| Introduction/rationale. Several occupational exposures that are widespread in the aluminum industry are suspected cardiotoxins. A case-control study nested in a longitudinal cohort study of aluminum workers was performed to examine the association of coronary artery disease (CAD) and four exposures [coal tar pitch volatiles (CTPV), particulates (total and respirable), heat and carbon monoxide], taking into account known CAD risk factors.; Method. 475 cases of CAD and 11,512 controls were investigated. CAD was defined using ICD-9 codes, 410, 411, 413 or 414. An extensive job dictionary and a job exposure matrix were created to assign exposure to relevant job titles. Cumulative exposure for CTPV [benzene soluble fraction (BSF)], benzo(a)pyrene (BAP), particulates (total and respirable) and carbon monoxide was calculated using qualitative industrial hygiene assessment and quantitative measurements and work history. A heat exposure index score was assigned based on the job at the time of diagnosis of CAD. A matched study design was used to evaluate risk of heat whereby two controls were assigned by the job they held during the same time period.; Results. The risk of CAD was similar in the cases compared to the controls for: BSF [odd ratio and 95% confidence interval (OR) 0.88 (0.61, 1.26)], BAP [OR 1.07 (0.99, 1.15)], respirable particulates [OR 1.0 (0.99, 1.01)], total particulate [OR 1.00 (0.99, 1.01)] and heat exposure [OR 0.97 (0.81, 1.15)]. Carbon monoxide showed a small but statistically significant increased risk of disease [OR 1.004 (1.001, 1.007)]. When investigated as a categorical variable (some occupational exposure versus no occupational exposure to carbon monoxide), there was a 41% increase in risk of CAD in cases compared to control [OR 1.41 (1.26, 1.72)].; Conclusion. There was a small but statistically significant association between carbon monoxide and CAD but no association between BSF, BAP, particulates and heat and CAD. |
