Cancer among women textile workers in Shanghai, China: overall incidence patterns, 1989-1998

BACKGROUND: Cancer incidence in women textile workers has not been adequately studied. The aim of this study was to examine site-specific cancer incidence patterns in a cohort of 267,400 women textile workers in Shanghai, China. METHODS: Women employed by the Shanghai Textile Industry Bureau (STIB) were followed for cancer incidence from 1989 to 1998. Age-adjusted standardized incidence ratios (SIRs) and 95% confidence intervals (CI) were computed based on Shanghai Cancer Registry (SCR) rates. RESULTS: There was a decrease in cancer incidence for the cohort compared with urban Shanghai women (SIR = 0.91, 95% CI = 0.89-0.93). There were small increased risks of other endocrine tumors (SIR = 1.31, 95% CI = 1.02-1.65). There were decreased risks for esophageal (SIR = 0.54, 95% CI = 0.44-0.66), stomach (SIR = 0.79, 95% CI = 0.73-0.85), rectal (SIR = 0.88, 95% CI = 0.78-0.98), lung (SIR = 0.80, 95% CI = 0.74-0.86), cervical (SIR = 0.37, 95% CI = 0.28-0.50), ovarian (SIR = 0.85, 95% CI = 0.75-0.96), and bladder cancers (SIR = 0.63, 95% CI = 0.46-0.85). CONCLUSIONS: Women employed in the textile industry had a lower than expected cancer experience compared with urban Shanghai women. Further research on this cohort will examine associations between site-specific cancers and occupational exposures to dusts and chemicals.     

Occupation and lung cancer in Shanghai: a case-control study

Occupation was evaluated as a potential risk factor for lung cancer as part of a large population based case-control study conducted in the ten urban districts of Shanghai. A total of 733 newly diagnosed cases of male lung cancer and 760 controls selected from the general population was interviewed to obtain lifetime occupational histories and information on smoking and other factors. Of the approximately 25 major industrial titles examined, significantly raised risks, adjusted for smoking, were found for employment in agricultural production (odds ratio (OR) = 1.6, 95% confidence interval (CI) = 1.0-2.6). A concomitant increase was detected for farmers (OR = 1.6, 95% CI = 1.0-2.5) when 35 major occupational titles were examined. There was a 70% excess among workers in the chemical industry (OR = 1.7, 95% CI = 0.9-3.1) and a significant decrease among textile industry workers (OR = 0.7, 95% CI = 0.5-1.0). Raised risks of 30% to 80% were associated with reported job exposures to wood and coal dusts, smoke from burning fuels, and chemical fumes. Employment categories were also examined for 672 cases and 735 controls among women, but small numbers in many of the industrial and occupational categories precluded detailed analyses. The largest excess risk among women (OR = 5.1, 95% CI 1.3-23.5) was among glass products workers. Although cigarette smoking was the dominant cause of lung cancer among men and a significant risk factor among women in Shanghai, these findings suggest the importance of certain workplace exposures and offer leads to occupational carcinogens.     

Occupation and lung cancer in Shanghai: a case-control study.

Occupation was evaluated as a potential risk factor for lung cancer as part of a large population based case-control study conducted in the ten urban districts of Shanghai. A total of 733 newly diagnosed cases of male lung cancer and 760 controls selected from the general population was interviewed to obtain lifetime occupational histories and information on smoking and other factors. Of the approximately 25 major industrial titles examined, significantly raised risks, adjusted for smoking, were found for employment in agricultural production (odds ratio (OR) = 1.6, 95% confidence interval (CI) = 1.0-2.6). A concomitant increase was detected for farmers (OR = 1.6, 95% CI = 1.0-2.5) when 35 major occupational titles were examined. There was a 70% excess among workers in the chemical industry (OR = 1.7, 95% CI = 0.9-3.1) and a significant decrease among textile industry workers (OR = 0.7, 95% CI = 0.5-1.0). Raised risks of 30% to 80% were associated with reported job exposures to wood and coal dusts, smoke from burning fuels, and chemical fumes. Employment categories were also examined for 672 cases and 735 controls among women, but small numbers in many of the industrial and occupational categories precluded detailed analyses. The largest excess risk among women (OR = 5.1, 95% CI 1.3-23.5) was among glass products workers. Although cigarette smoking was the dominant cause of lung cancer among men and a significant risk factor among women in Shanghai, these findings suggest the importance of certain workplace exposures and offer leads to occupational carcinogens.     

Risks of biliary tract cancer and occupational exposures among Shanghai women textile workers: a case-cohort study

BACKGROUND: Biliary tract cancer (BTC) is a relatively rare malignancy worldwide. Little is known about potential etiologic contributions of occupational exposures. METHODS: The associations between occupational exposures to textile dusts and chemicals and BTC are investigated in a cohort of 267,400 women textile workers in Shanghai, China. A nested case-cohort analysis of 162 BTC cases diagnosed during 1989-1998 was conducted with a reference subcohort of 3,188 workers. Exposures to workplace dusts and chemicals were reconstructed by linking complete work history data with a job-exposure matrix (JEM). Hazard ratios (HR) and dose-response trends were estimated by Cox proportional hazards modeling modified for case-cohort design. RESULTS: An elevated risk of > or = 1-year employment in maintenance jobs (HR 2.92, 95% CI: 1.48, 5.73) with a significant trend by duration is observed. Excess risk was also found for > or = 20 years exposure to metals (HR 2.50, 95% CI: 1.09, 5.72). CONCLUSIONS: Long-term exposure to maintenance work and metals in the textile industry may have increased BTC risk in this population.     

Construction work and risk of occupational disability: a ten year follow up of 14,474 male workers

Aims: Most industrialised countries have public income maintenance programmes to protect workers in case of disability but studies addressing disability risk of specific professional groups are rare. The objective of this study was to establish a detailed pattern of the nature and extent of occupational disability among construction workers. Methods: A cohort study was set up including 14 474 male workers from the construction industry in Württemberg (Germany) aged 25–64 years who underwent occupational health exams between 1986 and 1992. The cohort was linked to the regional pension register of the manual workers'' pension insurance institution to identify workers who were granted a disability pension during the 10 year follow up. All-cause and cause specific standardised incidence ratios (SIR) and 95% confidence intervals (CI) were calculated using disability rates from the general workforce and from all blue collar workers in Germany as references. Results: In total, 2247 (16%) members of the cohort were granted a disability pension. Major causes of disability were musculoskeletal (45%) and cardiovascular diseases (19%). In comparison with the general workforce, construction workers experienced a higher risk of disability from cancer (SIR = 1.26; 95% CI 1.08 to 1.47), respiratory diseases (SIR = 1.27; 95% CI 1.03 to 1.55), musculoskeletal diseases (SIR = 2.16; 95% CI 2.03 to 2.30), injuries/poisoning (SIR = 2.52; 95% CI 2.06 to 3.05), and all causes combined (SIR = 1.47; 95% CI 1.41 to 1.53). When compared with the blue collar reference group, increased risks of disability among construction workers were found for musculoskeletal diseases (SIR = 1.53; 95% CI 1.44 to 1.63), injury/poisoning (SIR = 1.83; 95% CI 1.50 to 2.21), and all causes combined (SIR = 1.11; 95% CI 1.07 to 1.16). Conclusions: Musculoskeletal diseases and external causes are major factors limiting the work capability of construction workers and lead to an increased proportion of occupational disability.     

Occupational risk factors for breast cancer among women in Shanghai

Although female breast cancer rates are lower in China than in Western countries, rates have been rising rapidly in China. This increase may be due to changes in established breast cancer risk factors, but it is possible that exposure to occupational and environmental carcinogens in Shanghai also have contributed to the rise in incidence. We used data collected by the Shanghai Cancer Registry and the Chinese Third National Census to study the risk of breast cancer by occupation and by occupational exposures. Standardized incidence ratios (SIRs) were used to compare observed cases to expected numbers of cases, based on the incidence rates for Shanghai and the number of women in each occupation according to the 1982 census. Statistically elevated SIRs for breast cancer were seen for a number of professional occupational categories, with the greatest risk seen among scientific research workers (SIR = 3.3). Administrative clerks, political and security personnel, and makers of rubber and plastics products also had significant excesses. Significant deficits of risk were seen for the categories of production and related workers, construction workers, and transportation equipment operators. For specific occupations, the highest SIRs were observed among doctors of Chinese-Western medicine (SIR = 14.7, 95% CI = 5.9–30.3) and doctors of Chinese medicine (SIR = 7.2, 95% CI = 4.4–11.4). We also found excesses among teachers at each level of education, librarians, clerical workers, electrical and electronic engineers, nurses, lab technicians, accountants and bookkeepers, rubber manufacturing products makers, weavers, and knitters. SIRs were significantly elevated for high probability of exposure to organic solvents (SIR = 1.4). For benzene exposure, we found significant excesses for overall exposure (SIR = 1.1) and for medium level of exposure (SIR = 1.3). There was no evidence of an association between risk and electromagnetic fields (EMF) exposure. Based on a small number of exposed, SIRs were elevated for both medium probability and high level of exposure to pesticides. The elevations in occupations reported here support some previous reports. Our finding of an increased risk associated with benzene also has been reported previously; the finding for organic solvents is new. However, the literature on the risk of breast cancer related to occupational exposures is limited and there is no consistent body of literature for any of the exposures studied here. Further, many comparisons were made and the problem of multiple hypothesis testing cannot be ignored in a survey such as ours. Am. J. Ind. Med. 34:477–483, 1998. © 1998 Wiley-Liss, Inc.     

Cancer morbidity in workers at aluminum foundries and secondary aluminum smelters

In a Swedish cohort of workers (n = 6,454) from seven aluminum foundries and three secondary aluminum (scrap) smelters there was no overall excess risk of cancer among male or female workers less than 85 years of age (males: 325 observed cases, standardized incidence ratio (SIR) 1.02, 95% confidence interval (CI) 0.91–1.13; females: 22 cases, SIR = 0.95, 95% CI = 0.60–1.44). In male workers, however, significantly elevated risk estimates were observed for cancer of the lung (51 cases; SIR = 1.49, 95%CI = 1.11–1.96), anorectal cancer (33 cases; SIR 2.13, 95%CI = 1.47–2.99), and sinonasal cancer (4 cases; SIR = 4.70, 95%CI = 1.28–12.01). There was no increase of urinary bladder or liver cancer. Lung cancer risks were highest in workers with a short duration of employment (<5 years) suggesting determinants of risk related to socioeconomic factors rather than the occupational environment under study, but there were also indications of a lung cancer hazard from sand casting of aluminum for 10 years or more (SIR = 2.10, 95%CI = 1.01–3.87). The increase in anorectal cancer could not be etiologically related to occupational determinants of risk. Sand casting of aluminum aside, the cancer risk in secondary aluminum smelting seems to be lower than in primary aluminum smelting and in iron and steel founding, respectively. Am. J. Ind. Med. 32:467–477, 1997. © 1997 Wiley-Liss, Inc.     

Bladder cancer and occupation in Shanghai, 1980-1984.

To investigate occupational determinants of bladder cancer in the urban area of Shanghai, occupation and industry information for 1,219 incident bladder cancer cases diagnosed during the period 1980 to 1984 were compared with 1982 census data on employment. Standardized incidence ratios (SIR) for bladder cancer were estimated for occupation and industry classifications. Significant excess risks were observed for plastic products workers (male: SIR = 432; female: SIR = 368); textile bleachers, dyers, and finishers (male: SIR = 169); metal refining and processing workers (male: SIR = 139; female: SIR = 197); petroleum refining workers (male: SIR = 2152); railway engine drivers and firemen (male: SIR = 683); and workers employed in industries of apparel and other textile products manufacturing (female: SIR = 204); paper processing (male: SIR = 146; female: SIR = 226); organic chemical manufacturing (male: SIR = 186); plastic product manufacturing (male: SIR = 218; female: SIR = 272); and metallurgy (male: SIR = 107; female: SIR = 561). This study indicates that many of the industries and occupations that are responsible for increased risk throughout the world are also associated with occupational bladder cancer in Shanghai.     

Cancer incidence and mortality among Finnish asbestos sprayers and in asbestosis and silicosis patients

Cohorts of Finnish asbestos sprayers and of asbestosis and silicosis patients were followed for cancer with the aid of the Finnish Cancer Registry in the period 1967–1994. Compared with the cancer incidence of the total Finnish population, asbestos sprayers had an increased risk for total cancer (standardized incidence ratio [SIR] 6.7, 95% confidence interval [95% CI] 4.2–10); lung cancer (SIR 17, 95% CI 8.2–31); and mesothelioma (SIR 263, 95% CI 85–614). The SIR of the asbestosis patients was 3.7 (95% CI 2.8–5.0) for all sites, 10 (95% CI 6.9–14) for lung cancer, and 65 (95% CI 13–188) for mesothelioma. The silicosis patients also had significantly high SIR values for all sites (1.5, 95% CI 1.0–2.1) and lung cancer (2.7, 95% CI 1.5–4.5). The values for the SIR and the standardized mortality ratio for all sites and lung cancer were very similar, and therefore it seems that both are reliable indicators of the occurrence of occupational cancer. It was concluded that pneumoconioses patients and asbestos-exposed workers have a markedly elevated risk for cancer. Asbestos-induced occupational cancers are not only diseases of the elderly, since the relative risk is high also for middle-aged people. Am. J. Ind. Med. 31:693–698, 1997. © 1997 Wiley-Liss, Inc.     

Cause-specific mortality among male textile workers in Rhode Island

Cause-specific mortality patterns among male textile workers in Rhode Island who died during the period 1968-1978 were examined using the proportionate mortality ratio (PMR) method. Textile worker decedents were identified by the usual occupation and industry statements on Rhode Island death certificates. A statistically significant PMR elevation was observed for nonmalignant respiratory disease (NMRD) among male textile workers (PMR = 110; Observed deaths [Obs] = 433; 95% confidence interval (CI) = 102-120). The PMRs for NMRD by specific textile occupation and by type of textile manufacturing generally exhibited the pattern expected for work-related mortality owing to textile dust exposure. High PMRs were observed among carding, lapping, and combing operatives, the decedents who probably had the highest dust exposure (PMR = 166; Obs = 24; CI = 114-243), and among operatives most likely to have worked in cotton manufacturing (PMR = 137; Obs = 47; CI = 104-179). This is the first report of excess mortality from NMRD among male textile workers in the United States. This finding is consistent with previous evidence that exposure to cotton dust can cause disabling chronic lung disease. Also noteworthy were statistically significant elevated PMRs for cancers of the rectum and esophagus among decedents who had been engaged in textile dyeing and finishing. Owing to the lack of direct information about occupational exposures and smoking habits of the decedents and uncertainties in classifying decedents by type of textile manufacturing, this investigation should be viewed as being exploratory in nature.     

Occupation and chronic bronchitis among Chinese women

OBJECTIVE: To examine the association between occupation and chronic bronchitis among a cross section of Chinese women who participated in the Shanghai Women's Health Study. METHODS: Cases were 4873 women who self-reported a physician-diagnosed bronchitis during adulthood. Controls were 9746 women randomly selected from Shanghai Women's Health Study participants and matched with the cases by year of birth and age at diagnosis. Lifetime occupational histories were obtained. Logistic regressions were used to evaluate the association between chronic bronchitis and occupation, adjusting for smoking, education, family income, and concurrent asthma. RESULTS: We observed excess prevalence of bronchitis for textile occupation (odds ratio, OR = 1.09; 95% CI = 1.00-1.18) and industry (OR = 1.11; 95% CI = 1.03-1.19), welders (OR = 1.40; 95% CI = 1.01-1.92), packing and baling workers (OR = 1.39; 95% CI = 1.15-1.68), and warehousing industry (OR = 1.58; 95% CI = 1.08-2.30) We also identified several new associations that may warrant further exploration and confirmation, including employment in some metal fabrication industries, postal and telecommunication industry, and a few white-collar occupations and industries. CONCLUSIONS: Our study indicates that the risk of chronic bronchitis among women may be increased in some occupations and industries.     

Gliomas among men employed in the Swedish pulp and paper industry

OBJECTIVES: This study investigated whether previous findings of an increased risk of gliomas among workers in some pulp and paper mills could be confirmed for all Swedish pulp and paper mill workers and whether the increase could be attributed to certain occupational groups. METHODS: The study was based on the Swedish Cancer Environment Register, which links the incidence of cancer from 1971 to 1990 and the 1960 and 1970 census data on codes of occupation and industry for the whole population. Standardized incidence ratios (SIR) were used to estimate the risks for men in different occupations in pulp (N = 28,142) and paper (N = 39,169) mills in 1960, 1970 or both years as compared with those of all gainfully employed men in Sweden. RESULTS: Maintenance workers employed in pulp or paper mills in 1960, 1970 or both years, as well aspulp workers, showed an increased incidence of gliomas in 1971-1990 [SIR 1.5, 95% confidence interval (95% CI) 1.1-2.1 and SIR 1.5,95% CI 1.0-2.2, respectively], whereas the incidence among process workers in paper mills was lower than expected (SIR 0.6, 95% CI 0.3-0.9). Taken together, all employed men in the pulp mill industry had an increased incidence of gliomas (SIR 1.3, 95% CI 1.0-1.7). CONCLUSIONS: Pulp mill workers, but not paper mill workers, were found to have more gliomas in 1971-1990 than expected. There was an increased risk of gliomas among maintenance workers in both pulp and paper mills. Few risk factors for brain tumors are recognized, and the causes of the increase are not obvious.     

中国联苯胺作业工人职业性膀胱癌发病率和死亡率流行病学调查

本文研究了1972年至1977年在册的累计专业工龄一年以上天津、上海和吉林1972名联苯胺男工的膀胱癌发病率和死亡率。与上海市普通居民相比联苯胺工人膀胱癌的标化死亡比(SMR)为17.5(95%可信限:7.5～34.5)、标化发病比(SIR)为25.0(95%可信限:16.9～35.7)。联苯胺工人膀胱癌发病率增高25倍,与接触水平有关。低接触组SIR=4.8;中接触组SIR=36.2;高接触组SIR=158.4(X~2趋势检验P<0.01)。联苯胺生产工人SIR=45.7(95%可信限:20.9～86.8),联苯胺使用工人SIR=20.9(95%可信限:12.9～32.0)。联苯胺吸烟者危险度增加31倍(95%可信限:20.4～46.4),而非吸烟者仅11倍(95%可信限:3.6～25.8)。     

Occupational risk factors for esophageal and stomach cancers among female textile workers in Shanghai, China

The authors evaluated associations between occupational exposures in the textile industry and the risks of esophageal cancer and stomach cancer. The authors conducted a case-cohort study nested in a cohort of female textile workers in Shanghai, China. One hundred and two workers with incident esophageal cancer and 646 workers with incident stomach cancer diagnosed between 1989 and 1998 were compared with an age-stratified reference subcohort (n = 3,188). Work histories were ascertained for all study subjects from factory personnel records or interviews. Exposures were reconstructed for chemicals and dusts by linking work history data with a job-exposure matrix developed for the Shanghai textile industry. Hazard ratios and 95 percent confidence intervals were calculated with Cox proportional hazards modeling adapted for the case-cohort design. Risk of esophageal cancer was associated with long-term (> or = 10 years) exposure to silica dust (hazard ratio = 15.8, 95% confidence interval: 3.5, 70.6) and metals (hazard ratio = 3.7, 95% confidence interval: 1.9, 7.1). Cumulative exposure to endotoxin, a contaminant of cotton dust, was inversely related to risks of both esophageal cancer (p-trend = 0.01) and stomach cancer (p-trend < 0.001) when exposures were lagged 20 years. Endotoxin has not been previously reported to be a protective factor for either stomach cancer or esophageal cancer and therefore warrants further study.     

#63 Cancer incidence in the u. s. radiologic technologists health study, 1983–1998

PURPOSE: Few studies have evaluated cancer risk associated with low-dose occupational ionizing radiation exposure to women. We present data on incident cancer risks among a predominantly (77%) female cohort of 73,963 U. S. radiologic technologists followed up from 1983 through 1998.METHODS: Cancer incidence information and data on work history, selected cancer risk factors, personal radiation exposure and other health outcomes were obtained from two mailed questionnaires (administered ~1984 and ~1995). Incident cancers were ascertained from the second survey and supplemented by mortality records. Medical records, obtained for 74% of all self-reported cancers, confirmed the cancer in 85%. We computed standardized incidence ratios (SIR) using cancer incidence rates from the National Cancer Institute's Surveillance Epidemiology and End Results Program.RESULTS: The SIR for all cancers combined in both sexes was 1.04 (95% confidence interval (CI): 1.00, 1.07; n = 3292). The incidence of solid cancers was elevated in women (SIR = 1.06, 95% CI: 1.02, 1.10), but lower than expected among men (SIR = 0.92 , 95% CI 0.85, 0.98). Female technologists had an elevated incidence of breast cancer (SIR = 1.16, 95% CI: 1.09, 1.23). Among both sexes combined, elevated risks were seen for melanoma (SIR = 1.59, 95% CI: 1.38, 1.80) and thyroid cancers (SIR = 1.61, 95% CI: 1.34, 1.88), and decreased risks were observed for buccal cavity/pharynx (SIR = 0.73, 95% CI: 0.55, 0.90), rectum (SIR = 0.62, 95% CI: 0.48, 0.76), and lung (SIR = 0.77, 95% CI: 0.70, 0.85) cancers.CONCLUSION: The elevated risk for breast cancer may be related to occupational radiation exposure. The observed melanoma and thryoid cancer excesses may reflect, at least in part, increased screening among medical workers with easy access to health care.     

Occupational exposures and risks of liver cancer among Shanghai female textile workers--a case-cohort study

BACKGROUND: Liver cancer is the fifth most frequent malignancy worldwide. Viral hepatitis B and C, alcohol, and aflatoxin are the major established risk factors. Little is known about the aetiological contributions of occupational exposures, as previous occupational epidemiological studies of liver cancer suggest few agent-specific associations. We investigated associations of occupational exposures to dusts and chemicals in a cohort of female textile workers. METHODS: Cancer incidence was determined among 267,400 female textile workers in Shanghai, China, who had been enrolled in an intervention trial of breast self-exam efficacy during 1989-98. Subjects were interviewed at baseline regarding basic demographics, smoking habits, alcohol consumption, and contraceptive practices. A case-cohort study of 360 liver cancer cases and 3,186 age-stratified randomly chosen subcohort subjects was conducted within this cohort. Exposures to workplace dusts and chemicals were reconstructed from complete work history data, historical exposure monitoring data for selected agents, and a specially designed job-exposure matrix for the textile industry. Relative risks and dose-response trends were estimated by Cox proportional hazards modelling, adapted for the case-cohort design. Latency analyses with different lag years were also applied. RESULTS: 2,095,904 person-years were contributed by this female cohort. The results of the case-cohort analysis revealed a protective effect of cotton fibre exposure years [adjusted hazards ratio (HR) = 0.64; 95% confidence interval (95% CI) 0.44-0.92] or endotoxin exposure (adjusted HR = 0.60; 95% CI 0.41-0.88) for the fourth quartile with significant trends for 20 year exposure lags. CONCLUSIONS: This study suggests that chronic exposure to endotoxin or some other component of cotton dust exposure may have reduced liver cancer risk in this population.     

Cohort study of cancer risk among male and female shift workers

OBJECTIVES: Melatonin, a hormone that inhibits experimentally induced cancers, is suppressed by nighttime exposure to light so that nighttime shift workers may be at an increased risk of cancer. Previous studies of shift workers found an increased risk of breast cancer among women and suggested a possible increased risk of colon cancer among women and prostate cancer. The present study was conducted to see whether these previous findings could be confirmed and whether shift workers are at elevated risk for cancer at additional sites. METHODS: Altogether 2 102 126 male and 1 148 661 female workers were identified who worked in both 1960 and 1970. Their jobs were classified according to the percentage of shift workers, and they were followed from 1971 through 1989 or until they were diagnosed with cancer or died. Standardized incidence ratios (SIR) were used to compare the adjusted cancer incidence rates for shift workers with those for nonshift workers. RESULTS: Cancer rates were not elevated for the male shift workers [all sites combined: N=6524 cases among shift workers, SIR 1.02, 95% confidence interval (95% CI) 1.00-1.05; prostate: N=1319, SIR 1.04, 95% CI 0.99-1.10] or for the female shift workers (all sites combined: N=268, SIR 1.00, 95% CI 0.89-1.13; breast: N=70 cases, SIR 0.94, 95% CI 0.74-1.18). CONCLUSIONS: No evidence was found for an association between shift work and breast or prostate cancer, or all cancer sites combined among shift workers.     

Cancer incidence among mild steel and stainless steel welders and other metal workers

The cancer incidence in a historical cohort of 10,059 metal workers employed during the period 1964–1984 was investigated. Standardized incidence ratios (SIR) were calculated based on registry extracts from the Danish Cancer registry. Lifetime exposure data (occupational and other) were obtained by a postal questionnaire in living cohort members and interviews by proxy for deceased and emigrated subjects. The incidence of lung cancer was increased among workers ever “employed as welders” (SIR = 1.38, 95% C.I. 1.03–1.81). There was a significant excess risk of lung cancer among “mild steel (MS) only welders” (SIR = 1.61, 95% C.I. 1.07–2.33) and “nonwelders” (SIR = 1.69, 95% C.I. 1.23–2.26) (indicating carcinogenic exposures other than welding), a borderline significant lung cancer excess among “MS ever welders” (SIR = 1.32, 95% C.I. 0.97–1.76), and a nonsignificant excess risk of lung cancer among “stainless steel (SS) only welders” (SIR = 2.38, 95% C.I. 0.77–5.55). In spite of signs of inconsistency in the risk estimation by duration and latency, we find the results support the conclusions of other studies: employment as a welder is associated with an increased lung cancer risk. © 1996 Wiley-Liss, Inc.     

Cancers in concrete workers: results of a cohort study of 33,668 workers

OBJECTIVES—To study cancer morbidity patterns in concrete workers.
METHODS—A cohort of 33 503 concrete workers was enrolled in the study from 1971-86. The average duration of follow up was 19.4 years (582 225 person-years). The workers' cancer morbidity was compared with the morbidity of the general population.
RESULTS—A total of 3572 incident cancers were observed. Significantly increased standardised incidence ratios (SIRs) were found for all malignant neoplasms (SIR 107; 95% confidence interval (95%CI) 103 to 110), cancer of the lip (SIR 179; 95%CI 134 to 234), cancer of the stomach (SIR 139; 95%CI 122 to 158), cancer of the lung (SIR 125; 95%CI 114 to 137), and cancer of the prostate (SIR 108; 95%CI 101 to 116). Reduced risk was found for cancer of the large intestine (SIR 80; 95%CI 69 to 93) and cancer of the testis (SIR 50; 95%CI 26 to 87). Smoking was more prevalent among the concrete workers than in the general population (50% v 35%).
CONCLUSION—The study has shown a slightly increased overall risk of cancer among concrete workers. The increased risk of lung cancer could entirely be due to differences in smoking habits between concrete workers and the general population. There is a possibility that the smoking also has contributed to the increased risks of stomach cancer and lip cancer, but occupational factors may have contributed to these cancer sites.


Keywords: occupational diseases; constructions workers; smoking     

Cancer in the Norwegian printing industry

OBJECTIVES: The aim of this study was to investigate cancer risk among Norwegian workers in the printing industry, particularly lung and bladder cancer. METHODS: Cancer incidence was investigated from 1953 through 1998 in a cohort of 10 549 male members of a trade union in the printing industry in Oslo and nearby areas. Rates from the region, were used to calculate standardized incidence ratios (SIR) separately for the skilled and unskilled workers. Smoking data from a sample of the cohort were utilized for evaluating the risk estimates of smoking-related cancers. Specific exposure data were not available. RESULTS: Among the skilled workers, significantly elevated risks of cancer of the urinary bladder [standardized incidence ratio (SIR) 1.47, 95% confidence interval (95% CI) 1.19-1.79], liver (SIR 1.92, 95% CI 1.15-2.99), pancreas (SIR 1.46, 95% CI 1.07-1.94) and colon (SIR 1.27, 95% CI 1.05-1.55) were observed, whereas an increased risk of lung cancer in this group was confined to those born before 1910. Among the unskilled workers, there were significantly increased risks of cancer of the mouth, esophagus, stomach, larynx, lung, and all sites. CONCLUSIONS: The study showed that workers in the printing industry were at increased risk of several types of cancer. In particular the increased risk of bladder cancer among the skilled workers is suggestive of an occupational cause. However, no specific agent could be identified as an occupational carcinogen. The results did not support the hypothesis of a generally increased risk of lung cancer. The risk pattern for unskilled workers may reflect confounding by nonoccupational factors.