1.Radiation Exposure and Cancer Mortality Among Nuclear Power Plant Workers: a Meta-analysis.
Eun Sook PARK ; Kieun MOON ; Han Na KIM ; Won Jin LEE ; Young Woo JIN
Journal of Preventive Medicine and Public Health 2010;43(2):185-192
OBJECTIVES: We conducted a meta-analysis to investigate the relationship between low external doses of ionizing radiation exposure and the risk of cancer mortality among nuclear power plant workers. METHODS: We searched MEDLINE using key words related to low dose and cancer risk. The selected articles were restricted to those written in English from 1990 to January 2009. We excluded those studies with no fit to the selection criteria and we included the cited references in published articles to minimize publication bias. Through this process, a total of 11 epidemiologic studies were finally included. RESULTS: We found significant decreased deaths from all cancers (SMR = 0.75, 95% CI = 0.62 - 0.90), all cancers excluding leukemia, solid cancer, mouth and pharynx, esophagus, stomach, rectum, liver and gallbladder, pancreas, lung, prostate, lymphopoietic and hematopoitic cancer. The findings of this meta-analysis were similar with those of the 15 Country Collaborative Study conducted by the International Agency for Research on Cancer. A publication bias was found only for liver and gallbladder cancer (p = 0.015). Heterogeneity was observed for all cancers, all cancers excluding leukemia, solid cancer, esophagus, colon and lung cancer. CONCLUSIONS: Our findings of low mortality for stomach, rectum, liver and gallbladder cancers may explained by the health worker effect. Yet further studies are needed to clarify the low SMR of cancers, for which there is no useful screening tool, in nuclear power plant workers.
Humans
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Neoplasms, Radiation-Induced/*mortality
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*Nuclear Power Plants
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Occupational Diseases/*mortality
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Occupational Exposure/adverse effects
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Radiation Monitoring
2.Suicide Mortality Across Broad Occupational Groups in Greece: A Descriptive Study.
Evangelos C ALEXOPOULOS ; Katerina KAVALIDOU ; Fani MESSOLORA
Safety and Health at Work 2016;7(1):1-5
BACKGROUND: Several studies have investigated the relationship between specific occupations and suicide mortality, as suicide rates differ by profession. The aim of this study was to investigate suicide mortality ratios across broad occupational groups in Greece for both sexes in the period 2000-2009. METHODS: Data of suicide deaths were retrieved from the Hellenic Statistical Authority and comparative mortality ratios were calculated. Occupational classification was based on the International Classification of Occupations (ISCO-88) and the coding for Intentional self-harm (X60-X84) was based on the international classification of diseases (ICD-10). RESULTS: Male dominant occupations, mainly armed forces, skilled farmers and elementary workers, and female high-skilled occupations were seen as high risk groups for suicide in a period of 10 years. The age-productive group of 30-39 years in Greek male elementary workers and the 50-59 age-productive group of Greek professional women proved to have the most elevated number of suicide deaths. CONCLUSION: Further research is needed into the work-related stressors of occupations with high suicide mortality risk and focused suicide prevention strategies should be applied within vulnerable working age populations.
Arm
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Classification
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Clinical Coding
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Female
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Greece*
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Humans
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International Classification of Diseases
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Male
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Mortality*
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Occupational Groups*
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Occupational Health
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Occupations
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Risk Assessment
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Suicide*
3.Compensation for Occupational Injuries and Diseases in Special Populations: Farmers and Soldiers.
Journal of Korean Medical Science 2014;29(Suppl):S24-S31
Some types of workers such as farmers and soldiers are at a higher risk of work-related injury and illness than workers from other occupations. Despite this fact, they are not covered under the Industrial Safety Health (ISH) Act or the Industrial Accident Compensation Insurance (IACI) Act. The Safety Aid System for Farmers (SASF) is a voluntary insurance scheme, and it is the only public compensation plan for self-employed farmers. Fifty percent of SASF premiums are subsidized by the Korean government. Soldiers are compensated by the Veterans' Pension (VP) Act. The approval standard of and procedure for the VP Act are provided in the Decree of VP Act, and the Council for VP Benefits determines work-relatedness in the claimed cases. Meanwhile, SASF applies the insurance clause automatically without any expert advice or additional procedures. Furthermore, compared with IACI, these programs pay fewer benefits to workers. Thus, a stronger institutional strategy is needed to maintain a safe work environment, to protect workers' health in unavoidably hazardous environments, and to compensate for work-related injuries and diseases.
Accidents, Occupational/economics
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*Agriculture
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Female
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Humans
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Insurance, Accident/economics
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Insurance, Health/economics
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Male
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*Military Personnel
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Occupational Diseases/*economics/mortality
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Occupational Health/economics
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Occupational Injuries/classification/*economics/mortality
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Republic of Korea
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Risk
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Workers' Compensation/*economics/standards
4.Significance of Time-dependent Exposure Variable in Occupational Disease Study.
Korean Journal of Occupational and Environmental Medicine 1997;9(2):201-207
Although the final cumulative exposure has been used as a exposure variable on the cohort study for the relation between exposure and disease, the bias from the use of fixed exposure can be developed because the exposure amount changes across the time. We developed the program to handle the Cox model with irregularly changing time-dependent exposure variable and covariates, and the validity about the application of time-dependent exposure variable and lagged interval was practically evaluated by analyzing the data collected for typical retrospective cohort study with that program. The results were as follows : The exposure-response relations between the deaths from lung cancer and exposures (fixed or time-dependent) were not clear when 0 year lagged interval was applied. When 15 years lagged interval was applied, the exposure-response relations between the deaths from lung cancer and the time-dependent exposures to crystalline silica were observed and relative risky increased like 1.00, 1.17, 1.30 and 2.45 across the exposure levels. The relative risk estimates for lung cancer with time-dependent exposure variable were higher than those with fixed exposure variable without regard to the application of lagged interval. The exposure-response relations between the deaths from non-malignant respiratory disease (NMRD) and exposures (fixed or time-dependent) were observed across exposure levels when 0 year lagged interval was applied. When 15 years lagged interval wag applied, the exposure-response relations between the deaths from NMRD and the time-dependent exposures to crystalline silica were observed, but were not with fixed exposure variable. The relative risk estimates for NMRD mortality with time-dependent exposure variable were higher than those with fixed exposure variable, and the application of lagged interval on the evaluation of NMRD mortality was meaningless. The results suggests that the application of time-dependent exposure variable on the study of exposure-effect relation should be considered and the application of lagged interval should be decided according to the time needed from disease detection to death.
Bias (Epidemiology)
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Cohort Studies
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Crystallins
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Lung Neoplasms
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Mortality
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Occupational Diseases*
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Retrospective Studies
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Silicon Dioxide
5.Cohort mortality study of workers in an automobile foundry factory.
Yu-Yu ZENG ; Fu-Ying LIU ; Min ZHANG ; Rui LU ; Hui-Lin YAO ; Qiu-Ling YANG ; Wei-Hong CHEN
Chinese Journal of Industrial Hygiene and Occupational Diseases 2008;26(10):596-600
OBJECTIVETo understand the major causes of death in automobile foundry workers and investigate casting manipulations hazards to health.
METHODSA cohort study of 3529 foundry workers registered in one big automobile factory in Shiyan city of China was performed. Standardized mortality ratios (SMRs) were calculated for the main causes of death by using Chinese national mortality rates as reference.
RESULTSThe cohort mortality was traced from 1980 to the end of 2005 with an accumulation of 84 999 person-years, revealed 265 deaths. The results of this study showed that the standardized mortality ratio for all subjects was 0.96 (95% CI: 0.85 approximately 1.08), which was very close to that expected on the basis of the China national mortality rates. The SMR increased with age, the SMR became greater than 1 in all groups of age 50 and higher. The results showed that malignant neoplasm (3.43%), accidents (1.16%), cerebro-vascular diseases (1.08%), cardio-vascular diseases (0.79%) were the first four illnesses that threatened workers' life span. Statistically significant mortality of malignant neoplasm (SMR = 7.87), accidents (SMR = 2.70), cardio-vascular diseases (SMR = 2.68) and digestive diseases (SMR = 2.79) were found in the foundry workers. The relative risk of malignant neoplasm for first line workers to assistant workers was 1.99 (P < 0.05).
CONCLUSIONThe occupational hazards in foundry factory have harmful impact on the workers' health and life span.
Automobiles ; Cause of Death ; China ; epidemiology ; Female ; Follow-Up Studies ; Humans ; Male ; Metallurgy ; Mortality ; Occupational Diseases ; mortality ; Occupational Exposure ; statistics & numerical data ; Retrospective Studies
6.Cancer mortality and asbestosis among workers in an asbestos plant in Chongqing, China.
Fei ZHONG ; Eiji YANO ; Zhi-Ming WANG ; Mian-Zhen WANG ; Ya-Jia LAN
Biomedical and Environmental Sciences 2008;21(3):205-211
OBJECTIVETo investigate whether asbestosis is a risk factor for mortality of lung cancer.
METHODSA fixed cohort study was established in an asbestos plant in Chongqing, China, and followed up for 30 years from the beginning of 1972. Basic personal information on life state, cause of death, and diagnosis of asbestosis was collected. Multiple logistic regressions were applied to analyze risk factors.
RESULTSDuring the 30-year follow-up, 584 male workers constituting a total of 14,664 person-years were monitored and data were analyzed. Among them, 203 (34.8%) died and the mortality rate was 13.8 per 1000 person-years, cancer accounting for 37.4%. Excess risks were observed for lung cancer (OR = 3.72) and nonmalignant respiratory diseases (OR = 2.73) among workers with asbestosis. High-exposure level was another risk factor for lung cancer (OR = 3.20). Workers with category II of asbestosis demonstrated a higher OR of both lung cancer and nonmalignant respiratory diseases than those with category I of asbestosis.
CONCLUSIONHigh asbestos exposure level and asbestosis were the risk factors for death of lung cancer and nonmalignant respiratory diseases. Asbestosis is an independent risk factor for lung cancer among Chinese workers exposed to chrysotile, the risk increases with the increasing profusion of opacities of lung.
Adult ; Air Pollutants, Occupational ; toxicity ; Asbestos, Serpentine ; toxicity ; Asbestosis ; complications ; mortality ; Chemical Industry ; China ; epidemiology ; Humans ; Lung Neoplasms ; chemically induced ; mortality ; Male ; Occupational Diseases ; chemically induced ; mortality ; Occupational Exposure ; adverse effects ; Odds Ratio ; Risk Factors
7.Occupational Radiation Exposure and Health Effects among Medical Workers.
Korean Journal of Medicine 2018;93(3):237-246
Medical radiation workers occupy the largest group of radiation workers and is rapidly increasing worldwide. They expose to protracted low-dose radiation and include a large proportion of women. The purpose of this article is to provide an overview of occupational radiation exposure and health effects among medical radiation workers through literature review and from the findings of Korean medical radiation workers' studies. Occupational radiation exposure increases the risk of many chronic diseases including cancer, cataract, cardiovascular diseases, thyroid diseases, and others. Although Korean medical radiation workers had a more favorable mortality than in general population, male workers experienced higher mortality from all cancers, leukemia, cancers of the stomach and the colon, and diseases of circulatory system after adjusting for the lower overall mortality. The potential adverse health risks from occupational radiation exposure are not negligible in medical radiation workers if current working level remains. Therefore, effective prevention efforts are needed to reduce the risks of diseases from occupational radiation exposures.
Cardiovascular Diseases
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Cataract
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Chronic Disease
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Colon
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Female
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Humans
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Leukemia
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Male
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Mortality
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Occupational Exposure
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Radiation Exposure*
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Stomach
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Thyroid Diseases
8.The Scope and Specific Criteria of Compensation for Occupational Diseases in Korea.
Jaechul SONG ; Inah KIM ; Byung Soon CHOI
Journal of Korean Medical Science 2014;29(Suppl):S32-S39
The range of diseases covered by workers' compensation is constantly expanding. However, new regulations are required for the recognition of occupational diseases (ODs) because OD types evolve with changes in industrial structures and working conditions. OD criteria are usually based on medical relevance, but they vary depending on the social security system and laws of each country. In addition, the proposed range and extent of work-relatedness vary depending on the socio-economic conditions of each country. The Labor Standards Act (LSA) and the Industrial Accident Compensation Insurance Act (IACIA) of Korea employ lists based on their requirements without listing causes and diseases separately. Despite a considerable reshuffle in 2003, the basic framework has been maintained for 50 yr, and many cases do not fit into the international disease classification system. Since July 1, 2013, Korea has expanded the range of occupational accidents to include occupational cancers and has implemented revised LSA and IACIA enforcement decrees. There have been improvements to OD recognition standards with the inclusion of additional or modified criteria, a revised and improved classification scheme for risk factors and ODs, and so on.
Accidents, Occupational/*classification/*economics
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Humans
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Insurance, Accident/economics
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Insurance, Health/economics
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Neoplasms/chemically induced
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Occupational Diseases/*classification/*economics/mortality
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Occupational Exposure/adverse effects
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Occupational Health
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Republic of Korea
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Risk Factors
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Workers' Compensation/*economics/legislation & jurisprudence/standards
9.An analysis of the main causes of death in different industrial systems in Guangzhou.
Weiwei LIU ; Chaoqiang JIANG ; Tai Hing LAM ; Weisen ZHANG ; Hosy A HEDLEY ; Changqi ZHU ; Jianmin HE ; Min CAO
Chinese Journal of Industrial Hygiene and Occupational Diseases 2002;20(4):289-292
OBJECTIVETo study the main causes of death in workers from different industries in Guangzhou.
METHODSThe industrial systems in Guangzhou were classified into six categories according to the Chinese Public Health Inspection Statistical Report. Baseline data on 79,547 workers, age > or = 35, were retrieved from individual health records under the Guangzhou Occupational Health Surveillance Record System established in 1989-1992. In this prospective cohort study, the workers' vital status and causes of death were followed up until 31 December 1998. Using SPSS 10.0, crude death rates were calculated and relative risks(RR) (95% CI) were estimated using Cox proportional-hazard models.
RESULTS(1) Among 79,547 workers were 49,355 men and 30,192 women, with mean age of (43.8 +/- 6.5) years, and 64% were aged 35-44. The mean age difference of workers in different industries was +/- 1 year. At baseline, 41% had been exposed to occupational hazards. Exposure was most prevalent in petroleum chemical industry(53.9%), followed by metallurgical industry, and the lowest exposure was in mechanical industry (30.2%). (2) The mean follow-up period was (8.0 +/- 1.3) years with 633,510 person-years. 1,577 workers had died with a total death rate of 248.9 per 100,000 person-years. The death rate in rubber industry was the highest, followed by metallurgical and petroleum chemical industries. Malignant neoplasms, vascular and respiratory diseases were most common, constituting 80.3% of all causes of death. (3) For all causes of death and the three main categories, the top three crude death rates were observed in rubber and petroleum chemical industries, and in the metallurgical industry except for vascular causes. The rubber industry had the highest crude death rate for all and vascular causes, and the metallurgical industry for malignant neoplasms and respiratory causes. (4) With the light industry as a reference (RR = 1.0), the metallurgical industry had the highest adjusted relative risks (RR) (95% CI) of 1.62(1.20-2.18) and 7.42(3.38-16.31) for malignant neoplasms and respiratory causes, respectively. The rubber industry had the highest RR of 1.69(1.40-2.04) for all causes. A significant RR of 2.03(1.43-2.88) for vascular causes was observed only in the rubber industry.
CONCLUSIONSThe main causes of death varied from industry. Malignant neoplasms and respiratory diseases were the leading causes in metallurgical and petroleum chemical industries. In rubber industry, vascular and respiratory causes were most common. Preventive measures for disease control should be tailor-made for each industry.
Adult ; Aged ; Cause of Death ; Cohort Studies ; Female ; Humans ; Industry ; Male ; Middle Aged ; Occupational Diseases ; mortality ; Occupational Exposure ; Proportional Hazards Models ; Prospective Studies
10.Does formaldehyde have a causal association with nasopharyngeal cancer and leukaemia?
Soon Chan KWON ; Inah KIM ; Jaechul SONG ; Jungsun PARK
Annals of Occupational and Environmental Medicine 2018;30(1):5-
BACKGROUND: The South Korean criteria for occupational diseases were amended in July 2013. These criteria included formaldehyde as a newly defined occupational carcinogen, based on cases of “leukemia or nasopharyngeal cancer caused by formaldehyde exposure”. This inclusion was based on the Internal Agency for Research on Cancer classification, which classified formaldehyde as definite human carcinogen for nasopharyngeal cancer in 2004 and leukemia in 2012. METHODS: We reviewed reports regarding the causal relationship between occupational exposure to formaldehyde in Korea and the development of these cancers, in order to determine whether these cases were work-related. RESULTS: Previous reports regarding excess mortality from nasopharyngeal cancer caused by formaldehyde exposure seemed to be influenced by excess mortality from a single plant. The recent meta-risk for nasopharyngeal cancer was significantly increased in case-control studies, but was null for cohort studies (excluding unexplained clusters of nasopharyngeal cancers). A recent analysis of the largest industrial cohort revealed elevated risks of both leukemia and Hodgkin lymphoma at the peak formaldehyde exposure, and both cancers exhibited significant dose-response relationships. A nested case-control study of embalmers revealed that mortality from myeloid leukemia increased significantly with increasing numbers of embalms and with increasing formaldehyde exposure. The recent meta-risks for all leukemia and myeloid leukemia increased significantly. In South Korea, a few cases were considered occupational cancers as a result of mixed exposures to various chemicals (e.g., benzene), although no cases were compensated for formaldehyde exposure. The peak formaldehyde exposure levels in Korea were 2.70–14.8 ppm in a small number of specialized studies, which considered anatomy students, endoscopy employees who handled biopsy specimens, and manufacturing workers who were exposed to high temperatures. CONCLUSION: Additional evidence is needed to confirm the relationship between formaldehyde exposure and nasopharyngeal cancer. All lymphohematopoietic malignancies, including leukemia, should be considered in cases with occupational formaldehyde exposure.
Biopsy
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Case-Control Studies
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Classification
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Cohort Studies
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Endoscopy
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Formaldehyde
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Hodgkin Disease
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Humans
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Korea
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Leukemia
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Leukemia, Myeloid
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Mortality
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Nasopharyngeal Neoplasms
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Occupational Diseases
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Occupational Exposure
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Plants
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Workers' Compensation