Controllers, air traffic. . 37 011* =
Cooks, chefs, candymakers a 825 47
Cooks, lumber camp...... 0 150 827 47
Coppersmiths.... . 525 38
Cosmetologists.......eeeeeeeeeeees 102 843 48
County/city road construction and

maintenance workers............- 1,616 496 29
Court reporters.... D 29 106* =
Craftsmen NEC. a : 545 39
Cranemen...... oe. . 415 28
Creamery workers. g 655 41
Credit men....... Q 253 18
Crossing watchmen a 329 860 49
Custodians, school......... . 836 -_—- 48
Cutters/sewers, manufacturing..... 103 705 412 28

D

Dairy farmers.......cccccccevccees 204 16
Dairy workers. o 655 41
Dancers...... g 20 070* --
Dancing teachers. o 20 070* -
Deans, college.. 9 54 030* —
Deckhands............0008 0 703 44
Decorators (home interior). O 501 35
Decorators (window dressers O 420 29
Deliverymen.........se00. 0 650 41
Deliverymen, milk route. 0 656 42
Demonstrators....... O 17 382 24
Dental technicians. o 185 14
DentistS........eeeeeeee o 071 9
Dentist office attendants . 6 303* =
Department heads....... O 250 17
Derrickmen.... . 415 28
Designers...........06 . . 93 072% =
Detectives and policemen. ° 853 49
Developers, real estate. . 393 25
Dietitians.......... . 23 073* SS
Dishwashers...... . 826 47
Dispatchers, vehicle.......... . 314 22
Distributors, egg and poultry..... 206 --- 17

118


COMMENTARY ON TABLE 1 (MALE MORTALITY, 1950-1979)

Wheat and Grain Farmers
Occupation code 205
Total deaths 4,217

Kidney cancer, cancer of the testis, and lymphatic leukemia show
excess deaths while lung cancer and cirrhosis of the liver show a deficit
of deaths. Hyperplasia of the prostate, hypertensive disease, chronic
enteritis, and motor vehicle, aircraft, and machinery accidents also show
excess deaths.

Egg/Poultry Farmers and Distributors
Occupation code 206
Total deaths 749

Lymphatic and acute leukemia show excess deaths, but the mortality
increase is limited to deaths in the years 1950-1969.

Florists
Occupation code 249
Total deaths 361

Florists have an unremarkable mortality pattern, with the exception
of increased deaths due to motor vehicle accidents.

Store Buyers and Department Heads
Occupation code 250
Total deaths 340

Leukemia has an elevated PMR.

Buyers and Shippers of Farm Products and Produce Brokers
Occupation code 251
Total deaths 839

Lymphosarcoma, myeloid, and acute leukemia show PMR increases.

17


COMMENTARY ON TABLE 1 (MALE MORTALITY, 1950-1979)

Funeral Directors and Embalmers
Occupation code 104
Total deaths 333

Leukemia, urinary bladder cancer, and cirrhosis of the liver show
excess deaths. No excess mortality is seen from either malignant or non-
malignant respiratory disease.

Lawyers and Judges
Occupation code 105
Total deaths 1,671

Intestinal cancers (age 20-64) show a significant PMR elevation. Lung
cancer and non-malignant respiratory diseases have significantly lowered
PMRs. Malignant tumors of the brain, Hodgkin's disease, leukemia, diabetes
mellitus, paralysis agitans, multiple sclerosis and amyotrophic lateral
sclerosis, hyperplasia of the prostate, and aircraft accidents also show PMR
elevations. The Registrar General's study agrees with the mortality patterns
seen for intestinal cancer, leukemia, lung cancer, and non-malignant respira-
tory diseases.

Musicians and Music Teachers
Occupation code 120
Total deaths 891

Hodgkin's disease, other lymphomas, aplastic anemia, multiple sclerosis,
and diseases of the pancreas show PMRs over 200. The Hodgkin's disease
excess is also seen in the school teachers rubric (occupation code 184).
Many of these men work in schools.

Optometrists
Occupation code 152
Total deaths 181

Malignant neoplasms of the pancreas, prostate, and leukemia show PMRs
over 200.

Personnel and Labor Relations Workers
Occupation code 154
Total deaths 204

The mortality pattern in this group is unremarkable except that
accidental deaths have a low PMR.

12


INTRODUCTION

The current study is an update of Occupational Mortality in Washington
State, 1950-1971 published in 1976 by NIOSH(1). The original file of about

300,000 deaths has been expanded by adding male resident deaths, age 20+,
in the years 1972-1979 and female resident deaths, age 20+, in the years
1974-1979. This increases the male file to, 429,926 deaths and the female
file has 25,066 deaths exclusive of 52,307 housewives.

Three new tables have been added to this report. They are a table of
female mortality (Table 2) in the same format as the male table (Table 1),
a table which ranks occupations by proportionate mortality ratio (PMR) for
each cause of death (Table 3), and a table which shows those causes of death
with a statistically significant (P < .05) excess or deficit for each occupa-
tion (Table 4).

This study had its beginnings in a case-control study(2) of Hodgkin's
disease which used the upstate New York death record file for occupational
and cause-of-death information. The study showed an excess of woodwork-
ing occupations in the Hodgkin's disease group as compared to matched
controls. When an interview study(3) and a population-based study(4) con-
firmed this finding, I decided to examine the occupational pattern in other
selected cause-of-death groupings. An unpublished case-control study of
male bladder cancer death certificates in Washington State was able to iden-
tify the same occupations with increased risk as previous clinical and inter-
view studies(5-8). Also, a study(9) of leukemia death certificates in Washington
State and Oregon was able to confirm and extend a previously reported(10)
association of leukemia with farming occupations.

The accuracy and completeness of the death certificate occupational
statement on the Washington State death certificate was seen to be quite
good. The occupational item on the death certificate asks for "Usual occupa-
tion during most of lifetime" (Exhibit 1 item 13a). Over 97% of adult male
death certificates contained a usable occupation statement, i.e., only 3%
had a blank or "retired" or "unknown" in the item 13a space. The death record
industrial statement was too poorly reported for use.

The accuracy of death certificate occupational statements was examined
for three different cancers. For men dying of Hodgkin's disease(3) and
urinary bladder cancer, interviews with next of kin indicated that the death
certificate occupational statement was identical to that obtained by inter-
view in 75% of cases, gave a related occupation in 10% of cases, and was
completely different in only 15% of cases. An example of "related" occupa-
tional statements is "plywood mill worker" vs "millworker."


INDEX OF OCCUPATIONS FOR MEN

Number
of Occupation Grouped Commentary
Deaths Code Code Page
R

Radio announcers.....seeeeseesseee 92 010% --
Radio operators.. os 128 164 23
Radio repairmen... eee 474 33
Raftsmen (loggers)........+ 970 51
Railroad brakemen and carmen.. 640 41
Railroad clerks.........+++ 361 23
Railroad conductors. 252 18
Railroad contractors 31 408 27
Railroad engineers.. 454 31
Railroad firemen.... 460 32
Railroad foremen. 427 29
Railroad inspectors. 447 30
Railroad laborers NEC......eee+e+. 3,164 981 52
Railroad (and car shop) mechanics. 475 33
Railroad switchmen........cseeeeee 713 44
Railroad workers NEC 469 32
Ranchers, cattle and sheep. 00 203 16
Ranchers, mink........eeeeeeeevese 266 387% --
Real estate agents, brokers,

developers, appraisers......+... 393 25
Receiving clerks......cceeeeeeee 343 23
Receptionists.....secseceee 3 341* --
Recreation ‘attendants (cardroom,

pool hall, carnival).......se.e. 812 46
Recreation/amusement ushers. 10 874% --
Recreation workers......... 74 165* --
Refrigeration engineers....... 160 095 11
Refrigeration repairmen....... 470 32
Religious workers........ 122 170* --
Reporters...secccceees 075 9
Representatives, sales. 380 24
Resort owners and managers........ 819 — 47
Restaurant/cafe owners, managers

and WOrTkers...cse eee e cece eeeeeee 817 --- 46
Restaurant/kitchen workers NEC.... 306 835 825 47
Retarded and disabled...........66 997 --- 53
Road construction, city/county.... 1,616 496 425 29
Road graders, machine operators. 425 -—- 29
Rodmen, surveying......s.see0. 21 642 181 14
Rollers/roll hands, metal.. 30 513 525 38
Roofers and slaters......... 514 = 37
Rope makers... sees 19 711 412 28
Routemen......... ber eeeeees 650 -—- 41
Rubber welderS.......eeessecenseee 477 -—- 34

130


EXHIBIT 4 -- OCCUPATION GROUPINGS FOR MEN

Grouped Occupation
Code Code Occupation Title
825 825 Cooks, Candymakers, and Chefs
827 Lumber Camp Cooks
835 Kitchen Workers (not private household)
826 826 Dishwashers
833 833 Window Cleaners and Wall Washers
834 834 Janitors, Maintenance Men, and Sextons
836 836 School Custodians
841 841 Porters
843 843 Hairdressers and Cosmetologists
850 850 Firemen and Fire Protection Workers
851 851 Guards, Watchmen, and Doorkeepers
853 853 Policemen, Sheriffs, and Marshals
852 Marshals and Constables
854 Sheriffs and Bailiffs
860 860 Bridge Tenders and Crossing Watchmen
875 875 Waiters
891 891 Garbage Collectors
892 892 Junk Dealers, Secondhand Store and Salvage
Workers
902 902 Farm Laborers
222 Farm Managers
901 Farm Foremen
903 Unpaid Family Farm Workers
904 Farm Caretakers
905 Self-employed Farm Workers
906 Itinerant Farm Laborers
907 907 Sheepherders and Wool Workers
962 962 Fishermen and Oystermen
964 964 Landscape Gardeners, Groundskeepers, and
Greenskeepers

108


COMMENTARY ON TABLE 3
(MALE MORTALITY BY OCCUPATION WITHIN CAUSE-OF-DEATH GROUPS)

and insulation workers and shipyard workers (asbestos), smelter workers and
orchardists (arsenic), roofers and slaters (benzopyrene). Body and fender
repairmen are exposed to paints and solvents. Boilermakers, miners, plumbers,
metal workers, and welders are exposed to metallic fumes, dusts, and ores.

Malignant Neoplasm of the Larynx (ICD 161)

Cancer of the larynx has been related to both cigarette smoking and
alcohol ingestion. Both factors are probably operating in the occupational
groups with high PMRs due to laryngeal cancer, i.e., bartenders.

Malignant Neoplasm of the Pleura (ICD 162.2)

This cancer has a high PMR in shipyard workers dying since 1970.

These men are exposed to asbestos, and the recent emergence of a high PMR
probably reflects the World War II shipbuilding boom and a long latent
period.

Malignant Melanoma of Skin (ICD 190)

Three of the four occupations with high PMRs (clergymen, school teach-
ers, hotel managers) have no obvious relationship to outdoor work or exposure

to sunlight. Navy and Coast Guard personnel, however, probably are exposed
to sunlight.

Hodgkin's Disease (ICD 201)

Millwrights, paper and pulp mill workers, and carpenters all show signi-
ficant excess deaths due to Hodgkin's disease. This association has been
reported previously(2,47).

Benign Neoplasms (ICD 210-229)

Three of the six occupations with elevated PMRs due to benign neoplasms
have known exposure to asbestos or silica (asbestos and insulation workers,
shipyard workers and miners). Examination of the death certificates reveals
that the excess seen in asbestos and insulation workers and shipyard workers
is due to pulmonary and/or abdominal mesothelioma, i.e., "malignant mesothe-
lioma" is coded to 162.2, while "mesothelioma" is coded to a benign neoplasm
rubric.

67


COMMENTARY ON TABLE 1 (MALE MORTALITY, 1950-1979)

Tuberculosis, multiple sclerosis, chronic rheumatic heart disease,
and the non-malignant respiratory disease excess may be due to self-
selection into this occupation of chronically ill men. The Registrar
General's data agree quite well.

Vehicle Dispatchers and Starters. and Traffic Managers
Occupation code 314
Total deaths 787

Cerebral embolism and thrombosis and coronary heart disease have
increased PMRs in these men. The Registrar General's tables for occupa-
tional unit 126 (traffic controllers and dispatchers, transport) show a
similar excess for coronary heart disease.

Adjusters and Examiners
Occupation code 321
Total deaths 404

No cause of death class has a significantly elevated PMR, but buccal
and pharyngeal cancers and kidney neoplasms show small number PMR elevations.

Mail Carriers
Occupation code 323
Total deaths 1,304

PMRs over 200 are seen for lymphosarcoma, Hodgkin's disease (age 20-64),
and diseases of the pancreas. The urinary bladder cancer increase seen in
the 1950s is not seen in the 1960-1979 period.

Postal Clerks
Occupation code 340
Total deaths 1,321

Like the mail carriers, lymphosarcoma shows a PMR increase. Diseases
of the blood-forming organs and hyperplasia of the prostate also show
mortality excesses.

22


INDEX OF OCCUPATIONS FOR WOMEN

Number
of Occupation Grouped Commentary
Deaths Code Code Page
Funeral directors......essesseeeee 11 104% --- --
Furniture store owners, managers,

CLETKS. cer ccc ccescccnccvccccees 55 297% --- --

HATES $13 F219 oo0000000000000 9 22 387% -_- --
G

Garage owners and attendants... O 13 291* --- --

Gardeners, landscape (not farm)... 9 964% --- --

Garment factory sewers, stitchers,

CULTETS cre c essere ccccccscccecnes 219 705 412 59
Gas station owners/attendants..... 13 291% --- --
Glaziers... . cece eee cece eeeeces . 5 434% --- --
Graders, fruit/nut/vegetables..... 108 654 975 64
Grain farmers............6. aeee 17 205 56
Grocers and clerks....... 9 298 57
Group and recreation leaders . 67 165* -
Guards and watchmen.............05 18 851* -— =

H
Hairdressers......seccccceserveace 843 — 63
Heating repairmen........ . 2 470* --
Home management advisers..... 8 102* --
Hospital attendants...........+... 810 -- 61
Hospital/nursing home managers and

OWNETS. 6. . cece ee eeereccrceeences 80 811* --
Hotel/motel maids/housekeepers.... 821 62
Hotel/motel owners and managers... 819 62
Housekeepers, hotel and motel..... 821 62
Housekeepers in private household. 832 63
Housemothers.....eseecececcccseene 67 165* — -
Housewives.......sseeeee +0 52,307 908* -- 1,5,54

I
Inspectors/markers, manufacturers. 6 643% = -
Inspectors, Boeing.......seceeeees 9 446 557 60
Inspectors, fruit....... ° 1 976 975 64
Inspectors, machinery. o00c 2 445* -—- --
Inspectors NEC... ec. eeeeeeescccees 7 450% =
Inspectors, public administration. 6 260% --
Inspectors, railroad.............. 1 447% --
Inspectors/scalers/graders, lumber 3 444x -- -
Installers/repairers, telephone... 4 459% --- --

141


COMMENTARY ON TABLE 1 (MALE MORTALITY, 1950-1979)

Artists and Art Teachers
Occupation code 014
Total deaths 322

Elevated PMRs are seen for lymphosarcoma, ulcer of the stomach, sub-
arachnoid hemorrhage, multiple sclerosis, cirrhosis of the liver, and
suicide.

Chemists
Occupation code 021
Total deaths 249

Cancer of the pancreas shows a PMR increase based on deaths 1950-1969.
No excess is seen in deaths since 1970. Leukemia has a PMR of 242 based on
5 deaths. Leukemia has an SMR of 141 (age 15-64) and a PMR of 320 (age 65-74)
in the Registrar General's study.

The American Chemical Society study(18) showed increased mortality from
cancer of the pancreas and malignant lymphoma. A study of Swedish chemistry
graduates(19) showed excess mortality due to lymphatic and hematopoietic
cancers and malignant brain tumors. A study of Dupont chemists(20) showed
an SMR of 50 for all malignant neoplasms, but cancer of the intestine,
Hodgkin's disease, and leukemia had SMRs >100.

Chiropractors
Occupation code 022
Total deaths 180

Malignant neoplasms of stomach and rectum show PMR increases as does
suicide in men age 20-64.

Clergymen
Occupation code 023
Total deaths 2,062

Significantly low PMRs are seen for lung cancer (PMR = 37**), emphysema
(PMR = 20**), and cirrhosis of the liver (PMR = 41**). ‘Presumably, this is due
to abstinence from alcohol and tobacco. Causes with a significant excess of
deaths are malignant neoplasms of the kidney (age 20-64), malignant neoplasms
of large intestine, malignant melanoma, malignant neoplasms of brain (age 20-64) D
Hodgkin's disease, other lymphomas, multiple myeloma, diabetes mellitus, dis-
eases of the blood-forming organs, diseases of the circulatory system, hyper-
tensive disease, pulmonary embolism and infarction. Suicide has a very low
PMR (PMR = 25**) based on 7 deaths observed to 28 expected.


INDEX OF OCCUPATIONS FOR WOMEN

Number
of Occupation Grouped Commentary
Deaths Code Code Page

Decorators and window dressers.... 24 420% -
Decorators, interior............66 16 501* —
Deliverymen and routemen. . 15 650* --
Demonstrators......... . 5 382* --
Dental technicians. . 185 55
Dentists.....cseeeeeeeees . 6 071* ~
Dentists' office attendants....... 64 303% =
Department heads/store buyers..... 96 250 - 56
Designers.. 00a po000 16 072* --
Dietitians........... . 073 54
Disabled and retarded.... . 137 997% -
Dishwashers..........000. . 33 826% --- --
Dispatchers o a 33 314* --- —
Draftsmen..... on 14 074* -—- --
Draftsmen, Boeing..... pa00000 10 089 557 60
Dressmakers and seamstresses,

except factory.........e.see0002 477 651 60
Drivers, bus..... a000 22 641* ——
Drivers, fuel truck........... 1 716* -
Drivers, moving/transfer trucks. 4 719% --
Drivers, taxicab............. 10 714* —
Drivers, truck.. 10 715* a
Druggists...........0e O 34 160* --- 3
Dry cleaning operatives. sees 674 -—- 61
DYCTS.. cece cece eee n ene ncececvccne 3 652 412 59

E

Economists..... cece cee eeeecsenee 1 172* -_- —
Editors 43 075* =
Egg farmers/distributors.......... 28 206 56
Electrical/electronic technicians 30 190* -
Electrical engineers.............. 1 083* een
Electricians.......... 6 421* —
Electricians, Boeing.. 16 419 60
Electricians, shipyard 1 422 60
Elevator operators.... 22 831* —
Embalmers....... . 11 104* --
Engineering technicians. 11 191* --
Engineers, Boeing....... 7 097* --- ~
Engineers, civil........ 3 082* --- -
Engineers, electrical... 1 083* --- —
Engineers, logging. 1 455% — a
Engineers NEC...... 6 093* --- =o
Engineers, stationary............. 1 520* --- -
Engravers, except photoengravers.. 1 424% = —
Entertainers..... 000000000000 seeee 9 101* - --


COMMENTARY ON TABLE 1 (MALE MORTALITY, 1950-1979)

Boilermakers
Occupation code 403
Total deaths 1,568

Respiratory tuberculosis, lung cancer, pulmonary emphysema, and
cirrhosis of the liver all have excess deaths. There are 2 deaths ascribed
to silicosis and 1 to asbestosis in these men. Inhaled metal particles and
fumes, plus dusts containing silica, account for some of this mortality
pattern. A recent cohort study of a boilermakers' union in this State (33)
supports these findings.

Brickmasons, Stonemasons, and Tile Setters
Occupation code 405
Total deaths 1,543

Cancers of the stomach, biliary passages and liver, lung and rectum
(1970-1979), avitaminosis and metabolic diseases, appendicitis, and falls
have elevated PMRs. The stomach and lung cancer excesses are seen in the
Registrar General's data.

Building Contractors, Construction Contractors, and Foremen
Occupation code 406
Total deaths 4,300

These men have increased deaths from cancers of the stomach and skin.
Lymphosarcoma, multiple myeloma and leukemia, aircraft accidents, machinery
accidents, and electrocution also have elevated PMRs.

Boatbuilders
Occupation code 407
Total deaths 430

Stomach cancer (age 20-64) and rectal cancer have high PMRs.

Cabinetmakers
Occupation code 410
Total deaths 1,249

Stomach cancer shows a significant mortality excess. Nephritis (1950-
1959) also shows a significant PMR rise especially in men under age 60.

27


MICROFICHE TABLES - TABLE 4, SIGNIFICANT MALE PMRS BY OCCUPATION

Grouped Microfiche
_ Code Occupation Page Row/Colum

380 Travelling Salesmen and Sales Representatives... 19 L 7-M 7
384 Lumber Salestmen......sseeseccesccccevescccccces " A8
385 Insurance Agents, Brokers, Underwriters,

and APpraiSeTS... ce eee eee eee nent eee eeee " B 8&-C 8
386 Car Salesmen........ socceces a eeesccceee " D8
390 NEWS D OYE w orelore)o-e) ofofelerolee)srole-e) eie-sivle viele ole\ole vie efels] o7eie<e " E8
393 Real Estate Agents, Brokers, Developers,

and Appraisers... 0 " F 8-G 8
395 Stocks and Bonds Salesmen.. 0 " HS8
396 Sales Clerks NEC.......sssesesccccrceceseceseee " I 8-J 8
400 Carpet Makers and Layers.. " K 8
401 EET EE0000000000000000000 " L8
402 Blacksmiths... " M8
403 Boilermakers.........seeeeeeeeeees " A 9-B 9
405 Brickmasons, Stonemasons, and Tile Setters..... " c9
406 Building and Construction Contractors and

FOTOMEN. cso reccccesccerecccsencesesvecesccces " D9-E 9
407 Boatbuilders. D " F9
410 Cabinetmakers. .... sees eee e eee esececeeteeeeeees " G9
411 (2g 03 F390 0000000000000000000000000000000000 " H 9-1 9
412 Fabric Workers. O D " 3I9
413 Cement and Concrete Finishers.... . " K9
415 Cranemen, Derrickmen, and Hoistmen...........+6 " L9
416 O41 Well Drillers.....ccccecsncensneccececseces " M9
420 Decorators and Window Dressers " A10
421 Electricians.......s+.eeeeees eee ecccccveccscces " B10
425 Road Graders and Pavers, Machine Operators,

and EXCAaVatOrs..secseccceccscccoessscrecceves " c10-D10
426 Water Well Drillers........cccesecececsceceneee " E10
427 Railroad Foremen.. o " F10
430 Foremen NEC. o " G10
434 Glaziers. .cscccccccccsrcccccccncescecesevoscees " H10
435 Smelter Workers and Heat Treaters...........+.. " 110
444 Log/Lumber Inspectors, Scalers and Graders,

and Timber Cruisers........eeeseeeeeeeeeeeeee " J10
447 Railroad Inspectors. " K10
450 Inspectors NEC... cece ccc e eee n eee ecereeenes " L10

164


EXHIBIT 3 - PMR Calculation

Table B, COMPUS'ALION OF PROPORTIONATE MORTALITY RATIOS FOR TUBERCULOSIS, ALL FORMS, FOR WHITE MINERS:
UNITED STATES, 1950

Proportionate Mortality Retio =

Tabulated deaths for an occupation-cause-color group x 100

Expected deaths for an occupation-cause-color group

Age

Percent tuber-
culosis deaths
of ell deaths
all occupations

Deaths from
all causes for
white miners

Expected deaths
from tubercu.
losis, all
forms, for
white miners

Tabulated
deaths fron
tuberculosis,
all forms, for
waite miners

(1) (2) (3) = (1) x (2) (4)

20.24 years. 6.28 292 18.34 10
25-29 years~. 8,30 357 29,63 20
50.34 years. 9.01 341 30.72 22
35.44 years. 7.78 1,095 85.19 98
45.54 years. 5.19 1,784. 92.58 14
§5-59 years-. 3.68 1,554 $7.19 nz
0-64 years-----. 2.77 2,051 56.61 ios
Totelt

25-59 years vee ee 295.32 46

20-64 years. vee aoe 370,47 540

Proportionate mortality ratio

Reference: Guralnick, L. Mortality by Occupation and Cause of Death among
Men 20-64 Years of Age: U.S. 1950.
Reports, Vol. 53, No. 3, 1963.

25-59 years = 2 X 100 = 46

96

Vital Statistics

20-64 years =

— X 100 = 144

370

Special


INDEX OF OCCUPATIONS FOR WOMEN

Number
of Occupation Grouped Commentary
Deaths Code Code Page

Clerks, file......... os 35 320 59
Clerks, furniture store. 55 297% -
Clerks, grocery store...... 298 57
Clerks, payroll/timekeeping 32 333 57
Clerks, postal.... 900 116 340 57
Clerks, railroad NEC. 67 361 59
Clerks, railway mail. 1 314% -
Clerks, saleS....ceeeeeeeeene 396 59
Clerks, shipping and receiving. 62 343 --- 58
Clerks, stock......seeeeees 46 350 343 58
Coaches, athletic........sseeeeeee 6 015* --- --
Coast Guard officers/enlisted men. 2 548% — =
Cocktail bar owners/operators/

managers/Workers...ssseseeveves 816 61
Collectors, bill and account...... 22 313* —
College presidents and deans. So 20 030* -~
Compositors and typesetters 10 414% --- --
Computer programmers.......++ 28 174% -- --
Conductors, bus/street railway 1 645% --- —
Conservationists..........+ 4 103* --- --
Construction contractors..... 4 406* _ --
Construction, city/county roads. 2 496% --- --
Construction engineers........ee06 1 094% --- --
Construction laborers.........+.++ 4 982% --- --
Contractors, building/construction 4 406* =
Contractors, railroad............+ 3 408% --
Controllers, air traffic . ab 011* --
COOKS. . eee ccecceescereeees 825 62
Cooks, lumber camp. 6 827* --
Cosmetologists.....seee- 843 63
Counter/fountain workers 13 830* --
Court reporters. 9 106* --
Craftsmen NEC........000005 21 545% --
Creamery workers/pasteurizers. 20 655* --
Credit men........ ococgacoo 57 253% —- --
Cutters, garment factory 219 705 412 59
Cutters, MEAL... seeee sere eeeeeee 675 -— 61

D

Dairy farmers.......seeeeeeeeeeees 20 204 56
Dancers......e0e . 10 070* --
Dancing teachers......... o 10 070* —
Day care/pre-school workers o 62 822* --
Deans, college...... 0000000000000 20 030* --- -~

138


EXHIBIT 2 - OCCUPATION CODzS

CLERICAL

301 Agents NEC

302 Attendants and assistants, library

303 Attendants, physician/dentist's office

304 Baggagemen, transportation

305 Bankers, bank clerks, managers

310 Bookkeepers

312 Cashiers

313 Collectors, bill and account

314 Dispatchers and starters, vehicle; traffic managers
315 Express messengers, railroad mail clerks
320 File clerks

321 Adjusters, examiners, investigators, inspectors
323 Mail carriers

324 Messengers and office boys

325 Office machine operators

333 Payroll and timekeeping clerks

340 Postal clerks

341 Receptionists

342 Secretaries

343 Shipping and receiving clerks

345 Stenographers

350 Stock clerks and storekeepers

351 Telegraph messengers

352 Telegraph operators

353 Telephone operators

354 Ticket, station, express, and travel agents
360 Typists

361 Railroad clerks

362 Boeing clerks

363 Public utility workers

364 Public utility supervisors and officials, etc.
370 Clerks NEC

SALES WORKERS

380 Travelling salesmen, sales representatives, advertising agents
381 Auctioneers
382 Demonstrators
383 Hucksters, peddlers, promoters
384 Lumber salesmen
385 Insurance agents, brokers, underwriters, appraisers
386 Car salesmen
388 Chemical salesmen
390 Newsboys
393 Real estate agents, brokers, developers, appraisers
395 Stocks and bonds salesmen
396 =Sales clerks NEC
89


COMMENTARY ON TABLE 1 (MALE MORTALITY, 1950-1979)

A cohort study of Lutheran ministers(21) and studies of Catholic
priests(22,23) support this pattem. The Catholic priests also show an
SMR increase for malignant melanoma.

Professors and Instructors
Occupation code 060
Total deaths 700

Malignant neoplasms of large intestine (age 20-64), malignant melanoma,
reticulosarcoma, other lymphomas, multiple myeloma, paralysis agitans, and
kidney infections have elevated PMRs. Lung cancer and respiratory diseases
show low PMRs.

Dentists ©
Occupation code 071
Total deaths 947

Lung cancer shows a low PMR. Cancer of pancreas, urinary bladder,
malignant melanoma, lymphosarcoma, myeloid leukemia, and aircraft accidents
have elevated PMRs. Suicide has a very high PMR as reported elsewhere(24,25).

Draftsmen
Occupation code 074
Total deaths 332

Increased mortality is seen due to diabetes mellitus, multiple sclero-
sis, and suicide. Motor vehicle accidents have a low PMR.

Editors and Reporters
Occupation code 075
Total deaths 323

Pneumonia (1970-1979) and accidental falls show PMR increases.

Newspaper Owners, Publishers, and Managers
Occupation code 076
Total deaths 449

Lymphosarcoma and cirrhosis of the liver show excess deaths.



EXHIBIT 2 - OCCUPATION CODES

975
976
980
981
982
983
984
985
986

908
909
996
997
998
999

LABORERS except farm and mine (continued)

Fruit warehousemen

Fruit inspectors
Laborers NEC

Railroad laborers NEC
Construction laborers NEC

Orchard laborers, brush pickers

Hod carriers
Chemical company employees
Pest control employees

Housewife/homemaker (her own home)

Nuns
Children under 18

Institutionalized, retarded, disabled war vete:

Unemployed
Not stated or unknown

OTHER

95

Tans; unemployable


EXHIBIT 4 -- OCCUPATION GROUPINGS FOR MEN

Ships' Officers, Pilots, Pursers, and Engineers
Public Administrators and Officials NEC

Lodge/Society/Union Officials

Purchasing Agents and Buyers NEC, Sales Managers
Managers, Officials, and Proprietors NEC

Gas Station/Garage Owners and Attendants

Lumber Company Managers, Owners, and Workers
Boeing Officials, Managers, and Supervisors
Fuel Oil Dealers and Workers

Furniture Store Owners, Managers, and Clerks

Bankers, Bank Clerks, and Managers
Bookkeepers, Cashiers, and Payroll Clerks.
Payroll and Timekeeping Clerks

Vehicle Dispatchers and Starters and Traffic

Shipping and Receiving Clerks

Grouped Occupation

Code Code Occupation Title
265 265
270 270
275 275
280 280 Postmasters
285 285
290 290
291 291
292 292
294 294
295 295
297 297
298 298 Grocers and Grocery Clerks
304 304 Transportation Baggagemen
305 305
310 310

312 Cashiers

333
314 314

Managers

321 321 Adjusters and Examiners
323 323 Mail Carriers
340 340 Postal Clerks
343 343
350 350

Stock Clerks and Storekeepers

100


INDEX OF OCCUPATIONS FOR MEN

Number
of Occupation Grouped Commentary
Deaths Code Code Page
Bookbinders.....cecesesenecscenes 95 404% -- Zz
Bookkeepers. 310 -- 21
Bootblacks...... 110 820* -—- >
Brakemen, railroad 640 --- 41
Brewery workers..... 818 --- 47
Bricklayer apprentices. 6 602 405 27
Brickmasons...........- 405 --- 27
Bridge tenders.........e+6 329 860 --- 49
385 —_— 25
251 -- 17
393 -—- 25
Brush pickers.......+ 983 — 53
Building contractors...........++6 406 --- 27
Building managers/superintendents. 262 — 18
Building trade apprentices NEC.... 17 613 27
Bus and street railway conductors. 101 645* =>
Bus drivers. .scseccsecccecsceccees 641 4l
Butchers, except slaughterhouse... 2,064 675 42
Butchers, slaughterhouse.........+ 843 677 42
Buyers, farm products 251 17
Buyers NEC......seeeeee 285 19
Buyers, StOLG.ssescecsvccccccccece 250 — 17
Cc
Cabinetmakers.......eeeeeeeeveeree 410 -- 27
Cafe/restaurant owners, managers
and workers......+sseeeee 817 _ 46
Canalmen........0+. 150 635* =
Candymakers and cooks 825 47
Cannery workers.... 527 38
Canvasmakers.... 412 28
Carmen, railroad 640 41
(2h5 4234.40 000000000000000000000 411 --- 27
Carpenter helpers, except logging
and mining......ceeeseeeeeeeeeee 960 27
Carpet layers and makers 400 26
Car salesmen........ee008- 386 25
Car shop/railroad mechanics....... 475 33
Car washers.......eeeeeeeee 0 291 --- 20
Cashiers.....-.+ » 169 312 310 21
Cement finishers 413 --- 28
Chainmen, surveying 21 642 181 14
Chauffeurs.......eeeeeeee 714 --- 44
Checkers, manufacturing.........++ 67 643 450 31

116


COMMENTARY ON TABLE 2 (FEMALE MORTALITY, 1974-1979)

Housekeepers and Stewards (in private households)
Occupation code 832
Total deaths 336

These women have a significantly lower PMR due to all malignant
neoplasms. Chronic rheumatic heart disease and pneumonia have elevated
PMRs as do accidental and specified falls.

Janitors
Occupation code 834
Total deaths 180

These women show a significant deficit of deaths due to malignant
neoplasms. Arteriosclerotic heart disease and pneumonia have significant
PMR increases. Accidental falls have a PMR of 277 based on 4 deaths.

Kitchen Workers (not private households)
Occupation code 835
Total deaths 174

Cancers of the brain and cervix have elevated PMRs.

Hairdressers and Cosmetologists
Occupation code 843
Total deaths 409

Cancer of the stomach, the other lymphoma category, multiple myeloma,
acute leukemia, and malignant neoplasms of other and unspecified sites have
PMR increases. Diseases of veins, cirrhosis of the liver without alcoholism,
accidental falls, and death due to fire and explosion also have increased
mortality.

Waitresses
Occupation code 875
Total deaths 862

Cancers of the esophagus, stomach, larynx, lung, cervix and uterus
unspecified have increased PMRs. Psychoses, pulmonary emphysema, cirrhosis
of the liver, motor vehicle accidents, and homicide have mortality increases.
Much of this mortality pattern may be due to life-style patterns, i.e.,
smoking, drinking, and promiscuity.

63


COMMENTARY ON TABLE 3
(MALE MORTALITY BY OCCUPATION WITHIN CAUSE-OF-DEATH GROUPS)

Accidental Falls (ICD 900-904)

Men whose occupations require them to work in elevated places (line-
men, roofers, painters, carpenters, construction laborers, structural
metal workers) have high PMRs.

Blow from falling object (ICD 910)

Loggers and logging truck drivers are at increased risk of being
struck by trees during the logging operation.

Accident caused by electric current (ICD 914)

Electricians, linemen, and public utility workers are occupationally
exposed to electricity. The cranemen are electrocuted when conductive
booms accidentally contact high-tension lines. Building contractors and
painters are frequently electrocuted when aluminum ladders accidentally
contact high-tension lines. The contractors are also electrocuted by
defective power tools.

Suicide (ICD 970-979)

Although the etiology of suicide is complex, the elevated PMR seen
in sheepherders may be due to the fact that these men are alone for long
periods of time in remote areas. Dentists, veterinarians, physicians,
and medical and dental technicians have access to drugs used in suicide
and the knowledge to use them effectively.

Homicide (ICD 980-985)

Policemen and detectives are at increased risk of homicide due to
the nature of their work. Taxi drivers and bartenders are at increased
risk of homicide incidental to robbery attempts. The other occupational
classes are at increased risk of homicide due to lifestyle.

69


COMMENTARY ON TABLE 1 (MALE MORTALITY, 1950-1979)

Surveyors
Occupation code 181
Total deaths 325

Cancers of buccal cavity and pharynx (8 deaths observed, 2 expected)
have a PMR of 511**. Four of these were cancers of the tongue.

School Teachers
Occupation code 184
Total deaths 2,773

Male school teachers have low PMRs for lung cancer and non-malignant
respiratory diseases. For malignant respiratory diseases there were 87
deaths observed to 149 expected. Low PMRs are also seen for buccal and
pharyngeal cancers and for cirrhosis of the liver with alcoholism. This
is most likely due to abstinence from tobacco and alcohol. Increased
mortality is seen due to cancer of the large intestine, biliary passages
and liver, malignant melanoma of skin, connective tissue cancers, Hodgkin's
disease, benign neoplasms, chronic rheumatic heart disease, and coronary
heart disease. Hodgkin's disease clusters have been reported in high
school students (27).

Medical and Dental Technicians
Occupation code 185
Total deaths 266

Infective and parasitic diseases, arteriosclerotic heart disease
including coronary disease, cirrhosis of the liver, and suicide show signi-
ficant mortality increases.

Electrical and Electronic Technicians
Occupation code 190
Total deaths 457

Cancers of pancreas, kidney, urinary bladder, and brain,. and the other
lymphomas show small number PMR increases. Arteriosclerotic heart disease
including coronary artery disease shows a significant mortality excess.

14


MICROFICHE TABLES - TABLE 3, MALE OCCUPATIONAL MORTALITY BY CAUSE OF DEATH

Microfiche
ICD No. Cause of Death Page Row/Column
001-138 Infective and Parasitic Diseases............2006. 17 Al-cl
001-019 Tuberculosis (Total)............. " D1-E1l
001-008 Tuberculosis of Respiratory System. " F1-Gl
140-205 Malignant Neoplasms (Total)............222005 eens " Hi-J 1
140-148 MN Buccal Cavity and Pharynx............eeeeeeees " K1-L 1
140 iis] 148550 000G0000000000000000 " M1
141 MN Tongue........... " A2
144 MN Other Parts of Mouth. " B2
145 MN Oral Mesopharynx........ccccceecsccececseecees " c 2
147 MN Hypopharynx........ " D2
148 MN Pharynx, Unspecified. " E2
150-159 MN Digestive Organs and Peritoneum............... " F 2-H 2
150 MN EsophagusS.......csccceccsec ccc cssncetecccevees " 12
151 MN Stomach....... " J 2-L 2
152 MN Small Intestine, including Duodenun " M2
153 MN Large Intestine, except Rectum...........-0005 " A 3-C 3
154 MN Rectum. ..cscccccrcccecccvcccscece . " D 3-E 3
155 MN Biliary Passages and Liver (Primaty). 90 " F3
155.0 RSJ 21KC¥35 00 00 000000000000000000000000 000000000000 " G3
155.1 MN Gallbladder, Ducts and Ampulla of Vater....... " H3
156 MN Liver (Secondary and Unspecified)........ O 13
157 MN Pancreas....sscccccecccccccccees " J 3K 3
159 ‘MN Unspecified Digestive Organs. " L3
160-165 MN of Respiratory System... " M 3-D 4
161 Lk] BETS 295: % oo 0000000000000000000000000000000000000 " E4
162 MN Bronchus, Trachea, Lung (Primary) " F 4-1 4
162.1,163 MN Bronchus and Lung " J4mM 4
162.2 MN Pleura......sseeeeeeee " AS
165 MN Thoracic Organs (Secondary) " BS
177 MN Prostate 000 " Cc 5-D 5
178 MN Testis.. " E5
180 MN Kidney.......ceeeeeeee " F5
181 MN Bladder and Other Urinary Organs 90000 " G 5-H 5
190 Malignant Melanoma of Skin....... " 15
191 Other MN of Skin........... " I5
193 MN Brain and Nervous System... " K 5-L 5

158


EXHIBIT 4 -- OCCUPATION GROUPINGS FOR MEN

Grouped Occupation
Code Code Occupation Title
000 000 Accountants, Auditors, and Assessors
012 012 Airplane Pilots and Navigators
013 013 Architects
014 014 Artists and Art Teachers
021 021 Chemists
022 022 Chiropractors
023 023 Clergymen
060 060 Professors and Instructors
031 Professors and Instructors, Agricultural Sciences
032 Professors and Instructors, Biological
034 Professors and Instructors, Chemistry
035 Professors and Instructors, Economics
040 Professors and Instructors, Engineering
041 Professors and Instructors, Geology and Geophysics
042 Professors and Instructors, Mathematics
043 Professors and Instructors, Medical Sciences
045 Professors and Instructors, Physics
050 Professors and Instructors, Psychology
052 Professors and Instructors, Natural Sciences NEC
053 Professors and Instructors, Social Sciences NEC
054 Professors and Instructors, Non-scientific subjects
071 071 Dentists
074 074 Draftsmen
075 075 Editors and Reporters
076 076 Newspaper Owners, Publishers, and Managers
080 080 Aeronautical Engineers
097 Boeing Engineers

97


COMMENTARY ON TABLE 1 (MALE MORTALITY, 1950-1979)

Public Administrators and Officials NEC
Occupation code 270
Total deaths 951

Malignant melanoma of skin, malignant neoplasm of rectum, and
coronary heart disease show elevated PMRs.

Lodge/Society/Union Officials
Occupation code 275
Total deaths 758

Myeloid leukemia has a PMR of 459 based on 6 deaths.

Postmasters
Occupation code 280
Total deaths 538

PMRs are elevated for malignant neoplasm of prostate, lymphosarcoma,
multiple myeloma, and myeloid leukemia.

Purchasing Agents and Buyers NEC, Sales Managers
Occupation code 285
Total deaths 1,007

Cancer of the large intestine and brain, arteriosclerotic heart
disease including coronary artery disease, and aircraft accidents have
significant PMR excesses.

Managers, Officials, and Proprietors NEC
Occupation code 290
Total deaths 9,122

Tuberculosis shows a low PMR while cancers of the large intestine,
rectum, and pancreas all have PMR excesses. Other rubrics with elevated
PMRs are malignant neoplasms of testis, brain, lymphatic, myeloid, and
acute leukemia, diseases of the blood-forming organs, arteriosclerotic
heart disease including coronary artery disease, and aircraft accidents.

19


COMMENTARY ON TABLE 1 (MALE MORTALITY, 1950-1979)

Window Cleaners and Wall Washers
Occupation code 833
Total deaths 163

Accidental falls, as expected, have an elevated PMR. Cerebral
embolism and thrombosis also shows a PMR elevation.

Janitors, Maintenance Men, and Sextons
Occupation code 834
Total deaths 6,558

Malignant neoplasms of the rectum and urinary bladder (age 20-64),
lymphosarcoma (especially 1970-1979), diseases of the endocrine glands,
and purpura and other hemorrhagic conditions have high PMRs.

School Custodians
Occupation code 836
Total deaths 1,744

School custodians show increased mortality in the 20-64 age class for
all malignant neoplasms. Cancer of the rectum, prostate, urinary bladder
(age 20-64), and lymphatic and hematopoietic tissues show elevated PMRs.
Multiple myeloma, reticulum-cell sarcoma, and the other lymphoma group have
elevated PMRs. Diseases of the circulatory system show small but significant
PMR increases as do deaths from duodenal ulcer (age 20-64). This pattern of
mortality agrees well with that seen for men in the janitors category.

Porters
Occupation code 841
Total deaths 191

Respiratory tuberculosis, malignant neoplasms of the stomach, hyper-
tensive disease, and cirrhosis of the liver have excess deaths.

Hairdressers and Cosmetologists
Occupation code 843
Total deaths 102

Men in this category show increased deaths due to lung cancer, cirrhosis
of the liver, suicide, and homicide.

48


EXHIBIT 2 - OCCUPATION CODES

673
674
675
676
677
680
685
690
691
692
693
694
695
701
702
703
704
705
706
710
711
712
713
714
715
716
717
718
719
720
721
722
724
725
726

810
811
812
813
814
815
816
817
818

OPERATIVES (continued)

Knitters, loopers and toppers, textile

Laundry and drycleaning operatives

Meatcutters (except slaughter- and packing house) and butchers
Heavy equipment operators

Slaughterhouse butchers

Milliners

Mine operatives and laborers NEC

Motormen, mine, factory, etc.

Motormen, street, subway, elevated railway

Oilers and greasers, except auto

Packers and wrappers NEC

Painters, sign (except construction and maintenance)
Photographic process workers

Power station operators

Divers

Sailors, deckhands, and seamen NEC

Sawyers, sawmill workers and saw filers

Sewers, stitchers, and cutters, manufacturing
Plywood workers

Spinners, textile

Rope makers

Stationary firemen

Railroad switchmen

Taxicab drivers and chauffeurs

Truck and tractor drivers

Fuel oil truck drivers

Sawmill truck drivers

Lumber and logging truck drivers

Moving, transfer, and storage truck drivers and workers
Weavers, textile

Welders and flame cutters

Operatives and kindred workers NEC

Tree farmers, Forest Service and Parks Department workers
Sandblasters

Ordnance plant workers

SERVICE WORKERS

Attendants, hospital and institutions

Nursing home, convalescent center, hospital managers, owners, etc.
Attendants, professional and personal service NEC

Attendants, recreation and amusement (cardroom, poolhall, carnival)
Barbers °
Bartenders

Cocktail bars and tavern owners, operators, managers, workers NEC
Restaurant and cafe owners, operators, managers, workers

Brewery workers

93


COMMENTARY ON TABLE 1 (MALE MORTALITY, 1950-1979)

Inspectors NEC
Occupation code 450
Total deaths 452

PMRs over 200 are seen for brain cancer, subarachnoid hemorrhage,
and kidney infections.

Jewelers, Watchmakers, Goldsmiths, Silversmiths, and Locksmiths
Occupation code 451
Total deaths 995

Lymphosarcoma and reticulosarcoma, chronic rheumatic heart disease,
coronary artery disease (age 20-64), and accidental falls on the same
level have PMR increases. The Registrar General's data agree with the
rheumatic and ischemic heart disease excesses.

Telegraph/Telephone/Power Linemen
Occupation code 453
Total deaths 1,125

As expected, accidental falls and electrocution have very high PMRs.
Acute and myelogenous leukemia and pulmonary embolism and infarction also
have elevated PMRs.

Locomotive Engineers
Occupation code 454
Total deaths 1,992

Cancer of the large intestine, arteriosclerotic heart disease
including coronary disease (age 20-64), and railway accidents have more
deaths than expected. The Registrar General's data corroborate the
accident and heart disease excess.

Telephone Installers and Repairers
Occupation code 459
Total deaths 344

Malignant neoplasms of the large intestine and brain and lymphosar-
coma have elevated PMRs.

31


MICROFICHE TABLES ~ TABLE 4, SIGNIFICANT MALE PMRS BY OCCUPATION

Grouped Microfiche

Code Occupation Page Row/Column
530 Tool and Die Makers and Setters......sseeereee 19 413
535 Upholsterers. ...cccceecscceccceeccecceecs " M13
551 Navy/Coast Guard Officers and Enlisted Men.... " A14-B14
555 Army/Air Force/Marine Corps Officers and

Enlisted Men......sseceesersccreeseeseeeeace " c14-D14
557 Boeing Workers. ..sseeeeeeecesceererecsceeesens " E14
558 Atomic Energy Workers NEC..........4- Q " F14
630 Asbestos and Insulation Workers..... . " G14
634 Blasters and Powdermen.......seeeeeseereeeeeee " H14
640 Railroad Brakemen. . : : " T14
641 Bus Drivers.....+..see0 D " J14
650 Deliverymen and Routemen......ssseeeeseeeeeeee " K14
655 Dairy Workers, Ice Cream and

Cheesemakers...........05 po000000G0000000000 " 114
674 Laundry/Dry Cleaning Operatives.. O " M14
675 Meatcutters and Butchers........ . " AlS
685 Mine Operatives and Laborers NEC Q " B15-D15
692 Oilers and Greasers, except auto...........-6 " E15
694 Painters SI 000 D " F15-G15
701 Power Station Operators......... " HIS
703 Sailors, Deckhands, and Seamen NEC " 115-J15
706 Plywood Workers.....seseeereeeereeeces " K15
713 Railroad Switchmen.......... occ c cc eeeseeresece " Ls
714 Taxicab Drivers and Chauffeurs . " M15-A16
715 Truck and Tractor Drivers.. o " B16-C16
716 Fuel Oil Truck Drivers........+eeeeeeee . " D16
718 Log/Lumber/Sawmill Truck Drivers......+.+.se.+ " E16
721 Welders and Flame CuttersS......seeeeeeeeceeeee " F16
724 Tree Farmers, Forest Service and Parks

Department Workers.......-++ 6000000000000000 " G16
726 Ordnance Plant Workers.......eeeeeeeeeeeereeee " H16
810 Hospital/Institution Attendants.......+++-+++++ " 116
812 Recreation/Amusement Attendants (cardroom,

pool hall, carnival).......sseeeeeeeee erence " J16
814 " K16
815 " L16-M16
817 Restaurant Owners, Managers, and Workers...... 20 Al
818 Brewery Workers...... 900000000000 o " Bl
819 Hotel/Motel Owners and Managers. 00 " cl
825 Cooks, Candymakers, and Chefs........seseseeee " DIF1

166


INDEX OF OCCUPATIONS FOR MEN

Number
of Occupation Grouped Commentary
Deaths Code Code Page
s

Sailmakers....cseseeeeeeeecenssens 412 — 28
Sailors........ 703 --- 44
Sales clerks NEC. 396 = 26
Sales engineers 65 092 093 11
Sales, lumber. 384 --- 25
Sales managers. 285 19
Salesmen, car........005 386 25
Salesmen, chemical......... 77 388* —
Salesmen, stocks and bonds... 395 26
Salesmen, travelling.. 380 24
Sales representatives.......eseeee 380 24
Salvage/secondhand store workers.. 892 50
Sandblasters.....sseeeceececeeenes 82 725% 45
Sanitarians... 63 176* --
Saw filers...........00. 704 51
Sawmill truck drivers. 717 45
Sawmill workers...... 704 51
SAWYETS. ce eeesscceeees 704 51
Scalers, log and lumber. 444 30
School custodians.. 836 48
Scientists, agricultura. 94 130* --
Scientists, biological.. 81 131* -
Scientists, natural NEC. 55 145* --
Scientists, social NEC 10 175* =
Seamen NEC......... 703 44
Secretaries........ 104 342% c --
Seed company workers.. 966 -—- 51
Servicemen, telegraph/telephone/

power Linemen......eeeeeeseeeeee 453 ated 31
Sextons......... 834 --- 48
Sewers, stitchers, cutters,

Manufacturing.......ceceeeee ees 103 705 412 28
Sheepherders..... eeeee 907 -—- 50
Sheet metal workers.. ee 525 = 38
Sheriffs and bailiffs 470 854 853 49
Shingle weavers......... 974 — 51
Shipfitters......ssseeee 507 --- 36
Shippers, farm products. 251 -_- 17
Shipping clerks......cceeeceesveee 343 -_— 23
Ships' officers, pilots, pursers,

engineers... 00 D000000000000000 265 -—- 18
Shipwrights.......... 273 409 507 36
Shipyard electricians 316 422 507 36
Shipyard machinists............05. 573 467 507 36

131


COMMENTARY ON TABLE 1, (MALE MORTALITY, 1950-1979)

Veterinarians
Occupation code 194
Total deaths 211

Cancer of the large intestine (PMR = 333**) and suicide (PMR = 223%)
show mortality excesses. A recent proportionate mortality study among
veterinarians(28) supports this mortality pattern.

Professional and Technical Workers NEC
Occupation code 195
Total deaths 275

No statistically significant mortality excesses are seen, but tuber-
culosis and cancer of the esophagus show small number PMR excesses.

Students (18 and over)
Occupation code 196
Total deaths 1,290

Tuberculosis, testicular, brain, and bone cancers, Hodgkin's disease,
myeloid and acute leukemia, multiple sclerosis, ulcerative colitis,
accidental falls, and suicide show excess deaths.

Farmers NEC
Occupation code 200
Total deaths 31,760

Due to a large sample size, many causes show statistically significant
excesses and deficits with only small PMR variations. Cancer of bronchus
and lung shows a 20% deficit (observed 646, expected 813, PMR = 79**),
PMRs over 125 are seen for malignant neoplasms of lip, salivary glands,
unspecified digestive organs, eye, and other endocrine glands. Reticulosarcoma,
multiple myeloma, lymphatic leukemia, agranulocytosis, amyotrophic lateral
sclerosis, other pneumoconiosis, acute yellow atrophy of liver, rheumatoid
arthritis, machinery accidents, and accidental electrocution all have
increased deaths. The excess accidental electrocution is due to metal irriga-
tion pipes coming in contact with high tension lines while being moved. The
Registrar General's tables agree with the lymphatic/hematopoietic excess and
with the pneumoconiosis and accidental death excess. Other studies support
these findings (10,29,30).

15


COMMENTARY ON TABLE 2 (FEMALE MORTALITY, 1974-1979)

Clerks NEC
Occupation code 370
Total deaths 829

Women in this category have increased mortality due to accidental
deaths, especially deaths caused by fire and explosion. The psychoses
rubric has an elevated PMR due to deaths in women over 80 years old.

Insurance Agents, Brokers, Underwriters, and Appraisers
Occupation code 385
Total deaths 162

There is a significant excess of total malignant neoplasms in the
20-64 age class. Tumors of the lung, breast, and ovaries show mortality
excesses,

Real Estate Agents, Brokers, Developers, and Appraisers
Occupation code 393
Total deaths 199

Cancers of the large intestine, lung, and cervix show PMR increases
based on small numbers of deaths.

Sales Clerks NEC
Occupation code 396
Total deaths 1,460

Cancer of the lung shows excess deaths while cervical cancer in age
group 20-64 shows a deficit. Multiple myeloma, other and unspecified
leukemia, cirrhosis of the liver, motor vehicle accidents, suicide, and
homicide show small mortality excesses.

Fabric Workers
Occupation code 412
Total deaths 264

Malignant neoplasms of the buccal cavity and pharynx, lung, and
brain show elevated PMRs.

59


INDEX OF OCCUPATIONS FOR MEN

Number
of Occupation Grouped Commentary
Deaths Code Code Page
P
Packers, fruit and vegetables..... 89 654 975 52
Packers NEC. ...c eee seesceeeee 693 -—- 43
Painters, auto... sc sec cee eeweenes 479 34
Painters, construction/maintenance 4,802 495 43
Painters, sSign.....ccccceseeeeeees 694 43
Paperhangers/decorators. 501 35
Paper mill workers.... 500 35
Parking attendants... 291 -—-- 20
Parks Department workers 724 --- 45
Parts finishers, Boeing.... 145 657 557 40
Pattern makers, except paper. 502 --- 35
Pavers, road......e.eeeeeee 425 29
Payroll clerks.. 142 333 yan
Peddlers......... 120 383 24
Personnel workers... 154 12
Pest.control employees 0000 61 986* --
Pet store owners...... sees 73 296% --
Pharmacists...... o 160 13
Photographers.......eseeeee 9000 161 -—- 13
Photographic process workers...... 99 695 161 13
PHYSLCLANS.. eee eee cece cerns ccsces 162 --- 13
Physicians' office attendants..... 6 303* --- =
PhHYSLcistS...ceececccccccceee 18 140* -- --
Physics professors....... 1 045 060 9
Piano tuners and repairmen.... 100 504* --- _-
Pilots, airplane. 00 seeeees 012 -—- 7
Pilots, ship..........seeeees 265 --- 18
Pipefitters, atomic energy. 65 509 558 40
Plasterers and lathers.... 505 -—— 36
Plastic workers.............05 27 436% --- --
Plumber/pipefitter apprentices 13 612 510 36
Plumbers....seeccccevvccceees _ 510 — 36
Plywood workers............ oe 706 --- 44
Policemen and detectives 853 --- 49
Polishers, metal........ 153 653 523 37
Porters. .seeeeevee 841 --- 48
Postal clerks. 340 --- 22
Postmasters..... 280 --- 19
Poultry farmers.. 206 --- 17
Pourers, furnacemen... 211 670 435 30
Powdermen and blasters 634 --~ 41
Power linemen...... 90000 453 -—— 31
Power station operators. 00 701 --- 43
Presidents, college............... 54 030* --- --

128


EXHIBIT 4 -- OCCUPATION GROUPINGS FOR WOMEN

Grouped Occupation
Code Code Occupation Title
527 527 Cannery and Food Processing Workers
557 557 Boeing Workers
089 Boeing Draftsmen
419 Boeing Electricians
446 Boeing Inspectors
466 Boeing Machinists
468 Boeing Maintenance Workers
657 Boeing Parts Finishers
651 651 Dressmakers and Steamstresses, except factory
524 Tailors
674 674 Laundry/Dry Cleaning Operatives
675 675 Meatcutters and Wrappers
677 Slaughterhouse Butchers
810 810 Hospital/Institution Attendants
815 815 Bartenders
816 816 Cocktail Bar/Tavern Owners, Operators, and Workers
817 817 Restaurant Owners, Managers, and Workers
819 819 Hotel/Motel Owners and Managers
821 821 Hotel/Motel Maids and Housekeepers
824 824 Charwomen and Cleaners
825 825 Cooks, Candymakers, and Chefs
832 832 Housekeepers and Stewards (in private households)
834 834 Janitors
836 School Custodians
835 835 Kitchen Workers (not private households)
843 843 Hairdressers and Cosmetologists
875 875 Waitresses
909 909 Nuns
975 975 Fruit Warehousemen
654 Fruit/Nut/Vegetable Graders and Packers
976 Fruit Inspectors

112


INDEX OF OCCUPATIONS FOR MEN

Number
of Occupation Grouped Commentary
Deaths Code Code Page

ANALYSES. cecsvcccncccncccsccccccs 174 -_— 13
Annealers....... 435 -— 30
Announcers, Yadio. 92 010* -—- --
Apartment house owners, managers.. 3,109 819 -_ 47
Appraisers, insurance........ 385 -_- 25
Appraisers, real estate. oe 393 — 25
Apprentice auto mechanics. o 6 601 472 33
Apprentice bricklayers and masons. 6 602 405 27
Apprentice, building trades NEC... 17 613 406 27
Apprentice electricians..........+ 13 604 421 29
Apprentice machinists and tool-

£2) ¢: 43 605 465 32
Apprentice mechanics except auto.. 3 610 480 34
Apprentice, metal working

trades NEC... ...ccececeeresscves 14 614 523 37
Apprentice, other specified trades 7 620* --- --
Apprentice plumbers and

Pipefstters))-jelelel-|-)-lelelellelelelelelolelele 13 612 510 36
Apprentice, printing trades.. on 6 615 512 36
Apprentice, trade not specified... 7 621% --- --
APCHITECEB.. cece cece cece cece sceees 013 — 7
Armed Forces civilian employees... 330 554% -- --
Armed Forces officers and

enlisted men NEC.......e++ee0++- 506 555 -- 39
Army officers and enlisted men.... 2,780 552 555 39
ALTISES. ccc eee ceeeeeeceeens eee 014 -- 8
Art teachers...sscesccsccccsssvens 014 -—- 8
Asbestos and insulation workers... 630 = 40
Assemblers......ceeessccececsceees 88 631* -—- --
ASSeSSOFS......006 ae 000 — 7
Assistants, library. 00 11 302* --- --
Athletes.......eeeeeeeee ~ 118 015* -—- -
Atomic energy accountants. aco 22 007 558 40
Atomic energy draftsmen..... 10 088 558 40
Atomic energy electricians........ 55 418 558 40
Atomic energy plant watchmen and

£303 g*1$5 p99 gop O0DD 000050000000 122 856 558 40
Atomic energy steamfitters and

Plpefitters.....ccecerecccsecee 65 509 558 40
Atomic energy workers NEC. ». 1,091 558 -- 40
Attendants, flight......... 00 10 009* --- --
Attendants, gas station/garage. 291 --- 20
Attendants, hospital/institution.. 810 --- 46
Attendants, Llibrary.......eeeeeeee 11 302* --- --


In a study of community arsenic exposure near a copper smelter(11),
county records alone were able to identify 24 smelter workers dying of
bronchogenic carcinoma. Ascertainment of bronchogenic carcinoma records
yielded only one more death, an out-of-county resident. Of 100 Boeing
engineers' deaths ascertained through union records, 98 were coded to
the Boeing engineer category.

With this experience and confidence in the occupational information
on the Washington State death record, I thought it appropriate to examine
the mortality pattern for all occupational groups. The rationale behind
this approach was that new occupational/cause-of-death associations would
be revealed and could be followed up in cohort studies. The great appeal
of identifying specific occupational causes of mortality is that, techni-
cally, all are preventable by environmental manipulation.

The decision to update the file was based on a number of facts:

1. Death records for all male deaths had been routinely coded
to occupation in this office, starting with 1972 deaths.
Female deaths had also been coded to occupation starting
with 1974 deaths.

2. <A number of findings of the 1950-1971 study had been sub-
stantiated in population-based studies (12-14).

3. The 1950-1971 tables had proven useful in a number of areas
but were not as current as was possible.

4. NIOSH was working with various states to promote this sort of
analysis and expressed an interest in supporting an update of
this study.

5. Since 30 consecutive years of data were present, I hoped that
time trends in occupational mortality would now be discernable.
The large increase (140,000 male deaths) in file size had also
made it possible to analyze more specific occupation classes

and to check on earlier findings based on small numbers of deaths.


EXHIBIT 2 - OCCUPATION CODES

465
466
467
468
469
476
470
471
472
473
474
475
480
477
479
490
491
492
493
494
495
496
500
501
502
504
505
507
508
509
510
512
513
514
515
520
521
523
524
525
526
527
528
530
535
545

CRAFTSMEN, FOREMEN AND KINDRED WORKERS (continued)

Machinists NEC

Machinists, Boeing

Machinists, shipyard

Maintenance workers, Boeing

Maintenance workers, ‘railroad

Maintenance workers, lumber, plywood, veneer, etc.

Mechanics and repairmen, air conditioning, heating, refrigeration
" " " airplane

automobile

office machines

radio, television (manufacturing, etc.)

railroad and car shop

" " " NEC

Tire recappers and repairers, rubber welders

Auto body and fender/car painters

Millers, grain, flour, feed, etc.

Millwrights

Molders, metal

Motion picture projectionists

Opticians, lens grinders, and polishers

Painters, construction and maintenance

County-city road construction and maintenance

Paper, pulp mill workers

Paperhangers and decorators (painters)

Pattern and model makers, except paper

Piano and organ tuners and repairmen

Plasterers and lathers

Shipyard workers, shipfitters

Steamfitters

Atomic steamfitters, pipefitters

Plumbers and pipefitters

Pressmen and plate printers, printing

Rollers and roll hands, metal

Roofers and slaters

Shoemakers and repairers (except factory), leather workers, tanners

Stationary engineers

Stonecutters and stone carvers

Structural metal workers

Tailors

Tinsmiths, coppersmiths and sheet metal workers

Aluminum workers

Cannery and food processing workers

Floor workers (covering, waxing, hardwood, linoleum, etc.)

Tool and die makers and setters, toolmakers, etc.

Upholsterers

Craftsmen and kindred workers NEC

91


COMMENTARY ON TABLE 1 (MALE MORTALITY, 1950-1979)

Plasterers and Lathers
Occupation code 505
Total deaths 773

Stomach and respiratory cancers have PMR elevations. Cancer of the
pleura had 2 deaths observed to less than .5 expected. Asthma and emphy-
sema without bronchitis also have elevated PMRs. The lung cancer and
pleural cancer increases may be asbestos related.

Shipyard Workers, Shipwrights, and Shipfitters
Occupation code 507

Total deaths 5,330

Lung cancer and malignancies of pleura (mesothelioma) have increased
PMRs. These workers were exposed to asbestos. Interestingly, 8 of the 9
pleural cancer deaths occurred 1970-1979, suggesting that the latency
period since the World War II shipbuilding boom has been spanned. Benign
neoplasms also show increased deaths because mesothelioma, not specified as
malignant, is coded to the benign neoplasm rubric.

Additional evidence for occupational asbestos exposure is the elevation
of PMR due to asbestosis. Silicosis and other chronic interstitial pneu-
monia show excess deaths. Hyperplasia of prostate, falls from ladders, and
motor vehicle accidents also have PMR elevations. Asbestosis has been
studied in other shipyards (36).

Plumbers and Pipefitters
Occupation code 510
Total deaths 4,313

The grouped malignant neoplasm rubric has excess deaths. Cancer of
esophagus, lung, and connective tissue have high PMRs. Pulmonary emphy-
sema without bronchitis and accidents due to fire and explosion have more
deaths than expected. The Registrar General's data support the lung cancer
excess. AU. S. plumbers' union study supports the lung and esophageal
cancer excesses (37).

Printing Pressmen, Plate Printers, and Typewetters
Occupation code 512
Total deaths 1,889

Cancers of the tongue, esophagus, large intestine (age 20-64), rectum,
lung, and kidney are all in excess. A cohort study(38) of newspaper press—
men supports the lung and kidney cancer increase. A PMR study of printing
pressmen(39) supports the rectal cancer increase.

36


MICROFICHE TABLES - TABLE 2, FEMALE MORTALITY

Grouped Microfiche

Code Occupation Page Row/Colum
000 Accountants, Auditors, and Assessors.........- 15 Al-G1l
014 Artists and Art Teachers....... " H1-K1
073 Dietitians and Nutritionists L 1-c 2
111 Librarians. .scescscceeeserenee w D 2-3 2
120 Musicians and Music Teachers. ad K 2-c 3
150 EitE}0500000000000000000 " D3-A 4
170 Religious Workers " B 4-F 4
184 School Teachers..... 0 a G 4-D5
185 Medical and Dental Technicians...........se005 " E 5-15
196 EXerten(a395000000000000000n0000 000 " J 5-A 6
200 Farmers. - a0D00000 " B 6-G 6
249 Ty eIC¥AJo 0000000500000 000000000000D000D0000000 " H 6-J 6
250 Store Buyers and Department Heads............. " K 6-B 7
255 City and Civil Service Employees.........+.... " C 7-3 7
290 Managers, Officials, and Proprietors NEC...... " K 7-E 8
298 Grocers and Grocery Clerks.+.++seseeeeeeerceee " F 8-M 8
305 Bankers, Bank Clerks, and Managers......... " A 9-F 9
310 Bookkeepers, Cashiers, and Payroll Clerks.. Ww) G 9-B10
340 Postal Workers..+++sssssseeees p000000c0Dp " C10-H10
342 Secretaries-++++sseseeeee seen " T10-F11
343 Shipping and Receiving Clerks.... w G11-K11
353 Telephone Operators... w L11-E12
362 Boeing Clerks........ 0 af F12-K12
363 Public Utility Workers.. 000000 000 " L12-D13
370 Clerks NEC... eee cece eee cece ence cence encene " E13-A14
385 Insurance Agents, Brokers, Underwriters,

and Appraisers........ 6060000000000000000 " B14-F14
393 Real Estate Agents, Brokers, Developers,

and Appraisers. ...eccee eee cee cee ccrccsesees " G14-L14
396 Sales Clerks NEC...... ee M14-115
412 Fabric Workers...+..eecseeecceeenceeeeeceeeees " J15-C16
500 Paper/Pulp Mill Workers.........00. O06 " D16-H16
507 Shipyard Workers and Shipfitters... 00 " T16-M16
527 Cannery and Food Processing Workers........... 16 Al1-G1
557 Boeing Workers. ....see eee c eee cc scence eeeeeeees " H1-L1
651 Dressmakers and Seamstresses, except factory.. M1-G 2
674 Laundry/Dry Cleaning Operatives... se eeeens " H 2-B 3
675 Meatcutters and Wrappers.......ecsseeeececeeee " C 3-F 3

156


INDEX OF OCCUPATIONS FOR MEN

Number
of Occupation Grouped Commentary
Deaths Code Code Page
Inspectors, Boeing......sseeeeeee4 273 446 557 40
Inspectors, construction. D 139 448 450 31
Inspectors, fruit........ G 56 976 975 52
Inspectors, log and lumber 9 444 --- 30
Inspectors, machinery..... Q 60 445 450 31
Inspectors, manufacturing. . 67 643 450 31
Inspectors NEC. .....ccce secs cneee 450 --- 31
Inspectors, public administration. 260 —_ 18
Inspectors, railroad..... . 345 447 30
Institution attendants. O 810 46
Institutionalized..... D 997 53
Instructors, sports. 5 48 180* =
Insulation workers........... D 630 --- 40
Insurance agents, brokers, under-
writers, appraisers...........66 385 --- 25
J
Tan tors... ccceccccccacncvccccscce 834 48
Janitors, school, 9 836 48
Jewelers......... a 451 31
Jobsetters, metal. . 9 452 37
Judges.......4. D 105 — 12
Junk dealers. .cccceecceeceeeecees 892 --- 50
K
Kitchen/restaurant workers NEC.... 306 835 825 47
Knitters, textile... ....e.sseeeees 53 673 412 28
L
Laborers, construction NEC. wees 4,097 982 52
Laborers, farm........... 0000 902 50
Laborers, garage......... oa00 291 20
Laborers, itinerant farm... 0000 46 906 50
Laborers, mine ac00 D 685 42
Laborers NEC... a 980 52
Laborers, orchard... . 983 53
Laborers, railroad NEC 981 52
Labor relations workers 154 12
Landscapers........... 964 50
Lathers.......- 505 36
Laundry operatives. 674 --- 42
Lawyers.......... 105 --- 12
Leather workers........csceeseees 515 -_- 37

123


EXHIBIT 4 -- OCCUPATION GROUPINGS FOR MEN

Grouped Occupation
Code Code Occupation Title
082 082 Civil Engineers
083 083 Electrical Engineers
085 085 Mechanical Engineers
086 086 Marine Engineers
093 093 Engineers NEC
081 Engineers, Chemical
084. Engineers, Industrial
090 Engineers, Metallurgical
091 Engineers, Mining
092 Engineers, Sales
095 Engineers, Refrigeration
099 Engineers, Steam
094 094 Construction Engineers
096 096 Operating Engineers
103 103 Foresters and Conservationists
104 104 Funeral Directors and Embalmers
105 105 Lawyers and Judges
120 120 Musicians and Music Teachers
152 152 Optometrists
154 154 Personnel and Labor Relations Workers
160 160 Pharmacists and Druggists
161 161 Photographers
695 Photographic Process Workers
162 162 Physicians
153 Osteopaths
174 174 Statisticians, Actuaries, Analysts, and
Computer Programmers
135 Mathematicians

98


COMMENTARY ON TABLE 1 (MALE MORTALITY, 1950-1979)

Tool and Die Makers and Setters
Occupation code 530
Total deaths 487

Lung cancer has elevated mortality (1950-1969) but not in the years
1970-1979. Suicide is more common in these men than expected.

Upholsterers
Occupation code 535
Total deaths 456

Small number PMR excesses are seen for malignant neoplasms of the
urinary bladder and brain, and chronic rheumatic heart disease.

Craftsmen and Kindred Workers NEC
Occupation code 545
Total deaths 395

This is a miscellaneous craftsmen group. Vascular lesions affecting
the central nervous system (age 20-64), lung cancer (age 20-64), and
diseases of the arteries (age 20-64) (1970-1979) have elevated PMRs.

Navy/Coast Guard Officers and Enlisted Men
Occupation code 551
Total deaths 2,309

Army/Air Force/Marine Corps Officers and Enlisted Men
Occupation code 555
Total deaths 4,654

PMRs are probably artificially elevated for a number of causes of
death (including lung cancer and cirrhosis of the liver) because of
referral of ill servicemen to the large military medical centers in this
State. Also, men retired for medical reasons are more likely to take up
residence near the military medical facilities in the State. These popula-
tions have a high risk of dying and inflate the PMR for these two occupa-
tional classes.

Aircraft accidents are elevated because of flight training and flight
activities associated with air bases in the State.

39