Investigations on health hazards of chimney sweeps in Germany: results of a follow-up study.

Within the framework of a longitudinal study, 127 chimney sweeps from the area of Upper and Middle Franconia (Bavaria, Germany), who had participated in a first medical check-up in 1974, were offered follow-up examinations in 1990. Eighty-one subjects participated in these examinations; in addition individual occupational case histories and medical case histories were obtained for a further 15 and 35 chimney sweeps, respectively. Five test subjects had died before the evaluation deadline (August 15, 1990). The causes of death were a non-Hodgkin's lymphoma, a bladder carcinoma, pulmonary metastases with unknown primary tumour, a suicide and an acute myocardial infarction. Conspicuous results were carcinoma of the oesophagus in one case and leucoplakia of the mucous membranes in the mouth and pharyngeal region in three cases; furthermore one chimney sweep had two haemorrhagic lumps on his vocal cords. Taking into account important non-occupational hazards (alcohol and nicotine abuse) as possible causes of these changes and the lack of relevant occupational exposure to products of incineration over a number of years, none of these cases nor any of the other ascertained results could be considered likely to be causally related to occupational activities. Due to the small number of cases, an epidemiological risk evaluation did not seem useful. Comparison with the results of other chimney sweep studies published in the international literature is not helpful due to the differences in study design, the varying case frequencies, and the different conditions of exposure.