A mortality study of nickel/chromium platers

The mortality experienced by a cohort of 2689 nickel/chromium platers between 1946 and 1983 has been investigated. All members of the study cohort had some period of chrome exposed employment. Overall, compared with the general population of England and Wales, statistically significant differences relating to cancer were found for cancer of the stomach (E = 16.2, O = 25), primary cancer of the liver (E = 0.8, O = 4), cancer of the nose and nasal cavities (E = 0.3, O = 3), cancers of the lung and bronchus (E = 48.1, O = 72), and all cancers (E = 164.2, O = 213). Chrome bath workers are the more heavily exposed workers, and a striking difference in SMRs was found for lung cancer among men first employed as chrome bath workers (SMR = 199) and men first employed as other chrome workers (SMR = 101). The method of regression models in life tables (RMLT) was used to compare the durations of chrome exposed employment of those dying from causes of interest with those of all matching survivors in the same year of follow up, while controlling for sex, and for year and age of starting employment. Significant positive associations were found only for cancers of the lung and bronchus and duration of chrome bath work. In this study exposure to nickel was shown not to be an important confounding exposure.     

A mortality study of nickel/chromium platers.

The mortality experienced by a cohort of 2689 nickel/chromium platers between 1946 and 1983 has been investigated. All members of the study cohort had some period of chrome exposed employment. Overall, compared with the general population of England and Wales, statistically significant differences relating to cancer were found for cancer of the stomach (E = 16.2, O = 25), primary cancer of the liver (E = 0.8, O = 4), cancer of the nose and nasal cavities (E = 0.3, O = 3), cancers of the lung and bronchus (E = 48.1, O = 72), and all cancers (E = 164.2, O = 213). Chrome bath workers are the more heavily exposed workers, and a striking difference in SMRs was found for lung cancer among men first employed as chrome bath workers (SMR = 199) and men first employed as other chrome workers (SMR = 101). The method of regression models in life tables (RMLT) was used to compare the durations of chrome exposed employment of those dying from causes of interest with those of all matching survivors in the same year of follow up, while controlling for sex, and for year and age of starting employment. Significant positive associations were found only for cancers of the lung and bronchus and duration of chrome bath work. In this study exposure to nickel was shown not to be an important confounding exposure.     

Lung cancer mortality in nickel/chromium platers, 1946-95

OBJECTIVES: To investigate mortality from lung cancer in nickel/chromium platers. METHODS: The mortality experience of a cohort of 1762 chrome workers (812 men, 950 women) from a large electroplating and light engineering plant in the Midlands, United Kingdom, was investigated for the period 1946-95. All subjects were first employed in chrome work at the plant during the period 1946-75, and had at least six months employment in jobs associated with exposure to chromic acid mist (hexavalent chromium). Detailed job histories were abstracted from original company personnel records and individual cumulative durations of employment in three types of chrome work were derived as time dependent variables (chrome bath work, other chrome work, any chrome work). Two analytical approaches were used--indirect standardisation and Poisson regression. RESULTS: Based on mortalities for the general population of England and Wales, male workers with some period of chrome bath work had higher lung cancer mortalities (observed deaths 40, expected deaths 25.41, standardised mortality ratio (SMR) 157, 95% confidence interval (95% CI) 113 to 214, p < 0.01) than did other male chrome workers (observed 9, expected 13.70, SMR 66, 95% CI 30 to 125). Similar findings were shown for female workers (chrome bath workers: observed 15, expected 8.57, SMR 175, 95% CI 98 to 289, p = 0.06; other chrome workers: observed 1, expected 4.37, SMR 23, 95% CI 1 to 127). Poisson regression was used to investigate risks of lung cancer relative to four categories of cumulative duration of chrome bath work and four categories of cumulative duration of other chrome work (none, < 1 y, 1-4 y, > or = 5 y). After adjusting for sex, age, calendar period, year of starting chrome work, period from first chrome work, and employment status (still employed v left employment), there was a significant positive trend (p < 0.05) between duration of chrome bath work and risks of mortality for lung cancer. Relative to a risk of unity for those chrome workers without any period of chrome bath work, risks were 2.83 (95% CI 1.47 to 5.45), 1.61 (95% CI 0.75 to 3.44), and 4.25 (95% CI 1.83 to 9.87) for the second, third, and fourth exposure categories, respectively. Duration of other chrome work was not a useful predictor of risks of lung cancer. Similar findings for both variables were obtained when adjustment was made for sex and age only. Similar findings for both variables were obtained relative to risk of chrome nasal ulceration. CONCLUSIONS: The findings are consistent with the hypothesis that soluble hexavalent chromium compounds are potent human lung carcinogens.

 

     

Lung cancer in Yorkshire chrome platers, 1972-97

OBJECTIVES—To investigate mortality from lung cancer in chrome platers, a group exposed to chromic acid.
METHODS—The mortality of a cohort of 1087 chrome platers (920 men, 167 women) from 54 plants situated in the West Riding of Yorkshire, United Kingdom, was investigated for the period 1972-97. All subjects were employed as chrome platers for 3 months and all were alive on 31 May 1972. Mortality data were also available for a cohort of 1163 comparison workers with no known occupational exposure to chrome compounds (989 men, 174 women). Information on duration of chrome work and smoking habits collected for a cross sectional survey carried out in 1969-72 were available for 916 (84.3%) of the chrome platers; smoking habits were available for 1004 (86.3%) comparison workers. Two analytical approaches were used, indirect standardisation and Poisson regression.
RESULTS—Based on serial mortality rates for the general population of England and Wales, significantly increased mortality from lung cancer was observed (obs) in male chrome platers (obs 60, expected (exp) 32.5, standardised mortality ratio (SMR) 185, p<0.001) but not in male comparison workers (obs 47, exp 36.9, SMR 127). Positive trends were not shown for duration of employment exposed to chrome, although data on working after 1972 were not available.
CONCLUSIONS—Confident interpretation is not possible but occupational exposures to hexavalent chromium may well have been involved in the increased mortality from lung cancer found in this cohort of chrome platers.


Keywords: chromium plating; lung cancer     

Mortality experience among chromeplating workers. Initial findings

A retrospective cohort study was conducted in nine chromeplating plants to examine the mortality of workers employed for at least one year during the period January 1951-December 1981. The study group totaled 178 individuals, 116 of whom were from "hard" and 62 from "bright" chromeplating plants. Vital status ascertainment was 97% complete. The total number of deaths was fairly close to the expected figure (15 observed, 15.2 expected), whereas deaths from tumors exceeded the expected number (8 observed, 4.2 expected). Individuals were distinguished into two subcohorts depending on the exposure intensity, which was much higher in hard than in bright chromeplating. Most deaths from cancer occurred among hard chromium platers, the excess against the expected rate being statistically significant (7 observed, 2.7 expected, p = 0.02). All deaths from lung cancer occurred in this subcohort (3 observed, 0.7 expected, p = 0.03). The increased mortality from cancer among chromium platers seems to be related to exposure intensity and strongly suggests the need for further studies on larger cohorts to confirm the carcinogenicity of chromic acid in man.     

Toxicity of chromic acid in the chromium plating industry (1).

Commercial chromium plating has been an expanding industry in Britain since 1925. The annual numbers of cases of skin and nasal mucosal ulceration due to the effects of chrome contact, reported under the 1919 Regulations, show that chromium platers are affected in this way at least as frequently as chrome handlers in, for instance, the chrome-chemical and chrome-pigment industries. It is generally accepted that there is an increased risk of cancer, especially in the form of broncho-pulmonary carcinoma, among workers in these latter industries, but hitherto no evidence has been sought to discover whether a comparable situation is present in the chromium plating industry.A retrospective mortality study among chromium platers in the West Riding of Yorkshire was carried out between the 20 February 1969 and the 31 May 1972, and a prospective study was initiated on the latter date. Concurrently, a matched control population, consisting of manual workers with no occupational chrome contact, was defined and subjected to the same “trace and interview” and “mortality search” techniques. For the mortality survey, 1238 chromium platers and 1284 controls were available for study.Prior to the 31 May 1972, 109 (8.80%) deaths were found among the plater population, compared with 85 (6.62%) among controls. Most of this increase in plater deaths was attributable to malignant neoplastic disease, which was certified as the cause of death in 39 (3.15%) platers and 21 (1.64%) controls (5.0% significant). The increase in cancer deaths among the platers was not confined to broncho-pulmonary cancer (17 platers, 10 controls), but showed itself to a similar extent in cancers at other sites (22 platers, 11 controls). Deaths due to non-neoplastic primary respiratory disease were slightly more numerous among platers (18 platers, 13 controls), but cardio-vascular deaths and those with other causes were almost identical (52 platers, 51 controls).Further information will doubtless be furnished by the prospective mortality study, which, in its first two years, has shown a similar trend in the distribution of certified causes of death. The significance of these findings is discussed.     

A prospective cohort study of chromium plating workers in Japan

A prospective cohort study was conducted in 415 small-scale chromeplating plants in Japan to examine the mortality of platers employed between 1970 and 1976. A group of 1,193 male metal platers was identified in 1976 and divided into a chromium plater subgroup (n = 626) and a nonchromium plater subgroup (n = 567). Both subgroups were followed from 1976 through December 1987. Among specific causes of death, only lung cancer was found to be significantly higher than expected for all platers (16 observed, 8.9 expected; SMR 179; 95% CI 102-290). This elevated SMR, however, was not statistically significant in either of the two plater subgroups. The SMR for lung cancer of the chromium plater subgroup was highest among those exposed for the shortest period and among those exposed in the most remote calendar years.     

Mortality from stomach cancer in United States cement plant and quarry workers, 1950-80.

In 1978 a study of the mortality of United States cement plant and quarry workers was initiated. The vital status of a cohort of 5292 men who had been employed for at least five years in a cement plant between 1950 and 1980 was traced to 1 January 1980. The mortality experience was evaluated for 4231 white men for whom complete work histories and demographic information were available. Deaths from stomach cancer were significantly increased during 1965-9 but not over the entire follow up period (1950-80). Additionally, stomach cancer mortality was not significantly associated with tenure under separate control for age at follow up, latency, nativity, or year of birth. Evidence from this and other epidemiological studies has not confirmed an association between the constituents of cement plant dust exposure and death from stomach cancer.     

Mortality of workers at a plant manufacturing nickel alloys, 1958-2000

BACKGROUND: Excess risks of respiratory cancer have been demonstrated in some groups of nickel-exposed workers. It is clear, however, that not all forms of nickel exposure are implicated in these excess risks. Aim To determine whether occupational exposures received in the manufacture of nickel alloys lead to increased risks of cancer, in particular nasal cancer and lung cancer. METHODS: The mortality experienced by a cohort of 1999 workers employed at a plant manufacturing nickel alloys has been investigated. Study subjects were all those male workforce employees first employed in the period 1953-1992 who had at least 5 years employment with the company. Observed numbers of cause-specific deaths were compared with expectations based on national mortality rates. Standardized mortality ratios (SMRs) were calculated by period from commencing employment and by operating area of first job. In addition, rate ratios derived from Poisson regression and based on an internal standard were calculated by levels of duration of employment. RESULTS: SMRs were significantly below 100 for all causes (observed 557, expected 704.3, SMR 79), all neoplasms (observed 169, expected 209.4, SMR 81) non-malignant diseases of the respiratory system (observed 50, expected 73.0, SMR 69) and diseases of the circulatory system (observed 261, expected 335.5, SMR 78). Significantly elevated SMRs were not shown for any cause of death and mortality was below expectation for stomach cancer (observed 8, expected 16.0, SMR 50), lung cancer (observed 64, expected 73.6, SMR 87) and bladder cancer (observed 3, expected 8.0, SMR 38). There were no deaths from nasal cancer (expected 0.33). More detailed findings were unexceptional. CONCLUSIONS: The analyses did not suggest the presence of an occupational cancer hazard in the mortality experience of the cohort.     

Epidemiological study of mortality from cancer among chromium platers

Cancer mortality was studied among 265 male workers in 40 small plating factories (chromium, copper and nickel) where bicycle parts are plated. The study utilized record linkage with the Osaka Cancer Registry file between January 1, 1965 and December 31, 1979. The results showed that seven workers had died of cancer, and the Standardized Mortality Ratio (SMR) calculated for all cancers, stomach cancer and lung cancer were 1.13, 1.23 and 1.11, respectively, with no significant relationship found between the observed and expected values. The SMR for lung cancer among those workers with a high degree of skin ulceration and with perforation of the nasal septum was high, 11.22 and 5.13, respectively, although not statistically significant because of the small sample size in the study. The results suggest that lung cancer occurs in those subjected to a high degree of exposure to chromium.     

A historical prospective study of European stainless steel, mild steel, and shipyard welders

A multicentre cohort of 11,092 male welders from 135 companies located in nine European countries has been assembled with the aim of investigating the relation of potential cancer risk, lung cancer in particular, with occupational exposure. The observation period and the criteria for inclusion of welders varied from country to country. Follow up was successful for 96.9% of the cohort and observed numbers of deaths (and for some countries incident cancer cases) were compared with expected numbers calculated from national reference rates. Mortality and cancer incidence ratios were analysed by cause category, time since first exposure, duration of employment, and estimated cumulative dose to total fumes, chromium (Cr), Cr VI, and nickel (Ni). Overall a statistically significant excess was reported for mortality from lung cancer (116 observed v 86.81 expected deaths, SMR = 134). When analysed by type of welding an increasing pattern with time since first exposure was present for both mild steel and stainless steel welders, which was more noticeable for the subcohort of predominantly stainless steel welders. No clear relation was apparent between mortality from lung cancer and duration of exposure to or estimated cumulative dose of Ni or Cr. Whereas the patterns of lung cancer mortality in these results suggest that the risk of lung cancer is higher for stainless steel than mild steel welders the different level of risk for these two categories of welding exposure cannot be quantified with precision. The report of five deaths from pleural mesothelioma unrelated to the type of welding draws attention to the risk of exposure to asbestos in welding activities.     

A historical prospective study of European stainless steel, mild steel, and shipyard welders.

A multicentre cohort of 11,092 male welders from 135 companies located in nine European countries has been assembled with the aim of investigating the relation of potential cancer risk, lung cancer in particular, with occupational exposure. The observation period and the criteria for inclusion of welders varied from country to country. Follow up was successful for 96.9% of the cohort and observed numbers of deaths (and for some countries incident cancer cases) were compared with expected numbers calculated from national reference rates. Mortality and cancer incidence ratios were analysed by cause category, time since first exposure, duration of employment, and estimated cumulative dose to total fumes, chromium (Cr), Cr VI, and nickel (Ni). Overall a statistically significant excess was reported for mortality from lung cancer (116 observed v 86.81 expected deaths, SMR = 134). When analysed by type of welding an increasing pattern with time since first exposure was present for both mild steel and stainless steel welders, which was more noticeable for the subcohort of predominantly stainless steel welders. No clear relation was apparent between mortality from lung cancer and duration of exposure to or estimated cumulative dose of Ni or Cr. Whereas the patterns of lung cancer mortality in these results suggest that the risk of lung cancer is higher for stainless steel than mild steel welders the different level of risk for these two categories of welding exposure cannot be quantified with precision. The report of five deaths from pleural mesothelioma unrelated to the type of welding draws attention to the risk of exposure to asbestos in welding activities.     

Mortality from stomach cancer in United States cement plant and quarry workers, 1950-80

In 1978 a study of the mortality of United States cement plant and quarry workers was initiated. The vital status of a cohort of 5292 men who had been employed for at least five years in a cement plant between 1950 and 1980 was traced to 1 January 1980. The mortality experience was evaluated for 4231 white men for whom complete work histories and demographic information were available. Deaths from stomach cancer were significantly increased during 1965-9 but not over the entire follow up period (1950-80). Additionally, stomach cancer mortality was not significantly associated with tenure under separate control for age at follow up, latency, nativity, or year of birth. Evidence from this and other epidemiological studies has not confirmed an association between the constituents of cement plant dust exposure and death from stomach cancer.     

Mortality among aircraft manufacturing workers

OBJECTIVES: To evaluate the risk of cancer and other diseases among workers engaged in aircraft manufacturing and potentially exposed to compounds containing chromate, trichloroethylene (TCE), perchloroethylene (PCE), and mixed solvents. METHODS: A retrospective cohort mortality study was conducted of workers employed for at least 1 year at a large aircraft manufacturing facility in California on or after 1 January 1960. The mortality experience of these workers was determined by examination of national, state, and company records to the end of 1996. Standardised mortality ratios (SMRs) were evaluated comparing the observed numbers of deaths among workers with those expected in the general population adjusting for age, sex, race, and calendar year. The SMRs for 40 cause of death categories were computed for the total cohort and for subgroups defined by sex, race, position in the factory, work duration, year of first employment, latency, and broad occupational groups. Factory job titles were classified as to likely use of chemicals, and internal Poisson regression analyses were used to compute mortality risk ratios for categories of years of exposure to chromate, TCE, PCE, and mixed solvents, with unexposed factory workers serving as referents. RESULTS: The study cohort comprised 77,965 workers who accrued nearly 1.9 million person-years of follow up (mean 24.2 years). Mortality follow up, estimated as 99% complete, showed that 20,236 workers had died by 31 December 1996, with cause of death obtained for 98%. Workers experienced low overall mortality (all causes of death SMR 0.83) and low cancer mortality (SMR 0.90). No significant increases in risk were found for any of the 40 specific cause of death categories, whereas for several causes the numbers of deaths were significantly below expectation. Analyses by occupational group and specific job titles showed no remarkable mortality patterns. Factory workers estimated to have been routinely exposed to chromate were not at increased risk of total cancer (SMR 0.93) or of lung cancer (SMR 1.02). Workers routinely exposed to TCE, PCE, or a mixture of solvents also were not at increased risk of total cancer (SMRs 0.86, 1.07, and 0.89, respectively), and the numbers of deaths for specific cancer sites were close to expected values. Slight to moderately increased rates of non-Hodgkin''s lymphoma were found among workers exposed to TCE or PCE, but none was significant. A significant increase in testicular cancer was found among those with exposure to mixed solvents, but the excess was based on only six deaths and could not be linked to any particular solvent or job activity. Internal cohort analyses showed no significant trends of increased risk for any cancer with increasing years of exposure to chromate or solvents. CONCLUSIONS: The results from this large scale cohort study of workers followed up for over 3 decades provide no clear evidence that occupational exposures at the aircraft manufacturing factory resulted in increases in the risk of death from cancer or other diseases. Our findings support previous studies of aircraft workers in which cancer risks were generally at or below expected levels.       

Incidence of cancer among welders, platers, machinists, and pipe fitters in shipyards and machine shops.

The incidence of cancer in 12,693 shipyard and machine shop male workers (1689 welders, 4308 platers, 6003 machinists, 693 pipe fitters) employed for at least one year between 1945 and 1960 was investigated in a retrospective cohort study. The welders had welded only mild steel and had not been exposed to hexavalent chromium containing fume. The follow up was 99.7% complete and the total number of person-years was 304,682. The incidence of cancer in 1953-81 was ascertained through the Finnish Cancer Registry. The observed numbers of cases of cancer were compared with the expected numbers based on regional urban rates. The smoking habits of the cohort were surveyed with a postal questionnaire sent to a sample of 961 workers. The smoking habits of the cohorts were similar and smoking was not more common than among the general population. The total number of cases of cancer was 611 (exp 629) among the shipyard workers and 376 (exp 388) among the machine shop workers. The incidence of lung cancer was increased among the shipyard workers (obs 227, exp 192). This excess was observed in all the worker groups and was most evident for the pipe fitters and platers. Among the machine shop workers, the incidence of lung cancer was lower than expected with the exception of the welders who had a slightly raised risk of lung cancer (obs 14, exp 10). The incidence of laryngeal cancer was slightly raised among the shipyard workers (obs 24, exp 20) but not in the machine shop workers. No excess risk was observed among the welders. The incidence of cancer of the prostate was increased among the machine shop workers (obs 39, exp 31) but not in the shipyard workers. The excess was statistically significant for the welders. No pronounced excess could be found for other types of cancer. Analysis by the duration or exposure showed that the excess of lung cancer in the shipyard workers was most evident during the last period of observation (1972-81). No other trends were obvious and the slight excess of lung cancer observed among the welders did not increase with increasing follow up time. No excess risk for mesothelioma was found. The small excess of lung cancer in welders could be due to chance. The fact that only a small and statistically insignificant excess of lung cancer could be found among this group of heavily exposed welders suggest that if the risk of lung cancer was associated with welding this risk must nowadays be low and probably too low to be unequivocally detected in most epidemiological studies.     

Risk of lung cancer among masons in Iceland.

OBJECTIVES: To estimate the risk of gastrointestinal cancer and lung cancer in a cohort of masons exposed to cement and hexavalent chromium by a follow up in the Icelandic Cancer Registry. METHODS: The cohort, 1172 men, was defined as those who had served their apprenticeship and were fully licensed as masons (cement finishers) in Iceland, were born after 1880 and were alive in 1955. The men were exposed to an aerosol of wet concrete, particularly when spraying. According to the analyses of urinary chromium the masons were exposed to hexavalent chromium. A computer file on masons was record linked to the Cancer Registry by making use of the personal identification numbers. Expected cancer incidence was calculated on the basis of number of person-years for each five-year age category during the individual calendar years of the study period and multiplied by the specific incidence for cause and calendar year for men in Iceland provided by the Cancer Registry. RESULTS: The standardised incidence ratio (SIR) for all cancers was 1.13 in the total cohort and 1.33 when allowance was made for 30 years to elapse before starting to count person years of risk. The risk for gastrointestinal cancers was not increased. The SIR for lung cancer was 1.69 in the total cohort and 1.77 when a lag of 30 years was included. The SIR for lung cancer among those born in 1920 or later was 1.86. Results from a postal questionnaire showed that fewer masons had never smoked and more masons had stopped smoking than the controls from the general population. CONCLUSION: The increased risk of lung cancer among the masons may be related to their work. The exposure information, although limited, supports the suggestion that hexavalent chromium in the cement may be the causal link, as information on the smoking habits indicate that the control for this important possible confounder is adequate.     

Risk of lung cancer in workers producing stainless steel and metallic alloys

Objectives: The mortality of workers involved in the production of stainless and alloyed steel from 1968 to 1992 was studied, in order to investigate the risk of lung cancer due to exposure to metals, i.e. iron oxides, chromium and/or nickel compounds. Methods: The study design was a historical cohort mortality study and a nested case-control study concerning lung cancer. Standardized mortality ratios (SMRs) were computed using regional mortality rates as an external reference for comparing observed and expected numbers of deaths, adjusting for age, sex and calendar time. Conditional logistic regression was used to estimate odds ratios (ORs). Occupational exposure was assessed through the complete job histories of cases and controls and a specific job-exposure matrix. Results: The cohort comprised 4,288 male and 609 female workers. The observed overall mortality was significantly lower than expected [649 deaths; SMR = 0.91; 95% confidence interval (CI) 0.84–0.98]. No significant SMR was observed for mortality from lung cancer (54 deaths; SMR = 1.19; CI 0.88–1.55). The case-control study was based on 54 cases and 162 individually matched controls. Smoking habits were available for 71%. No lung cancer excess was observed for exposure to (1) metals and/or their compounds, i.e. iron (OR = 0.94, CI 0.48–1.86), chromium and/or nickel (OR = 1.18, CI 0.62–2.25), and cobalt (OR = 0.64, CI 0.33–1.25), (2) acid mists (OR = 0.43, CI 0.17–1.10), and (3) asbestos (OR =  1.00, CI 0.54–1.86). With respect to exposure to polycyclic aromatic hydrocarbons (PAHs) and silica, which are often found together in workplaces, (1) high and statistically significant lung cancer excesses were observed, the ORs being 1.95 (CI 1.03–3.72) and 2.47 (CI 1.28–4.77) respectively, (2) quantitative exposure parameters revealed upward trends reaching statistical significance (P < 0.05), and (3) adjustments for tobacco consumption did not reveal any confounding factors from smoking. Conclusion: This study failed to detect any relationship between lung cancer and exposure to iron, chromium, nickel and/or their compounds. High and statistically significant relative risks, along with increasing trends, were observed for simultaneous exposure to PAHs and silica. Received: 12 April 1999 / Accepted: 2 October 1999     

A cohort study on mortality among wives of workers in the asbestos cement industry in Casale Monferrato, Italy.

The study investigates mortality from cancer and other diseases in a cohort of wives of asbestos cement workers in Casale Monferrato (northwest Italy). After the exclusion of women with an occupational record in the asbestos cement industry, the cohort comprised 1964 women. Their domestic exposure was estimated according to their husbands' periods of employment in the plant: 1740 had a period of domestic exposure whereas the remaining 224 married an asbestos cement worker only after he definitely stopped his activity in the asbestos cement plant; these have, therefore, been considered as unexposed. The cohort of wives was constructed entirely through official records in the town offices and is both exhaustive and unaffected by recall bias. At the end of follow up (1988) 1669 women were alive, 270 were dead and 25 (1.2%) were untraced. Main mortality analyses were only up to age 79 to reduce the misclassification of causes of death. Expected mortality was based on local rates. Mortality analyses were limited to the period 1965-88 due to the availability of local rates: in that period 210 deaths occurred among women with domestic exposure v 229.1 expected. There were four deaths from pleural tumours (one diagnosed as mesothelioma at necropsis) and six from lung cancer v. 0.5 and 4.0 expected respectively. Two further cases of mesothelioma were diagnosed by histological examination after the end of follow up. None of the three wives with histologically diagnosed mesothelioma had been engaged in industrial activities. Corresponding information for the other three cases could not be traced.     

Mortality and cancer incidence in Swedish battery workers exposed to cadmium and nickel

OBJECTIVE: To follow up cancer incidence and mortality in a group of Swedish battery workers exposed to nickel hydroxide and cadmium oxide. METHODS: 869 workers, employed at least one year between the years 1940 and 1980 were followed up until 1992. Vital status and causes of death were obtained from the Swedish cause of death registry. Cancer morbidity was retrieved from the Swedish cancer registry. Regional reference rates were used to compute the expected numbers of deaths and cancers. RESULTS: Up to 31 December, 1992, a total of 315 deaths (292 in men and 23 in women) had occurred in the cohort. For men, the overall standardised mortality ratio (SMR) was 106 (95% confidence interval (95% CI) 93.7 to 118) and for women 83.8 (95% CI 53.1 to 126). The SMRs for total cancer mortality were 125 (95% CI 98.2 to 157) for men and 69.5 (95% CI 25.5 to 151) for women. The SMR for lung cancer in men was 176 (95% CI 101 to 287). No lung cancers were found among female workers. Up to 31 December, 1991, a total of 118 cancers had occurred in the cohort. A significantly increased standardised incidence ratio (SIR) was found for cancer of the nose and nasal sinuses in men, three cases v 0.36 expected, yielding an SIR of 832 (95% CI 172 to 2430). Applying a 10 year latency period in cohort members exposed to > or = 1000 micrograms cadmium/m3, the SIR was 1107 (95% CI 134 to 4000). Similarly, for cohort members exposed to 2000 micrograms nickel/m3, the SIR was 1080 (95% CI 131 to 3900). CONCLUSION: There was an increased overall risk for lung cancer, but no exposure-response relation between cumulative exposure to cadmium or nickel and risk of lung cancer. There was a highly significant increased risk of cancer of the nose and nasal sinuses, which may be caused by exposure to nickel or cadmium or a combination of both exposures.

 

     

Exposure to nickel compounds and smoking in relation to incidence of lung and nasal cancer among nickel refinery workers.

OBJECTIVES: To investigate the relation between occupational hazards among nickel refinery workers and their exposure to different forms of nickel over time and the interaction between smoking and total exposure to nickel. METHODS: The cohort consisted of 379 workers with first employment 1916-40 and at least three years of employment and 4385 workers with at least one year of employment 1946-83. Data on smoking (ever or never) were available for almost 95% of the cohort. Two analyses were used, indirect standardisation from observed and expected numbers and Poisson regression. RESULTS: During the follow up 1953-93, 203 new cases of lung cancer were observed v 68 expected (standardised incidence ratio (SIR) 3.0, 95% confidence interval (95% CI) 2.6-3.4) and 32 cases of nasal cancer were observed v 1.8 expected (SIR 18.0, 95% CI 12-25). The Poisson regression analysis showed an excess risk of lung cancer in association with exposure to soluble forms of nickel, with a threefold increase in relative risk (RR) (P < 0.001) and a multiplicative effect of smoking and exposure to nickel. The RRs were 1.1 (95% CI 0.2-5.1) for exposed workers who had never smoked and 5.1 (95% CI 1.3-20.5) for exposed workers who smoked. CONCLUSION: It is not possible to state with certainty which specific nickel compounds are carcinogenic, but a significant excess risk was found for workers exposed to soluble nickel alone or in combination with other forms of nickel. The present study suggests a multiplicative effect of smoking and nickel exposure.