Mortality and cancer morbidity among cement production workers: a meta-analysis

Objectives: To analyze overall and cause-specific mortality, especially from cancer, among cement production workers. Introduction: Results from some epidemiological studies suggested an increased risk of overall mortality and of stomach cancer associated with employment in the cement production, but the presence of a hazard and, if present, the magnitude of a risk have not been precisely quantified. We conducted a systematic review and meta-analysis of data on mortality from all causes, cardiovascular or respiratory diseases, and cancer among cement workers. Methods: The literature search in PubMed and Scopus up to February 2016 and with appropriate keywords on mortality among cement workers revealed 188 articles which were screened. A total of 117 articles were reviewed in full text and 12 articles, referring to 11 study populations, were found to be relevant and of sufficient quality for further analysis. Meta-analyses were performed using a random-effects model. Results: Eight cohort studies, one proportionate mortality study, and two case–control studies were identified. The summary RRs were 0.89 [95 % confidence interval (CI) 0.76–1.01] for all-cause mortality, 0.94 (95 %, CI 0.80–1.08) for cancer mortality, 1.07 (95 % CI 0.79–1.35) for lung cancer mortality, and 0.93 (95 % CI 0.70–1.17) for stomach cancer mortality, respectively. Significant heterogeneity in results was observed among studies. Conclusion: The present meta-analysis does not provide evidence of increased risk of overall mortality, as well as cancer, cardiovascular or respiratory mortality in relation to employment in cement production. © 2016, Springer-Verlag Berlin Heidelberg.