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BACKGROUND AND OBJECTIVES: To study the mortality from cardiovascular diseases after long-term exposure to inorganic mercury. POPULATION AND METHOD: 3,998 workers exposed to mercury in Minas de Almadén y Arrayanes S.A. were studied. The follow-up period was a century, since 1895 to 1994. The study was completed assessing the vital status and the basic cause of death, in case of fatalities. Standardized mortality ratios (SMR) by age, sex and calendar period were calculated. Expected deaths were obtained from age, sex and calendar period specific from rates for the Spanish and regional populations. RESULTS: A significant increase in mortality due to circulatory diseases was found (SMR 1.11, 95% confidence interval [CI], 1.02-1.20), especially for hypertension (SMR 2.78, 95% CI, 1.89-3.95), cerebrovascular diseases (SMR 1.17, 95% CI, 1.01-1.35), and other diseases of the heart (SMR 1.51, 95% CI, 1.29-1.76). Ischemic heart disease showed a significant decrease in these workers, with an SMR 0.69, and a CI between 0.57 and 0.84. Cerebrovascular diseases showed a trend over the time since first exposure, duration of exposure and with the accumulated expected exposure, while none of the exposure variables was lineally associated with mortality due to ischemic heart diseases. There was also a trend over the time since first exposure for mortality due to hypertension and other heart diseases. CONCLUSIONS: This study suggests an association between long-term exposure to inorganic mercury in workers of mercury mines and an increased risk of circulatory mortality, especially mortality due to hypertension and cerebrovascular diseases.

Objectives: To study the mortality due to genitourinary diseases in mercury miners. Population and methods: 3.998 workers exposed to mercury in Minas de Almadén y Arrayanes S.A. were studied. The follow-up period was a century, since 1,895 to 1,994. It was completed assessing the vital status and the basic cause of death, in case of fatalities. Standardized Mortality Ratios by age, sex and calendar period were calculated. Expected deaths were obtained from age, sex and calendar period specific rates for the Spanish and Castilla-La Mancha populations. Results: A significant increase in mortality due to genitourinary diseases was found (CIE-9 codes 580 to 629), being significant with respect to the total population for nephritis, nephrotic syndrome and nephrosis, with SMR of 1.69 an 95% CI 1.18 to 2.34. Mortality excesses due to nephritis, nephrotic syndrome and nephrosis were higher in the metallurgy workers than in miners. A Poisson multivariate regression detected a positive trend in the mortality due to nephritis and nephrosis associated to the exposure length, with the risk increasing fivefold after 30 years of exposure to mercury. Conclusions: This paper shows an excess in the mortality due to genitourinary diseases, specially in nephritis, nephrotic syndrome and nephrosis, whose estimation and significance increases when compared to the population of Castilla-La Mancha.

Objetivos: Estudiar la mortalidad por enfermedades genitourinarias de los mineros de mercurio. Población y métodos: 3.998 trabajadores expuestos a mercurio de Minas de Almadén y Arrayanes S.A. fueron seguidos hasta 1994, lo que supuso un periodo de observación de un siglo, desde 1895 hasta 1994. Se determinó el estado vital y causa básica de defunción, en caso de muerte. Se calcularon las razones de mortalidad estandarizadas (RMEs) según edad, sexo y periodo de calendario. Las muertes esperadas se obtuvieron a partir de las tasas específicas por edad, sexo y periodo de calendario, de la población española y la castellano-manchega. Resultados: Se encontró un aumento en la mortalidad por las enfermedades del sistema genitourinario en general (códigos CIE-9 580 a 629), exceso que resultaba significativo respecto a la población general, para el caso de las muertes por nefritis, síndrome nefrótico y nefrosis (CIE-9 580-589), con una RME de 1,69, y un intervalo de confianza al 95% de 1,18 a 2,34. Los excesos encontrados en la mortalidad por nefritis, síndrome nefrótico y nefrosis, fueron mayores entre los trabajadores de la metalurgia que entre los mineros. Tras el análisis de regresión multivariante de Poisson, se observó una tendencia positiva en la mortalidad por nefritis y nefrosis con la duración de la exposición, multiplicándose por cinco veces el riesgo tras 30 años de exposición al mercurio. Conclusiones: Esta investigación muestra un exceso en la mortalidad por enfermedades del aparato genitourinario, en concreto de la mortalidad por nefritis, síndrome nefrótico y nefrosis, cuyo estimado y significación estadística se incrementan al comparar con la población de Castilla-La Mancha. Objectives: To study the mortality due to genitourinary diseases in mercury miners. Population and methods: 3.998 workers exposed to mercury in Minas de Almadén y Arrayanes S.A. were studied. The follow-up period was a century, since 1,895 to 1,994. It was completed assessing the vital status and the basic cause of death, in case of fatalities. Standardized Mortality Ratios by age, sex and calendar period were calculated. Expected deaths were obtained from age, sex and calendar period specific rates for the Spanish and Castilla-La Mancha populations. Results: A significant increase in mortality due to genitourinary diseases was found (CIE-9 codes 580 to 629), being significant with respect to the total population for nephritis, nephrotic syndrome and nephrosis, with SMR of 1.69 an 95% CI 1.18 to 2.34. Mortality excesses due to nephritis, nephrotic syndrome and nephrosis were higher in the metallurgy workers than in miners. A Poisson multivariate regression detected a positive trend in the mortality due to nephritis and nephrosis associated to the exposure length, with the risk increasing fivefold after 30 years of exposure to mercury. Conclusions: This paper shows an excess in the mortality due to genitourinary diseases, specially in nephritis, nephrotic syndrome and nephrosis, whose estimation and significance increases when compared to the population of Castilla-La Mancha.