An industry-wide mortality study on the association between @entity2 and occupational exposure to @entity1953 and @entity45480 was carried out in the French hard-metal industry. This case-control study was nested in the historical cohort of workers ever employed in this industry's 10 facilities, most of which are located in eastern France. Workers were followed up from 1968 to 1991. Occupational exposure was assessed using a job-exposure matrix that provided semiquantitative scores for 320 job periods. These scores were significantly correlated with the levels of @entity1953 measured in 744 historical air samples. In this cohort, which comprised 5,777 males and 1,682 females, the @entity204 rate from @entity2 was significant (63 deaths, standardized mortality ratio=1.30, 95% confidence interval (CI) 1.00-1.66) when compared with national @entity204 rates. Sixty-one cases and 180 controls were included in the study. When the exposures during the last 10 years were ignored, a twofold @entity2 risk was observed among workers simultaneously exposed to @entity1953 and @entity45480 (odds ratio (OR)=1.93, 95% CI 1.03-3.62) adjusted for other @entity1953 exposure ( @entity69600 , 95% CI 0.99-4.90). The odds ratios increased with cumulative exposure (first quartile, OR=1.00; second quartile, OR=2.64; third quartile, OR=2.59; fourth quartile, OR=4.13) and, to a lesser degree, with duration of exposure (one decade, OR=1.00; two decades, OR=1.61; three decades, OR=2.77; four decades, OR=2.03). Adjustments for smoking and for exposures to known or suspected carcinogens did not change the results, yet the odds ratio for smoking (3.38) was lower than expected, suggesting the possibility of some misclassification. Occupational risk was highest among smokers. This study supports the hypothesis that workers who manufacture hard metals have an increased mortality from @entity2 due to simultaneous exposure to @entity1953 and @entity45480 .

XXXX risk in hard-metal workers.

@entity2 :: ('MESH:D008175', 'Disease') :: ['lung cancer'] @entity45480 :: ('MESH:C002802', 'Chemical') :: ['tungsten carbide'] @entity69600 :: ('81061', 'Gene') :: ['OR=2.21'] @entity204 :: ('MESH:D003643', 'Disease') :: ['death'] @entity1953 :: ('MESH:D003035', 'Chemical') :: ['cobalt']
@entity2 :: (MESH:D008175,Disease) :: ['Lung cancer']
