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Fifty-year-follow-up of mortality among a cohort of iron-ore miners in Sweden, with specific reference to myocardial infarction mortality
Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Occupational and Environmental Medicine.
Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Occupational and Environmental Medicine.
Umeå University, Faculty of Medicine, Department of Radiation Sciences, Oncology.
Umeå University, Faculty of Medicine, Department of Radiation Sciences, Oncology.
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2009 (English)In: Occupational and Environmental Medicine, ISSN 1351-0711, E-ISSN 1470-7926, Vol. 66, no 4, 264-268 p.Article in journal (Refereed) Published
Abstract [en]

Objectives: This study investigates both general mortality and mortality from myocardial infarction among men employed in iron-ore mines in Sweden.

Methods: The mortality of employees (surface and underground workers) at the iron-ore mines in Malmberget and Kiruna, Sweden was investigated. The study cohort comprised men who had been employed for at least 1 year between 1923 and 1996. The causes of death were obtained from the national cause of death register from 1952 to 2001. Indirect standardised mortality ratios (SMR) were calculated for four main causes. Mortality specifically from myocardial infarction was also analysed.

Results: 4504 deaths in the cohort gave an SMR for total mortality of 1.05 (95% CI 1.02 to 1.09). Mortality was significantly higher for lung cancer (SMR 1.73, 95% CI 1.52 to 1.97). There was an increased risk of injuries and poisonings (SMR 1.34, 95% CI 1.24 to 1.46) and respiratory diseases (SMR 1.14, 95% CI 1.00 to 1.28). There were 1477 cases of myocardial infarction, resulting in an SMR of 1.12 (95% CI 1.07 to 1.18). SMR was higher (1.35, 95% CI 1.22 to 1.50) for men aged ≤60 years than for those >60 years of age (1.06, 95% CI 1.00 to 1.13).

Conclusions: Mortality from myocardial infarction was higher than expected. There was also an increased risk of death from injuries and poisonings, lung cancer and respiratory diseases, as well as higher general mortality. Our findings support the results of previous studies that there is an association between working in the mining industry and adverse health outcomes.

Place, publisher, year, edition, pages
London: BMJ Publishing Group , 2009. Vol. 66, no 4, 264-268 p.
National Category
Medical and Health Sciences
Identifiers
URN: urn:nbn:se:umu:diva-3586DOI: 10.1136/oem.2008.040147PubMedID: 19017687OAI: oai:DiVA.org:umu-3586DiVA: diva2:142360
Available from: 2008-11-06 Created: 2008-11-06 Last updated: 2017-12-14Bibliographically approved
In thesis
1. Myocardial infarction and cardiac regulation in relation to vibration exposure
Open this publication in new window or tab >>Myocardial infarction and cardiac regulation in relation to vibration exposure
2008 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

The purpose of this thesis was to assess the possible risk of myocardial infarction in work entailing exposure to vibration, and to study whether there is any relation between short-term exposure to vibration and cardiac regulation.

Epidemiological methods were applied to investigate a possible association between occupational exposure to vibration and myocardial infarction. Two study populations were used; one case-control study (n=475) and one cohort of iron-ore miners in Kiruna and Malmberget, Sweden (n=13621). In the former, the cases were first-time myocardial infarction patients and the controls were selected to match for sex, age and hospital catchment area. Job-exposure matrixes for vibration were established for both the case-control study and the cohort study.

In order to study acute effects on cardiac regulation, an experimental study was conducted on healthy subjects (n=20) who were exposed to hand-arm vibration exclusively and in combination with exposure to noise. The effect on the autonomic balance was measured by heart rate-variability.

In the case-control study, an increased risk of contracting myocardial infarction was found among occupations entailing vibration exposure. The results from the cohort show an increased risk of myocardial infarction mortality compared to a reference population. The increment was higher for those younger than 60 years. Relative risks for myocardial infarction mortality increased with increasing exposure to vibration in the group at working-age and the increased risk remained after adjusting for exposure to dust. In the experimental study, exposure to hand-arm vibration was found to acutely affect the autonomic nervous system as the total heart-rate variability decreased during exposure to hand-arm vibration.

To conclude: work entailing exposure to vibration is a risk factor for myocardial infarction, increased myocardial infarction mortality attributed to exposure to vibration seems to be mainly observed at working-age, and exposure to hand-arm vibration acutely decreases heart-rate variability and thus affects heart-rate regulation.

Place, publisher, year, edition, pages
Umeå: Yrkes- och miljömedicin, 2008
Series
Umeå University medical dissertations, ISSN 0346-6612 ; 1185
Keyword
vibration exposure, myocardial infarction, cardiac regulation, exposure assessment, occupational exposure, epidemiology, cohort study, case-control study
Research subject
Occupational and Environmental Medicine
Identifiers
urn:nbn:se:umu:diva-1903 (URN)978-91-7264-571-4 (ISBN)
Public defence
2008-11-14, sal 933, 3A, NUS, Umeå, 13:00 (English)
Opponent
Available from: 2008-11-06 Created: 2008-11-06 Last updated: 2010-01-18Bibliographically approved

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