Cancer Mortality of Workers Exposed to Styrene in the U.S. Reinforced Plastics and Composite Industry

Collins, James J.; Bodner, Kenneth M.; Bus, James S.

doi:10.1097/ede.0b013e318281a30f

Cited by 52 publications

(76 citation statements)

References 31 publications

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“…The recently updated British styrene cohort also had an excess of lung cancer deaths, especially among workers with high-styrene exposure, and, like us, no leukaemia or lymphoma excess 27. However, a recent update of a large (N=15 826) US study of workers in the reinforced plastics industry originally studied by Wong and colleagues32 33 found an increase in lung cancer mortality, but with an inverse trend with exposure,26 and a previous update had found an increase in mortality from ‘other respiratory diseases’, but only in short-term (<1 year) or low-exposure workers 33. The difference in findings between our cohorts and others could be due to differences in styrene levels or lifestyle or other differences between the cohorts.…”

Section: Discussionmentioning

confidence: 49%

“…Previous reviews and studies of lymphatic and haematopoietic neoplasm in styrene-exposed workers4 22 have varied widely, including a statistically significant deficit of cancer deaths,26 a lack of association with styrene,27 and a moderate association of increased lymphoma and leukaemia mortality with longer latency and higher average level of exposure 28. Incidence studies are preferred over mortality studies for cancers with relatively high survival rates, such as lymphohaematopoietic cancers 29 30.…”

Section: Discussionmentioning

confidence: 99%

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Mortality among styrene-exposed workers in the reinforced plastic boatbuilding industry

2015

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COPD was more pronounced among those with potential high-styrene exposure. However, no outcome was related to estimated cumulative styrene exposure, and there was no change when latency was taken into account. We found no excess leukaemia or lymphoma mortality. As in most occupational cohort studies, lack of information on lifestyle factors or other employment was a substantial limitation although we excluded from the analyses those (n=3525) who worked <1 year. Unanticipated excess ovarian cancer mortality could be a chance finding. Comparing subcohorts with potential high-styrene and low-styrene exposure, COPD mortality SRR was elevated while lung cancer SRR was not, suggesting that smoking was not the only cause for excess COPD mortality.

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Section: Discussionmentioning

confidence: 49%

Section: Discussionmentioning

confidence: 99%

Mortality among styrene-exposed workers in the reinforced plastic boatbuilding industry

2015

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“…Additionally, a large epidemiologic study described excess mortality from obstructive lung disease in highly exposed, short-term reinforced-plastics workers, which would be consistent with obliterative bronchiolitis [Collins et al, 2013; Cummings et al, 2014]. Furthermore, an occupational study in an Egyptian reinforced plastics factory found that styrene exposure correlated with decreased pulmonary function tests, including FEV1/FVC and percent of predicted FEV1, FVC, and MMEF, indicating that obstruction, especially mid-flow obstruction, might be a consequence of styrene exposure [Helal and Elshafy, 2012].…”

Section: Discussionmentioning

confidence: 99%

Styrene‐associated health outcomes at a windblade manufacturing plant

McCague

Cox‐Ganser

Harney

et al. 2015

American J Industrial Med

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Background Health risks of using styrene to manufacture windblades for the green energy sector are unknown. Methods Using data collected from 355 (73%) current windblade workers and regression analysis, we investigated associations between health outcomes and styrene exposure estimates derived from urinary styrene metabolites. Results The median current styrene exposure was 53.6 mg/g creatinine (interquartile range: 19.5–94.4). Color blindness in men and women (standardized morbidity ratios 2.3 and 16.6, respectively) was not associated with exposure estimates, but was the type previously reported with styrene. Visual contrast sensitivity decreased and chest tightness increased (odds ratio 2.9) with increasing current exposure. Decreases in spirometric parameters and FeNO, and increases in the odds of wheeze and asthma-like symptoms (odds ratios 1.3 and 1.2, respectively) occurred with increasing cumulative exposure. Conclusions Despite styrene exposures below the recommended 400 mg/g creatinine, visual and respiratory effects indicate the need for additional preventative measures in this industry.

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“…Styrene exposures are common in the reinforced plastics and composite industry, in which Collins, Bodner, and Bus () examined mortality rates in relation to cumulative exposure, duration of exposure, peak exposures, and average exposure. The peak exposure metric reflected days with 15 or more minutes above 100 ppm styrene (reportedly the lowest level at which irritation from styrene occurs).…”

Section: Case Studiesmentioning

confidence: 99%

Peak Exposures in Epidemiologic Studies and Cancer Risks: Considerations for Regulatory Risk Assessment

Checkoway

Lees

Dell³

et al. 2019

Risk Analysis

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We review approaches for characterizing “peak” exposures in epidemiologic studies and methods for incorporating peak exposure metrics in dose–response assessments that contribute to risk assessment. The focus was on potential etiologic relations between environmental chemical exposures and cancer risks. We searched the epidemiologic literature on environmental chemicals classified as carcinogens in which cancer risks were described in relation to “peak” exposures. These articles were evaluated to identify some of the challenges associated with defining and describing cancer risks in relation to peak exposures. We found that definitions of peak exposure varied considerably across studies. Of nine chemical agents included in our review of peak exposure, six had epidemiologic data used by the U.S. Environmental Protection Agency (US EPA) in dose–response assessments to derive inhalation unit risk values. These were benzene, formaldehyde, styrene, trichloroethylene, acrylonitrile, and ethylene oxide. All derived unit risks relied on cumulative exposure for dose–response estimation and none, to our knowledge, considered peak exposure metrics. This is not surprising, given the historical linear no‐threshold default model (generally based on cumulative exposure) used in regulatory risk assessments. With newly proposed US EPA rule language, fuller consideration of alternative exposure and dose–response metrics will be supported. “Peak” exposure has not been consistently defined and rarely has been evaluated in epidemiologic studies of cancer risks. We recommend developing uniform definitions of “peak” exposure to facilitate fuller evaluation of dose response for environmental chemicals and cancer risks, especially where mechanistic understanding indicates that the dose response is unlikely linear and that short‐term high‐intensity exposures increase risk.

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Cancer Mortality of Workers Exposed to Styrene in the U.S. Reinforced Plastics and Composite Industry

Abstract: We found no coherent evidence that styrene exposure increases risk from cancers of the lymphatic and hematopoietic tissue, pancreas, or lung.

Cited by 52 publications

References 31 publications

Mortality among styrene-exposed workers in the reinforced plastic boatbuilding industry

Mortality among styrene-exposed workers in the reinforced plastic boatbuilding industry

Styrene‐associated health outcomes at a windblade manufacturing plant

Peak Exposures in Epidemiologic Studies and Cancer Risks: Considerations for Regulatory Risk Assessment

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