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Background: The UAB-ITREOH program has initiated a skill-based MPH program at Manipal University (MU), India, in 2009, to address the critical need for trained public health professionals and build institutional public health training capacity in the country., Methods: Funds from Fogarty have supported the curriculum development and specialized training of MU faculty to teach in the MPH program., Results: The program has been successfully launched and is gaining momentum. The lessons learned from our experiences as well as several challenges faced from the initialization to execution of the program are described in the article., Conclusions: Government support is crucial for raising the profile of this program by accreditation, creating job opportunities and by recognizing these professionals as leaders in the public health sector., (Copyright © 2012 Wiley Periodicals, Inc.)

Background: Although environmental and occupational health (EOH) research and services in Sri Lanka have a long history, policies related to EOH are outdated., Methods: We review the International Training and Research in Environmental and Occupational Health (ITREOH) program in Sri Lanka that commenced in 2006 as a collaboration between the University of Alabama at Birmingham and the Faculty of Medicine of the University of Kelaniya, Sri Lanka., Results: The program has trained over 20 scientists in conducting EOH research. New pioneering research in EOH was initiated. The program was instrumental in furthering the training and research in EOH by initiating a MPH degree program, the first in the country., Conclusions: The program has established North-South, South-South and in-country collaborations between institutions and scientists, increasing the visibility of EOH in the future., (Copyright © 2011 Wiley Periodicals, Inc.)

Background: This retrospective follow-up study evaluated mortality during 1970-1996 among 6,956 employees at a petrochemical research facility in Illinois., Methods: Standardized mortality ratios (SMRs) compared employees' mortality rates with those of the Illinois general population. Poisson regression procedures estimated rate ratios for various subject subgroups compared to other facility employees., Results: Subjects had 267 observed/524 expected deaths (SMR = 51) from all causes combined and a large deficit of deaths from all cancers (76/136, SMR = 56) and from most other major diseases. Other results included fewer than expected brain cancers (1/4.0, SMR = 25) and a slight increase in colorectal cancer (20/14, SMR = 139) that was concentrated in white male scientists employed for one of the three main companies at the facility (SMR = 295, RR = 2.6)., Conclusions: The deficit of brain cancer deaths contrasts with an excess incidence seen in a companion study. Subjects' generally favorable mortality experience probably reflects socioeconomic advantages of employees relative to the Illinois general population., (Copyright 2001 Wiley-Liss, Inc.)

Background: The purpose of this investigation was to evaluate the relation between employment in motor vehicle manufacturing (MVM) and fatal prostate cancer., Methods: The study included 322 prostate cancer deaths occurring in 1973 through 1987 and 1,285 controls, selected from a cohort of 126,100 male MVM workers., Results: Men employed in casting operations had an odds ratio of 1.5 (95% CI = 1. 1-2.0). The association was consistent across casting facilities and was attributable primarily to work in core and mold making (OR = 1.5, 95% CI = 1.1-2.2) and metal melting and pouring jobs (OR = 1.9, 95% CI = 1.0-3.6). Other results included ORs of 1.9 (95% CI = 1.0-3.7) for warehousing and distribution operations and 2.1 (95% CI = 1.2-3. 7) for electric and electronic equipment manufacturing. The latter two associations exhibited little internal consistency., Conclusions: The relationships seen in this study were weak and may have been due to chance. Core and mold making and metal melting and pouring foundry operations entail potential exposure to metal dusts and fumes, to polycyclic aromatic hydrocarbons (PAHs), and to other chemicals. However, associations between these exposures and prostate cancer have not been reported consistently, nor have other studies of foundry workers consistently noted an excess of prostate cancer., (Copyright 2000 Wiley-Liss, Inc.)

Background: From 1970 through 1997, 17 intracranial neoplasms were identified among 6,800 employees of a petrochemical research facility. This investigation describes the case-series., Methods: The intracranial neoplasms were identified by self reports and record linkages, and were confirmed by medical records and a pathology review. Standardized incidence ratios (SIRs) compare observed and expected numbers of cases according to certain work characteristics., Results: Overall, there were 17 observed and 10.5 expected intracranial neoplasms, including 11/4.7 benign intracranial tumors and 6/5.9 brain cancers. All brain cancers occurred among male research scientists or technicians. Four had worked at some time on the same floor of one building (SIR=12.6, 95% CI=3.4-32.1), and several had worked on a research project with at least one other brain cancer case. The benign intracranial neoplasm cases did not have common building assignments or work activities., Conclusions: The occurrence pattern of brain cancers, but not that of benign tumors, suggests a possible occupational etiology., (Copyright 1999 Wiley-Liss, Inc.)

A nested case-control study of lung cancer was conducted among workers at an iron foundry and two engine manufacturing plants whose lung cancer mortality rates were slightly higher than expected. The study included 231 lung cancer cases and 408 controls for whom complete work histories were obtained. There was no association between usual plant of employment and lung cancer mortality. The odds ratio for persons employed for 20 or more years in the foundry compared with persons employed in the engine plants was 0.90 (95% confidence interval: 0.55, 1.5). Long-term employment as an engine plant worker was associated with odds ratios slightly, but not statistically significantly, below unity. In the foundry, only usual employment in the material handling departmental group and any employment in the quality control departmental group were statistically significantly directly related to lung cancer risk. However, the number of subjects so employed was small and there was no dose-response relation between length of employment in these departmental groups and lung cancer risk. Cases were less frequently employed than were controls in engine plant machining and assembly jobs and departments. It is concluded that employment in this facility was either unrelated, or only weakly related, to lung cancer risk.

Triazine herbicides, used extensively in the United States, have not been assessed adequately for carcinogenicity in humans. This study evaluated the mortality experience during the period 1960-1986 of 2,683 men with definite or probable manufacturing exposure to triazine herbicides and 2,234 men with possible exposure to triazines. Standardized mortality ratios (SMRs) were computed as the observed numbers of deaths among study subjects divided by the numbers expected on the basis of general population mortality rates. Subjects with definite or probable exposure to triazines had a favorable mortality experience, compared with U.S. men [all causes, SMR = 72, 95% confidence interval (CI) = 58-89; all cancer, SMR = 85, CI = 46-142]. This group had an increase in deaths from non-Hodgkin's lymphoma (NHL) (3 observed/0.78 expected, SMR = 385, CI = 79-1,124). Two of the decedents with NHL had worked for less than 1 year in triazine-related jobs. Among the 2,234 subjects with possible triazine-related work, the mortality rate for all causes combined was similar to the rates of U.S. men. There was only one confirmed death from NHL. On balance, the results were consistent with previous investigations, which have found no convincing evidence of a causal link between triazines and cancer. However, the exposed cohorts were relatively young and had, on average, only 18 years of follow-up. In particular, results were imprecise for subjects having both a long duration of exposure and long potential induction periods.

This retrospective follow-up study evaluated the mortality experience of 11,271 women employed in a large motor vehicle manufacturing company in 1973. Company computerized personnel records were used to identify subjects and to obtain their employment histories. Follow-up through December 31, 1985, was conducted using company, state, and national data sources. The mortality rates of the cohort were compared with the rates of the U.S. general population of white or black women, adjusting for age and calendar time and using the standardized mortality ratio (SMR) as the measure of association. The overall mortality rate of the cohort was lower than the U.S. rate by 15% among whites (SMR = 85, 95% confidence interval (CI) = 78-93) and by 40% among blacks (SMR = 59, CI = 49-70). Among whites, the low mortality rate was due primarily to deficits of noncancer deaths, although a 32% deficit also was observed for breast cancer (SMR = 68, CI = 48-92). Black female workers had 40% fewer deaths than expected overall, and their all cancer SMR also was below expectation (SMR = 82, CI = 60-109). Despite evidence of a strong healthy worker effect among women in the motor vehicle manufacturing industry, the study found excesses of lung cancer among white women in assembly jobs (SMR = 158, CI = 107-226) and of pancreatic cancer among white assembly workers in upholstery and trim operations (SMR = 302, CI = 97-704).

A retrospective follow-up study of 21,013 workers employed at a foundry and two engine manufacturing plants was conducted to determine if these workers had an unusual mortality experience. A total of 2,235 deaths occurred during the follow-up period of 1970-1987. Mortality from all causes was lower than expected. Men experienced a 6-13% excess of lung cancer deaths, depending on the choice of the comparison group. The data displayed evidence of a positive trend between lung cancer mortality and increasing duration of employment (p = 0.008). White men experienced a statistically significant excess of deaths from stomach cancer (standardized mortality ratio [SMR] = 158; 95% confidence interval [CI] = 101-234). Black men had increased mortality from pancreatic cancer, especially among engine plant workers (SMR = 303; CI = 121-624), and an excess of prostate cancer, concentrated among foundry workers (SMR = 234; CI = 112-430).

This retrospective follow-up study evaluates the mortality experience of 123,232 male hourly workers employed at a motor vehicle manufacturing company in 1973. Company computerized personnel records were used to identify subjects and to obtain their employment history. Follow-up through December 31, 1985 was conducted using company, state, and national data sources. The mortality rates of the cohort were compared with the rates of the United States (U.S.) general population of white or black men, adjusting for age and calendar time, and using the standardized mortality ratio (SMR) as the measure of association. The overall mortality rate of cohort members is lower than the U.S. rate by 11% among whites (11,060 observed/12,427 expected deaths; SMR = 89) and by 24% among blacks (3,744/4,926 deaths; SMR = 76). These low mortality rates reflect deficits of diseases other than cancer. Cancer SMRs are 99 for whites and 90 for blacks. There are slight excesses of stomach cancer (SMR = 113) and of lung cancer (SMR = 108) among whites and of cancer of the large intestine and rectum (SMR = 114) and of the lymphopoietic tissue (SMR = 111) among blacks. Both whites and blacks have a large deficit of buccal cancer and pharynx cancer, and blacks also have a deficit of esophagus cancer. The cohort's overall deficit of deaths is due largely to the favorable mortality experience of active workers. In contrast, white subjects who have left active employment have an 11% mortality excess, and inactive black subjects have a mortality rate that is similar to the general population rate. The increased mortality among inactive whites is not limited to any one particular disease category. This pattern may reflect illness-related employment termination and generalized confounding by socioeconomic status, although the study does not rule out a relationship between workplace exposures and specific diseases.

This survey was designed to assist with planning epidemiologic studies of the effects of solvent exposure among motor vehicle manufacturing workers. The objectives were to identify subgroups of workers with solvent exposure, and to evaluate the availability of data for a job-exposure matrix (JEM). Of 65 plants selected, 31 (48%) participated. Participant plants represent all production activities initially included in the survey, and employ 97,655 hourly workers. About 14% of these workers use organic solvents (direct exposure), and 19% work in the proximity of solvent-using operations (indirect exposure). However, only 3% have direct exposure, and 6% have indirect exposure to large-volume (> or = 100 gallons/month)/high-frequency (hourly)-use solvents. The highest solvent exposure prevalence occurs in plants manufacturing engines and power train components and in metal degreasing/cleaning and painting tasks, and entails exposure to petroleum fractions, aromatic hydrocarbons, alcohols, and ketones. A JEM can be developed using plant records on job titles, work histories, production scheduling, and plant engineering, and using the corporate computerized personnel and industrial hygiene databases. However, information on solvent use and on exposure is adequate only for recent time periods.

This case-control study evaluated the relationship between lung cancer and occupational factors among employees at a dye and resin manufacturing plant. The study included 51 lung cancer cases and 102 controls who were members of a cohort of workers investigated in a previous retrospective follow-up study. Information on area of employment and on potential exposure to certain chemicals was obtained from plant personnel and medical records and from interviews with long-term employees. Information on potential confounders, including cigarette smoking, was obtained by interviewing study subjects or their next-of-kin. The odds ratio (OR) for heavy smokers compared with light or nonsmokers was 5.9 (95% confidence interval (CI) = 2.4-15). An elevated OR for lung cancer was observed for subjects who worked in the anthraquinone dye and epichlorohydrin manufacturing area of the plant (OR = 2.4; 95% CI = 1.1-5.2) and for employees who were seen at the plant infirmary for acute exposure to chlorine (OR, adjusted for smoking = 27; 95% CI = 3.5-205). Pipefitters employed at the plant for five or more years also had an elevated OR (3.3; 95% CI = 0.8-14).

This retrospective follow-up study evaluated the mortality experience of 4,323 men employed at a plant in Alabama (AL) that manufactures agricultural and other chemicals. On average, there were 18 years of follow-up per subject during the study period of 1951 to 1987. The observed numbers of deaths among cohort members were compared with the numbers expected on the basis of United States (US) and AL general population mortality rates. The all causes standardized mortality ratio (SMR), computed using US rates as the referent, was 97 (233 observed/240 expected deaths) for whites and 68 (47/69) for blacks. White subjects had more than expected deaths from buccal cavity and pharynx (BCP) cancer [SMR = 388; 95% confidence interval (CI) = 125-905] and from esophageal cancer (SMR = 417; 112-1,067). Their lung cancer mortality rate was 50% higher than the rate of US white men and 14% higher than the rate of AL white men. Each of these three cancers has strong nonoccupational determinants, the roles of which were not assessed and which may have been responsible in whole or in part for the observed increases. The excesses of lung and esophageal cancer were concentrated among short-term employees, an observation which also argues against a causal link with occupational factors. Black men experienced no increased mortality from BCP, esophageal or lung cancer, but results for blacks were imprecise. For white and black subjects combined, there were 3 observed versus 0.62 expected deaths due to soft tissue sarcoma (p = 0.05). The job histories of subjects with this type of cancer did not suggest any shared occupational exposure.

In this case-control study the detailed employment histories of 121 rubber plant employees who died of lung cancer from 1964 through 1973 were compared to those of 448 plant employees (controls) who died of other causes during the same calendar period. All subjects were white male hourly employees. Lung cancer cases and controls were matched individually on year of birth and year of first hire at the plant. Results of matched analyses indicated that there was no association between lung cancer mortality and employment in either rubber compounding and mixing jobs or curing jobs. Men who had worked for at least five years in rubber reclaim operations, where there was potentially heavy exposure to particulates and fumes, experienced a twofold increase in lung cancer risk. In addition, there was a 70% excess of lung cancer risk among men employed in making special products, where the primary production activity was fuel cell manufacturing. The latter two findings were marginally statistically significant.

This report compares the mortality experience of 6,533 men employed in the industrial products division of a rubber manufacturing company with that of U.S. males and of other rubber workers. For most causes of death the mortality rates of industrial products workers were lower than those of U.S. males and similar to those of other rubber workers. Relative to other rubber workers, men in the industrial products division had a 50% excess of deaths from lymphoma, a 90% excess of deaths from multiple myeloma, and a 20% excess of deaths from bladder cancer during the study period. The excesses of lymphoma and multiple myeloma were strongest during recent follow-up in 1970-78 (observed/expected deaths: 10/4.3 for lymphoma; 10/4.4 for multiple myeloma), whereas bladder cancer mortality was not excessive during this calendar period.

This study evaluated cause-specific mortality among 3,161 men who were employed in the aerospace division of a rubber manufacturing company. Compared to other production workers at the plant, aerospace workers in deicer and fuel cell manufacturing jobs experienced a 60% excess of deaths from lung cancer. Deicer and fuel cell workers who were under 65 years of age had lung cancer rates that were approximately twice those of other rubber workers of comparable age. Aerospace division employees also had elevated rates of bladder cancer, leukemia, lymphoma, and multiple myeloma. However, detailed analyses suggested that, with the exception of lung cancer, these cancer excesses were not likely to be attributable to employment in the aerospace division.

A retrospective follow-up study was conducted to evaluate mortality and cancer incidence between 1954 and 1976 among 1,792 white male production workers employed for at least 2 years at a tire manufacturing plant. There were no marked excesses in overall or site-specific cancer deaths or incident cases. Compared to U.S. white males, men employed for at least 10 years experienced small increases in deaths from cancers of the large intestine, pancreas, and lung. Results obtained by comparing observed incident cancer cases to the numbers expected based on age- and calendar time-specific incidence rates of Connecticut males also suggested excesses of these three malignancies. These findings were based on small numbers and therefore do not necessarily indicate causal associations between cancer excesses and employment in the rubber tire industry. However, because the workers studied comprised a relatively young population that may not have experienced the full impact of carcinogenic occupational exposures, further follow-up is warranted.

This research examined mortality among 1,152 white male production workers employed in the tire-curing department of a large rubber manufacturing plant. To determine whether these men had any cause-specific mortality excesses, their experience was compared with that of both the U.S. white male general population and a group of production workers at the same plant who had not worked in the curing division. Both types of comparisons indicated that the curing workers experienced excess mortality from lung cancer. There were 45 deaths from lung cancer among curing workers compared to 24.6 expected based on the age- and calendar period-specific rates of other rubber workers. In addition, the mortality rate ratio for pneumonia was 2.2 for curing relative to noncuring workers. These findings are consistent with the results of other studies and suggest that occupational exposures may have contributed to the development of pulmonary disease among curing workers.

This study evaluated the mortality experience of 1,352 white and 438 nonwhite men who worked in the rubber-reclaiming division of a large rubber manufacturing company. In comparisons of mortality of white reclaim workers with that of nonreclaim workers rate ratios were 2.7 for esophageal cancer (six observed deaths among reclaim workers), 2.1 for bladder cancer (seven observed deaths), and 4.5 for multiple myeloma (six observed deaths). The excess of bladder cancer among white reclaim workers may be associated with their employment in other high-risk areas of the plant, whereas no such explanation was found for the excesses of esophageal cancer and multiple myeloma. Overall, the lung cancer mortality rate of white reclaim workers was similar to the rate of US white males and other white rubber workers. There was a 50% excess of lung cancer deaths among nonwhite reclaim workers compared with other nonwhite rubber workers. However, this observation is based on small numbers, and no firm conclusions can be reached about the risk of lung cancer associated with reclaim operations in this group of rubber workers.

A death certificate-based case-control study was performed to investigate associations between occupation and non-Hodgkin's lymphoma (NHL) in North Carolina. Cases consisted of 501 men who died of NHL (International Classification of Diseases codes 200 and 202) during the years 1968-1970, 1975-1977, and 1980-1982. Controls were selected from other noncancer deaths, and were frequency matched for age, year of death, and race. Occupation and industry were obtained from the death certificates and coded without knowledge of case-control status. An increased risk for men in professional, technical, and managerial occupations, compared with all others, was detected among whites (OR = 2.69, 1.95-3.72). Black men classified as having "low exposures" by an occupational exposure linkage system had an odds ratio of 1.74 (0.84-3.60). Because of this finding, the occupations were ranked by social class and a statistically significant linear relationship was noted in whites, with risk increasing from lower social class to upper social class. An increased risk was also detected among whites in the rubber, plastics, and synthetics industries (p = .03), and among blacks employed in machine trades occupations (OR = 3.63, 1.32-9.97) and structural work occupations (OR = 2.38, 0.93-6.05). An increased risk was also detected for black painters (p = .02), but not for whites. There was no association found between NHL and employment in the following areas: textile industry; farming; laborers; or occupations with exposures to asbestos or benzene. The association with farming was further examined in counties with high use of pesticides and herbicides, and no increased risk of NHL was detected. Cases were more likely to live in the western part of the state than the eastern. However, NHL mortality rates provided by the North Carolina State Center for Health Statistics did not confirm the relationship.