World Cancer Day 2020 – Reflecting on a Decade of NIOSH Cancer Research

February 4^th, 2020 is World Cancer Day, and we are reflecting on the role of the occupational cancer research being done at the National Institute for Occupational Safety and Health (NIOSH) in reducing the burden of cancer worldwide. Cancer develops as a result of the body losing its ability to control the growth and spread of abnormal cells. Globally, cancer is the 2^nd leading cause of death accounting for 9.6 million deaths in 2018 (IARC 2020). There are 17 million people diagnosed with cancer every year worldwide, and this number is expected to increase (ACS 2018).

While there is no single root cause of cancer, there are a wide range of exposures that may contribute to a person’s risk of cancer; this includes but is not limited to:

• Modifiable behaviors, such as alcohol and tobacco use;
• Environmental exposures to ultraviolet light, pesticides, and pollution;
• Infectious agents, such as viruses;
• Inherited genetic mutations; and
• Workplace exposures.

The Role of Workplace Exposures in Cancer Burden

Some specific occupations that have been linked to increased cancer risk include rubber manufacturing, paving, roofing, painting, and chimney sweeping. It has been estimated that 2-8% of all cancers worldwide are caused by exposures to carcinogens (substances known to cause cancer) in the workplace (Purdue et al. 2015). In 2016 (the most recent year with available data), there were between 49,761 and 132,697 new cancer cases in the U.S. that were caused by past exposure in the workplace (U.S. Cancer Statistics Working Group 2019). Worldwide, there are 340,738 and 1,362,952 new cancer diagnoses each year caused by occupational exposure. It may be safely assumed that these numbers are underestimated since our knowledge of all the possible carcinogens in the workplace is emerging.

Cancers that occur due to workplace exposures can be prevented. At NIOSH, we investigate the carcinogenic risk related to physical and chemical agents by conducting studies of exposed workers. This allows us to better understand the relationship between work and cancer.

A Decade of NIOSH Cancer Epidemiology Studies

Over the last decade, investigators at NIOSH have published over 50 epidemiologic studies of workplace-related cancer. These studies have evaluated a wide range of potentially carcinogenic agents. See the NIOSH Cancer Study References, 2009-2020 below.

• Particulates, fibers, and metals (such as diesel exhaust, asbestos, cadmium metal) and lung cancer
• Chlorinated solvents and pesticides and glioma
• Ortho-toluidine and bladder cancer
• Formaldehyde, polychlorinated biphenyls (PCBs), and ionizing radiation and several cancer types, such as lung and stomach cancer
• Industry-specific exposures (such as construction and microelectronics manufacturing) and several cancer types, such as leukemia
• Occupation-specific exposures (such as coal miners, aircrew, and firefighters) and several cancer types, such as lung cancer

The Impact of NIOSH Occupational Cancer Research

NIOSH has had a far-reaching impact on both national and international evaluations of potentially carcinogenic agents as well as exposure limits and recommendations released by national and international agencies.

Some important findings of recently published studies include:

• Mortality from leukemia was associated with duration of employment among styrene-exposed workers, such as those in the boatbuilding industry (Ruder et al. 2016; Bertke et al., 2018). These findings provide evidence for the carcinogenicity of styrene in humans, which the International Agency for Research on Cancer (IARC) classified as a Group 2A (probably carcinogenic to humans) carcinogen (IARC 2019a).
• NIOSH investigators developed a large cohort of nearly 30,000 firefighters from Chicago, Philadelphia, and San Francisco. In this cohort, elevated rates of overall and site-specific cancers were observed, including digestive, oral, respiratory, and urinary cancers as well as leukemia (Daniels et al. 2014; Daniels et al. 2015). These previous findings were confirmed in a recent cohort update (Pinkerton et al. 2020). Findings from these studies contributed to the newly established National Firefighter Registry (NFR) (NFR 2019).
• Previous NIOSH studies of industrial chemical exposures (IARC 2018), insecticides and herbicides (IARC 2017), solvents (IARC 2016), and diesel exhaust (IARC 2013) have also been vital in recent reviews of carcinogenic agents conducted by IARC.
• In one of the largest cohorts of former flight attendants, an association was observed between higher cosmic radiation exposure, greater number of times zones crossed, and incidence of breast cancer in a sub-group of women (Pinkerton et al. 2016). The NIOSH flight attendant study is one of very few aircrew studies with detailed individual exposure estimates for circadian rhythm disruption and cosmic radiation exposure.
• Incidence of bladder cancer was positively associated with exposure to ortho-toluidine in a cohort of rubber manufacturing workers (Carreon et al. 2010; Carreon et al. 2014). This study was included in the National Toxicology Program (NTP) 2014 assessment of ortho-toluidine as a potential cancer-causing agent, which ultimately considered ortho-toluidine be a known human carcinogen. The results of this study were also important in IARC’s review of ortho-toluidine, which IARC determined to be Group 1 carcinogen (IARC 2012).
• Risk of lung cancer was elevated in beryllium-exposed workers at several processing plants (Schubauer-Berigan et al. 2011). These findings were used in an assessment of lung cancer risk by the Occupational Health and Safety Administration (OSHA) as part of a reevaluation of the permissible exposure limit for beryllium and beryllium compounds in workplaces (OSHA 2015; OSHA 2017). A follow-up study was published which also supported these findings (Schubauer-Berigan et al. 2017).*

NIOSH investigators remain committed to improving our understanding of the complex role of work-related factors in the development of cancer. Looking to the future, NIOSH cancer research will continue to be a critical component to the prevention of cancer worldwide.

The Future of Occupational Cancer Research

In 2019, a group of 29 cancer researchers from 18 countries met to prioritize over 100 nominations of potential carcinogens that were submitted to the Monographs Program of IARC for evaluation during 2020-2024. The group’s recommendations included many potential occupational exposures, such as metalworking fluids, disinfection byproducts, nanomaterials, non-ionizing radiation, and firefighting exposures (IARC 2019b).

Additional work at NIOSH on preventing occupational cancer includes the development of the National Firefighter Registry (NFR). The NFR is a new voluntary registry of U.S. firefighters that will help monitor and better understand their occupational cancer risks. NIOSH will work with fire service organizations to announce when enrollment is open. For more information and program updates please visit: https://www.cdc.gov/niosh/firefighters/registry.html

What do you think should be at the forefront of future research on workplace cancer risks? Let us know in the comments below.

Raquel Velazquez-Kronen, Ph.D., is an epidemiologist in the NIOSH Division of Field Studies and Engineering

Jasmine Nelson, B.S., is a public health advisor in the NIOSH Division of Field Studies and Engineering

This blog has been translated into Spanish.

*Content updated 2/25/20

References

IARC. Wild CP, Weiderpass E, Stewart BW, editors. 2020. World Cancer Report: Cancer Research for Cancer Prevention. WHO, IARC, Lyon, France; 611 pp. http://publications.iarc.fr/586

American Cancer Society (ACS). 2018. Global Cancer Facts & Figures 4th Edition. Atlanta: American Cancer Society.

Siegel RL, Miller KD, Jemal A. 2020. Cancer statistics, 2020. CA A Cancer J Clin 70: 7-30.

Purdue MP, Hutchings SJ, Rushton L, Silverman DT. 2015. The proportion of cancer attributable to occupational exposures. Annals of epidemiology 25(3): 188-192.

U.S. Cancer Statistics Working Group. 2019. U.S. Cancer Statistics Data Visualizations Tool, based on November 2018 submission data (1999-2016): U.S. Department of Health and Human Services, Centers for Disease Control and Prevention and National Cancer Institute; www.cdc.gov/cancer/dataviz

Ruder AM, Meyers AR Bertke-SJ. 2016. Mortality among styrene-exposed workers in the reinforced plastic boatbuilding industry. Occup Environ Med 73(2):97-102.

Bertke SJ, Yiin JH, Daniels RD. 2018. Cancer mortality update with an exposure response analysis among styrene-exposed workers in the reinforced plastics boatbuilding industry. Am J Ind Med 61(7):566-571.

IARC. 2019a. IARC Monographs on the Evaluation of Carcinogenic Risks to Humans: Styrene, Styrene-7,8-oxide, and Quinoline. Vol. 121. WHO, IARC, Lyon, France; 345 pp.

Daniels RD, Kubale TL, Yiin JH, Dahm MM, Hales TR, Baris D, Zahm SH, Beaumont JJ, Waters KM, Pinkerton LE. 2014. Mortality and cancer incidence in a pooled cohort of US firefighters from San Francisco, Chicago and Philadelphia (1950-2009). Occup Environ Med 71(6):388-397.

Daniels-RD; Bertke-S; Dahm-MM; Yiin-JH; Kubale-TL; Hales-TR; Baris-D; Zahm-SH; Beaumont-JJ; Waters-KM; Pinkerton-LE. 2015. Exposure-response relationships for select cancer and non-cancer health outcomes in a cohort of US firefighters from San Francisco, Chicago and Philadelphia (1950-2009). Occup Environ Med 72(10):699-706.

Pinkerton L, Bertke SJ, Yiin J, Dahm M, Kubale T, Hales T, Purdue M, Beaumont JJ, Daniels R. 2020. Mortality in a cohort of US firefighters from San Francisco, Chicago and Philadelphia: an update. Occup Environ Med 77(2):84-93.

National Firefighter Registry (NFR). 2019. Firefighter resources; https://www.cdc.gov/niosh/firefighters/registry.html

IARC. 2018. IARC Monographs on the Evaluation of Carcinogenic Risks to Humans:   Some Industrial Chemicals. Vol. 115. WHO, IARC, Lyon, France; 289 pp.

IARC. 2017. IARC Monographs on the Evaluation of Carcinogenic Risks to Humans:  Some Organophosphate Insecticides and Herbicides. Vol. 112. WHO, IARC, Lyon, France; 452 pp.

IARC. 2016. IARC Monographs on the Evaluation of Carcinogenic Risks to Humans: Some Chemicals Used as Solvents and in Polymer Manufacture. Vol. 110. WHO, IARC, Lyon, France; 273 pp.

IARC. 2013. IARC Monographs on the Evaluation of Carcinogenic Risks to Humans: Diesel and gasoline engine exhausts and some nitroarenes. Vol. 105. WHO, IARC, Lyon, France; 703 pp

Pinkerton LE, Hein MJ, Anderson JL, Little MP, Sigurdson AJ, Schubauer-Berigan MK. 2016. Breast cancer incidence among female flight attendants: exposure response analyses. Scandinavian Journal of Work, Environment & Health 42 (6): 538-546.

Carreón T, Hein MJ, Viet SM, Hanley KW, Ruder AM, Ward EM. 2010. Increased bladder cancer risk among workers exposed to o-toluidine and aniline: a reanalysis. Occup Environ Med 66(5):348-350.

Carreón T, Hein MJ, Hanley KW, Viet SM, Ruder AM. 2014. Bladder cancer incidence among workers exposed to o-toluidine, aniline and nitrobenzene at a rubber chemical manufacturing plant. Occup Environ Med 71(3):175-82.

National Toxicology Program (NTP). 2014. Report on carcinogens: Monograph on ortho-Toluidine. U.S. DHHS, NIEHS, NTP; 236 pp.

IARC. 2012. IARC Monographs on the Evaluation of Carcinogenic Risks to Humans: Chemical Agents and Related Occupations. Vol. 100F. WHO, IARC, Lyon, France; 599 pp.

Occupational Safety and Health Administration (OSHA). 2015. A Proposed Rule by OSHA on 08/07/2015. Occupational Exposure to Beryllium and Beryllium Compounds. Document Citation:
https://www.federalregister.gov/documents/2015/08/07/2015-17596/occupational-exposure-to-beryllium-and-beryllium-compounds

Occupational Safety and Health Administration (OSHA). 2017. Final Rule. Occupational Exposure to Beryllium. Fed Register # 82:2470-2757; https://www.osha.gov/laws-regs/federalregister/2017-01-09

IARC. 2019b. Report of the Advisory Group to Recommend Priorities for the IARC Monographs during 2020–2024. IARC Monographs on the Identification of Carcinogenic Hazards to Humans. WHO, IARC, Lyon, France; 309 pp.

Recent NIOSH Studies and Other Cited References

NIOSH Cancer Study References, 2009-2020

Particulates (Including Diesel) and Fibers

Bang KM, Mazurek JM, Wood JM, Hendricks SA. 2013. Diseases attributable to asbestos exposure: Years of potential life lost, United States, 1999-2010. Am J Ind Med. 2014 57(1):38-48.

Attfield MD, Schleiff PL, Lubin JH, Blair A, Stewart PA, Vermeulen R, Coble JB, Silverman DT. 2012. The Diesel Exhaust in Miners Study: A cohort mortality study with emphasis on lung cancer. J Natl Cancer Inst 104(11):869-883.

Silverman DT, Samanic CM, Lubin JH, Blair A, Stewart PA, Vermeulen R, Coble JB, Rothman N, Schleiff PL, Travis WD and others. 2012. The Diesel Exhaust in Miners Study: A nested case–control study of lung cancer and diesel exhaust. J Natl Cancer Inst 104(11):855-868

Elliott L, Loomis D, Dement J, Hein MJ, Richardson D, Stayner L. 2012. Lung cancer mortality in North Carolina and South Carolina chrysotile asbestos textile workers. Occup Environ Med 69(6):385-390.

Loomis D, Dement JM, Elliott L, Richardson D, Kuempel ED, Stayner L. 2012. Increased lung cancer mortality among chrysotile asbestos textile workers is more strongly associated with exposure to long thin fibres. Occup Environ Med 69(8):564-8.

Metals and Metalworking Fluids

Park RM. 2018. Risk assessment for metalworking fluids and cancer outcomes. Am J Ind Med 61(3):198-203.

Schubauer-Berigan MK, Couch JR, Deddens JA. 2017. Is beryllium-induced lung cancer caused only by soluble forms and high exposure levels? Occup Environ Med 74(8):601-603.

Bertke-SJ, Lehman EJ, Wurzelbacher SJ Hein MJ. 2016. Mortality of lead smelter workers: a follow-up study with exposure assessment. Am J Ind Med 59(11):979-986.

Park RM, Stayner LT, Petersen MR, Finley-Couch M, Hornung R, Rice C. 2012. Cadmium and lung cancer mortality accounting for simultaneous arsenic exposure. Occup Environ Med 69(5):303-9.

Schubauer-Berigan MK, Couch JR, Petersen MR, Carreón T, Jin Y, Deddens JA. 2011. Cohort mortality study of workers at seven beryllium processing plants: update and associations with cumulative and maximum exposure. Occup Environ Med 68(5):345-353.

Schubauer-Berigan MK, Deddens JA, Couch JR. Petersen MR. 2011. Risk of lung cancer associated with quantitative beryllium exposure metrics within an occupational cohort. Occup Environ Med 68(5):354-360.

Chlorinated and Other Organic Solvents

Ruder AM, Yiin JH, Waters MA, Carreon T, Hein MJ, Butler MA, Calvert GM, Davis-King KE, Schulte PA, Mandel JS and others. 2013. The Upper Midwest Health Study: gliomas and occupational exposure to chlorinated solvents. Occup Environ Med 70(2):73-80.

Meyers AR, Pinkerton LE, Hein MJ. 2013. Cohort mortality study of garment industry workers exposed to formaldehyde: Update and internal comparisons. Am J Ind Med 59(9):1027-39.

Lauby-Secretan B, Loomis D, Grosse Y, El Ghissassi F, Bouvard V, Benbrahim-Tallaa L, Guha N, Baan R, Mattock H, Straif K and others. 2013. Carcinogenicity of polychlorinated biphenyls and polybrominated biphenyls. Lancet Oncol 14(4):287-8.

Ruder AM, Hein MJ, Hopf NB, Waters MA. 2013. Mortality among 24,865 workers exposed to polychlorinated biphenyls (PCBs) in three electrical capacitor manufacturing plants: A ten-year update. Int J Hyg Environ Health 2014 217(2-3):176-187.

Neta G, Stewart PA, Rajaraman P, Hein MJ, Waters MA, Purdue MP, Samanic C, Coble JB, Linet MS, Inskip PD. 2012. Occupational exposure to chlorinated solvents and risks of glioma and meningioma in adults. Occup Environ Med 69(11):793-801.

Silver SR, Whelan EA, Deddens JA, Steenland NK, Hopf NB, Waters MA, Ruder AM, Prince MM, Yong LC, Hein MJ, Ward EM. 2009. Occupational exposure to polychlorinated biphenyls and risk of breast cancer. Environ Health Perspect 117(2):276-282.

Pesticides, Herbicides, and Fertilizers

Yiin JH, Daniels RD, Kubale TL, Dunn KL, Stayner LT. 2016. A study update of mortality in workers at a phosphate fertilizer production facility. Am J Ind Med 59(1):12-22.

Silver SR, Bertke SJ, Hines CJ, Alavanja MCR, Hoppin JA, Lubin JH, Rusiecki JA, Sandler DP, Beane-Freeman LE. 2015. Cancer incidence and metolachlor use in the Agricultural Health Study: an update. Int J Cancer 137(11):2630-2643.

Yiin JH, Ruder AM, Stewart PA, Waters MA, Carreon T, Butler MA, Calvert GM, Davis-King KE, Schulte PA, Mandel JS and others. 2012. The Upper Midwest Health Study: a case-control study of pesticide applicators and risk of glioma. Environ Health 11(1):39.

Charles LE, Burchfiel CM, Fekedulegn D, Gu JK, Petrovitch H, Sanderson WT, Masaki K, Rodriguez BL, Andrew-ME, Ross-GW. 2010. Occupational exposure to pesticides, metals, and solvents: the impact on mortality rates in the Honolulu Heart Program. Work 37(2):205-215.

Aromatic Amines

Carreón T, Hein MJ, Hanley KW, Viet SM, Ruder AM. 2014. Bladder cancer incidence among workers exposed to o-toluidine, aniline and nitrobenzene at a rubber chemical manufacturing plant. Occup Environ Med 71(3):175-82.

Carreón T, Hein MJ, Hanley KW, Viet SM, Ruder AM. 2014. Coronary artery disease and cancer mortality in a cohort of workers exposed to vinyl chloride, carbon disulfide, rotating shift work, and o-toluidine at a chemical manufacturing plant. Am J Ind Med 57(4):398-411.

Carreón T, Hein MJ, Viet SM, Hanley KW, Ruder AM, Ward EM. 2010. Increased bladder cancer risk among workers exposed to o-toluidine and aniline: a reanalysis. Occup Environ Med 66(5):348-350.

Ionizing Radiation

Kelly-Reif K, Sandler DP, Shore D, Schubauer-Berigan M, Troester MA, Nylander-French L, Richardson DB. 2019. Mortality and cancer incidence among underground uranium miners in the Czech Republic 1977-1992. Occup Environ Med 76(8):511-518.

Yiin JH, Anderson JL, Bertke SJ, Tollerud DJ. 2018. Dose-response relationships between internally-deposited uranium and select health outcomes in gaseous diffusion plant workers, 1948-2011. Am J Ind Med 61(7):605-614.

Daniels RD, Bertke SJ, Richardson DB, Cardis E, Gillies M; O’Hagan JA, Haylock R, Laurier D, Leuraud K, Moissonnier M, Thierry-Chef I, Kesminiene A, Schubauer-Berigan MK. 2017. Examining temporal effects on cancer risk in the International Nuclear Workers’ Study. Int J Cancer 140(6):1260-1269.

Yiin JH, Anderson JL, Daniels RD, Bertke SJ, Fleming DA, Tollerud DJ, Tseng C-Y, Chen P-H, Waters KM. 2016. Mortality in a combined cohort of uranium enrichment workers. Am J Ind Med 60(1):96-108.

Schubauer-Berigan-MK; Daniels-RD; Bertke-SJ; Tseng-C-Y; Richardson-DB. 2015. Cancer mortality through 2005 among a pooled cohort of U.S. nuclear workers exposed to external ionizing radiation. Radiat Res 183(6):620-631.

Daniels RD, Bertke S, Waters KM, Schubauer-Berigan MK. 2013. Risk of leukaemia mortality from exposure to ionising radiation in US nuclear workers: a pooled case-control study. Occup Environ Med 70:41-48, 2013.

Silver SR, Bertke SJ, Hein MJ, Daniels RD, Fleming DA, Anderson JL, Pinney SM, Hornung RW, Tseng CY. 2013. Mortality and ionising radiation exposures among workers employed at the Fernald quant Materials Production Center (1951-1985). Occup Environ Med 70(7):453-63.

Yiin JH, Anderson JL, Daniels RD, Seel EA, Fleming DA, Waters KM, Chen-PH. 2009. A nested case-control study of multiple myeloma risk and uranium exposure among workers at the Oak Ridge gaseous diffusion plant. Radiat Res 171(6):637-645.

Schubauer-Berigan MK, Daniels RD, Pinkerton LE. 2009. Radon exposure and mortality among white and American Indian uranium miners: an update of the Colorado Plateau cohort. Am J Epidemiol 169(6):718-730.

Occupations

Pinkerton L, Bertke SJ, Yiin J, Dahm M, Kubale T, Hales T, Purdue M, Beaumont JJ, Daniels R. 2020. Mortality in a cohort of US firefighters from San Francisco, Chicago and Philadelphia: an update. Occup Environ Med 77(2):84-93.

Pinkerton LE, Hein MJ, Anderson JL, Christianson A, Little MP, Sigurdson AJ, Schubauer-Berigan MK. 2018. Melanoma, thyroid cancer, and gynecologic cancers in a cohort of female flight attendants. Am J Ind Med 61 (7): 572-581.

Shumate AM, Yeoman K, Victoroff T, Evans K, Karr R, Sanchez T, Sood A, Laney AS. 2017. Morbidity and health risk factors among New Mexico miners: a comparison across mining sectors. J Occup Environ Med 59(8):789-794.

Pinkerton LE, Hein MJ, Anderson JL, Little MP, Sigurdson AJ, Schubauer-Berigan MK. 2016. Breast cancer incidence among female flight attendants: exposure response analyses. Scandinavian Journal of Work, Environment & Health 42 (6): 538-546.

Schubauer-Berigan MK, Anderson JL, Hein MJ, Little MP, Sigurdson AJ, Pinkerton LE. 2015. Breast cancer incidence in a cohort of U.S. flight attendants. Am J Ind Med 58(3): 252-266.

Daniels-RD; Bertke-S; Dahm-MM; Yiin-JH; Kubale-TL; Hales-TR; Baris-D; Zahm-SH; Beaumont-JJ; Waters-KM; Pinkerton-LE. 2015. Exposure-response relationships for select cancer and non-cancer health outcomes in a cohort of US firefighters from San Francisco, Chicago and Philadelphia (1950-2009). Occup Environ Med 72(10):699-706.

Tsai RJ, Luckhaupt SE, Schumacher P, Cress RD, Deapen DM, Calvert-GM. 2015. Risk of cancer among firefighters in California, 1988-2007. Am J Ind Med 58(7):715-729.

Yong LC, Pinkerton LE, Yiin JH, Anderson JL, Deddens JA. 2014. Mortality among a cohort of U.S. commercial airline cockpit crew. Am J Ind Med 57(8): 906-914.

Tsai RJ, Luckhaupt SE, Schumacher P, Cress RD, Deapen DM, Calvert GM. 2014. Acute myeloid leukemia risk by industry and occupation. Leuk Lymphoma 55(11):2584-2591.

Graber JM, Stayner LT, Cohen RA, Conroy LM, Attfield MD. 2014. Respiratory disease mortality among US coal miners; results after 37 years of follow-up. Occup Environ Med 71(1):30-9.

Hammer GP, Auvinen A, De Stavola BL, Grajewski B, Gundestrup M, Haldorsen T, Hammar N, Lagorio S, Linnersjo A, Pinkerton L and others. 2014. Mortality from cancer and other causes in commercial airline crews: a joint analysis of cohorts from 10 countries. Occup Environ Med 71(5):313-22.

Daniels RD, Kubale TL, Yiin JH, Dahm MM, Hales TR, Baris D, Zahm SH, Beaumont JJ, Waters KM, Pinkerton LE. 2014. Mortality and cancer incidence in a pooled cohort of US firefighters from San Francisco, Chicago and Philadelphia (1950-2009). Occup Environ Med 71(6):388-397.

Silver SR, Pinkerton LE, Fleming DA, Jones JH, Allee S, Luo L, Bertke SJ. 2013. Retrospective cohort study of a microelectronics and business machine facility. Am J Ind Med. doi:10.1002/ajim.22288.

Calvert GM, Luckhaupt S, Lee SJ, Cress R, Schumacher P, Shen R, Tak S, Deapen D. 2012. Lung cancer risk among construction workers in California, 1988-2007. Am J Ind Med 55(5):412-22.

Luckhaupt SE, Deapen D, Cress R, Schumacher P, Shen R, Calvert GM. 2012. Leukemia among male construction workers in California, 1988-2007. Leuk Lymphoma 53(11):2228-36.

Pinkerton LE, Waters MA, Hein MJ, Zivkovich Z, Schubauer-Berigan MK, Grajewski B. 2012. Cause-specific mortality among a cohort of U.S. flight attendants. Am J Ind Med 55(1):25-36.

Ruder AM, Waters MA, Carreon T, Butler MA, Calvert GM, Davis-King KE, Waters KM, Schulte PA, Mandel JS, Morton RF and others. 2012. The Upper Midwest Health Study: industry and occupation of glioma cases and controls. Am J Ind Med 55(9):747-55.

Gu-JK; Burchfiel CM, Charles LE, Andrew ME, Violanti JM. 2011. Cancer incidence among police officers in a U.S. northeast region: 1976-2006. Int J Emerg Mental Health 13(4):279-289.

Robinson CF, Sullivan PA, LiJ; Walker JT. 2011. Occupational lung cancer in US women, 1984-1998. Am J Ind Med 54(2):102-117.

Birdsey J, Alterman T, Li J, Petersen MR; Sestito J. 2010. Mortality among members of a truck driver trade association. AAOHN J 58(11):473-480.

Ruder AM, Carreon T, Butler MA, Calvert GM, Davis-King KE, Waters MA, Schulte PA, Mandel JS, Morton RF, Reding DJ, Rosenman KD, Brain Cancer Collaborative Study Group. 2009. Exposure to farm crops, livestock, and farm tasks and risk of glioma. The Upper Midwest Health Study. Am J Epidemiol 169(12):1479-1491.

Other Chemicals

 Bertke SJ, Yiin JH, Daniels RD. 2018. Cancer mortality update with an exposure response analysis among styrene-exposed workers in the reinforced plastics boatbuilding industry. Am J Ind Med 61(7):566-571.

Ruder AM, Bertke SJ. 2017. Cancer incidence among boat-building workers exposed to styrene. Am J Ind Med 60(7):651-657.

Ruder AM, Meyers AR Bertke-SJ. 2016. Mortality among styrene-exposed workers in the reinforced plastic boatbuilding industry. Occup Environ Med 73(2):97-102.

Pinkerton LE, Yiin JH, Daniels RD, Fent KW. 2016. Mortality among workers exposed to toluene diisocyanate in the US polyurethane foam industry: update and exposure-response analyses. Am J Ind Med 59(8):630-643.

Ruder AM, Yiin JH. 2011. Mortality of US pentachlorophenol production workers through 2005. Chemosphere 83(6):851-861.

Other

Martin CJ, Jin C, Bertke SJ, Yiin JH, Pinkerton LE. 2019. Increased overall and cause-specific mortality associated with disability among workers’ compensation claimants with low back injuries. Am J Ind Med: 1-9.

Bang KM, Mazurek JM, Storey E, Attfield MD, Schleiff PL, Wood, JM, Wassell JT. 2009. Malignant mesothelioma mortality – United States, 1999–2005. JAMA 302(1):25-26.