Comparison of the Total Mortality Risk for Nuclear Workers, Uranium Miners and other Occupations with the Risk of Passive Smoking (Meta-Analysis)

Despite thousands of studies and about 150 meta-analyses for the effects of second hand smoking (SHS) on the mortality risks from individual diseases for mortality from all causes there are two orders of magnitude less work and only one meta-analysis Lv X. et al, 2015. Based on a selected sample of works (search in MEDLINE, PubMed, Cochrane Library, Elibrary, Google and reference lists of sources) on all cause mortality due to SHS for exposure to adults (18 publications; 1984–2014), a systematic review, combined analysis and meta-analysis of the appropriate risk (Relative Risk, RR; odds ratio, OR and Hazard Ratio, HR), the value of which was 1.14 (95 % confidence intervals: 1.10, 1.19). This value according to the gradation of risks (R. Monson, 1980, 1990) is ‘indeterminable’, but when compared with the risks of mortality from occupational factors, it is very significant. By searching through these systems, as well as in the supported database, a selection of meta- and pooled analyzes on the Standardized Mortality Ratio (SMR) for all causes with reference to various kinds of activity, including harmful/dangerous trades was collected. For a number of professions, their own meta-analyses have previously been performed. Of the 20 employment types considered, only five (25 %) were comparable in risk to or slightly higher than the SHS total mortality index (in increasing magnitude of risk: coal miners, dust exposure, asbestos exposure, beta-naphthylamine, and asbestos cement production). For 70 % of rhazardous/harmful occupations reviewed, the risk of death was statistically significantly lower than from SHS (pilots, nuclear workers, physicians, wood processing, cotton textile production, acrylonitrile exposure, military, rubber production, chemical industry, organic solvent production, drivers, working with plant protection chemicals, exposure to Hg, Cd, Pb, Cu and uranium miners). Only for a few professions was the ‘Healthy Worker Effect’ possible: pilots, the nuclear workers, the military and, less expectedly, drivers and physicians. Thus, the risk of death from SHS is higher than the risk for most hazardous/harmful occupations, including the nuclear industry and uranium mines. This indicates, on the one hand, the special danger of SHS and the need to strengthen measures to limit smoking, including at enterprises subordinate to the FMBA of Russia. On the other hand, the fact that for most hazardous occupations the mortality risks are now lower or comparable to the risks from SHS may reflect the high level of occupational safety and health and progress in its organization. The importance and public-social significance of this study, which complements and corrects the earlier meta-analysis of the SHS effect (Lv X. et al, 2015), is that the risk index of overall mortality, all causes, was used, that is, the final index, in contrast from the risks of mortality from individual pathologies or situations.