| Cause-Specific Mortality in the Unionized U.S. Trucking Industry Francine Laden,1,2,3 Jaime E. Hart,1,2 Thomas J. Smith,2 Mary E. Davis,2,4 and Eric Garshick1,5 1Channing Laboratory, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts, USA; 2Exposure, Epidemiology and Risk Program, Department of Environmental Health, and 3Department of Epidemiology, Harvard School of Public Health, Boston, Massachusetts, USA; 4Department of Resource Economics and Policy, University of Maine, Orono, Maine, USA; 5Pulmonary and Critical Care Medicine Section, Medical Service, VA Boston Healthcare System, West Roxbury, Massachusetts, USA Abstract
Background: Occupational and population-based studies have related exposure to fine particulate air pollution, and specifically particulate matter from vehicle exhausts, to cardiovascular diseases and lung cancer. Objectives: We have established a large retrospective cohort to assess mortality in the unionized U.S. trucking industry. To provide insight into mortality patterns associated with job-specific exposures, we examined rates of cause-specific mortality compared with the general U.S. population. Methods: We used records from four national trucking companies to identify 54,319 male employees employed in 1985. Cause-specific mortality was assessed through 2000 using the National Death Index. Expected numbers of all and cause-specific deaths were calculated stratifying by race, 10-year age group, and calendar period using U.S. national reference rates. Standardized mortality ratios (SMRs) and 95% confidence intervals (CIs) were calculated for the entire cohort and by job title. Results: As expected in a working population, we found a deficit in overall and all-cancer mortality, likely due to the healthy worker effect. In contrast, compared with the general U.S. population, we observed elevated rates for lung cancer, ischemic heart disease, and transport-related accidents. Lung cancer rates were elevated among all drivers (SMR = 1.10 ; 95% CI, 1.02–1.19) and dockworkers (SMR = 1.10 ; 95% CI, 0.94–1.30) ; ischemic heart disease was also elevated among these groups of workers [drivers, SMR = 1.49 (95% CI, 1.40–1.59) ; dockworkers, SMR = 1.32 (95% CI, 1.15–1.52) ], as well as among shop workers (SMR = 1.34 ; 95% CI, 1.05–1.72) . Conclusions: In this detailed assessment of specific job categories in the U.S. trucking industry, we found an excess of mortality due to lung cancer and ischemic heart disease, particularly among drivers. Key words: diesel, ischemic heart disease, lung cancer, mortality, occupation, traffic exposure, trucking industry. Environ Health Perspect 115:1192–1196 (2007) . doi:10.1289/ehp.10027 available via http://dx.doi.org/ [Online 27 April 2007]
Address correspondence to F. Laden, Channing Laboratory, 181 Longwood Ave., Boston MA 02115 USA. Telephone: (617) 525-2271. Fax: (617) 525-2578. E-mail: Francine.Laden@channing.harvard.edu We thank M.J. Canner for programming assistance, the Teamster Health and Safety Office, and the participating companies. This study was supported by grant R01 CA90792 from the National Institutes of Health/National Cancer Institute. The authors declare they have no competing financial interests. Received 21 December 2006 ; accepted 27 April 2007.
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