Mortality of iron and steel workers in Korea

• Published in: American journal of industrial medicine Vol. 48; no. 3; pp. 194 - 204
• Main Authors: Park, Robert M., Ahn, Yeon-Soon, Stayner, Leslie T., Kang, Seong-Kyu, Jang, Jae-Kil
• Format: Journal Article
• Language: English
• Published: Hoboken Wiley Subscription Services, Inc., A Wiley Company 01.09.2005; Wiley-Liss
• Subjects: Biological and medical sciences; Cardiovascular Diseases - mortality; Chemical and industrial products toxicology. Toxic occupational diseases; developing country; fatal work injury; Healthy Worker Effect; Humans; Iron; iron and steel industry; Korea; Medical sciences; Metallurgy; Metals and various inorganic compounds; mortality; Myocardial Ischemia - mortality; Neoplasms - mortality; Occupational Diseases; Regression Analysis; retrospective cohort study; Retrospective Studies; stainless steel; Steel; Stroke - mortality; Toxicology; Asia; Korea; Korea, Rep; Human; Mortality; Developing countries; Metallurgical industry; Iron; Occupational exposure; Heavy metal; retrospective cohort study; Occupational accident; developing country; Stainless steel; Cohort study; Iron steel industry; Worker; iron and steel industry; fatal work injury; Occupational medicine; Healthy worker effect
• ISSN: 0271-3586; 1097-0274
• DOI: 10.1002/ajim.20197

Background The mortality experience of iron and steel workers from modern plants in developing countries has not been extensively described. Methods Mortality at two Korean iron and steel manufacturing complexes was analyzed using Poisson regression methods with both direct and indirect standardization. Work histories were linked with a national mortality registry. Workers (44,974) hired beginning in 1968 were followed from 1992 to 2001. Results The 806 deaths observed during 10 years of follow‐up comprised 2% of the population at risk and represented a large healthy worker effect (HWE) for all causes (SMR = 0.59, 95% CI = 0.55–0.63) and for cancer (SMR = 0.79, 95% CI = 0.70–0.90). Mortality at subsidiaries was considerably higher than at the parent plants (SRR = 1.71, 95% CI = 1.47–1.99). Relative mortality rates declined with employment duration: > 20 years had significantly reduced mortality (SRR = 0.59, 95% CI = 0.43–0.82) compared to duration < 1 year (test for trend: P = 0.0006). Fatal injury deaths in the first year were highly elevated (SMR = 3.10, 95% CI = 2.17–4.26) declining to less than that expected after 5 years. Cancer mortality was elevated in stainless steel production (SRR = 3.26, 95% CI = 1.37–6.49) and overall mortality was elevated for work in plant maintenance departments (SRR = 1.17, 95% CI = 1.00–1.37), particularly for fatal injuries (SRR = 1.67, 95% CI = 1.29–2.14). All‐cause mortality increased with employment duration in the steel‐production departments, as did fatal injuries in material handling/construction. Conclusions This steelworker cohort exhibits excess mortality in some process areas. More detailed retrospective exposure assessment and future follow‐up of this cohort will better define health risks in the modern iron and steel manufacturing. Am. J. Ind. Med. 48:194–204, 2005. © 2005 Wiley‐Liss, Inc.