Cancer incidence among male pulp and paper workers in Norway

Abstract

Objectives The study investigated cancer incidence among 23 718 male pulp and paper workers employed continuously for at least 1 year between 1920 and 1993 in Norway. Methods The name, date of birth, personal identification number, dates of hire and termination for all employment periods, specific department, and job categories were registered for each worker. Six subcohorts were established (sulfite mill, sulfate mill, paper mill, maintenance department, administrative staff and other departments). Data on the cohort were linked with data in the Norwegian Cancer Register. The follow-up period for cancer incidence, date of death, or emigration was from 1953 through 1993. Results An excess incidence of lung cancer was found among both short-and long-term employees [standardized incidence ratio (SIR) 1.5, 95% confidence interval (95% CI) 1.13-2.03 and SIR 1.2, 95% CI 1.09-1.34, respectively], especially for workers with the longest latency (SIR 1.3,95% CI 1.08-1.44) and for sulfite mill workers (SIR 1.5,95% CI 1.09-1.99). The risk for pleural mesothelioma was also increased (SIR 2.4,95% CI 1.45-3.75), especially among maintenance workers. The results also showed an increased risk for malignant melanoma (SIR 1.3,95% CI 1.04-1.60), an unexpected finding. C O~C~U S~O~S Almost all the increased risk for lung cancer can be explained by a combination of smoking habits and asbestos use, although an effect of other work-related exposures (sulfur and chloride compounds, wood dust) cannot be excluded. Most of the cases of pleural mesothelioma occurred in departments where asbestos was used. There is no clear explanation for the excess of malignant melanoma, and the finding may be a chance occurrence.Key terms lung cancer, malignant melanoma, occupational cohort, pleural mesothelioma, pulp and paper mills.

Nested case‐control study of lung cancer among pulp and paper workers in relation to exposure to dusts

“…Band et al [1997], in a large cohort study in British Columbia, observed an excess risk for lung cancer among sul®te mill workers. A Norway cohort study indicated an excess incidence of lung cancer among all male employees of the pulp and paper industry and especially among workers involved in sul®te pulp production [Langseth and Andersen, 2000]. In a separate analysis concerning women the same authors observed an increased risk of lung cancer in shortterm workers only [Langseth and Andersen, 1999].…”

Mortality from lung cancer in workers exposed to sulfur dioxide in the pulp and paper industry.

“…Some early studies (Lee and Fraumeni 1969;Rencher et al 1977) in SO 2 -exposed workers showed an increased mortality from lung cancer, but in those studies exposure to SO 2 occurred together with exposure to known or suspected carcinogens such as arsenic. Previous studies have reported an increased mortality from lung cancer among workers employed in the pulp and paper industry and, in particular, in sulfite pulp manufacture and maintenance (Band et al 2001;Langseth and Andersen 2000;Szadkowska-Stanczyk and Szymczak 2001;Toren et al 1991). It was suggested that asbestos, dust, or chlorinated compounds could be among the agents responsible for the increased lung cancer mortality, but no formal attempt was made in these studies to assess exposure to specific agents.…”

Familial risk for lung cancer

“…A high mortality rate has been observed among workers employed in the paper and pulp industry, and among those exposed to sulphur dioxide combined with arsenic. Other studies suggested that sulphur dioxide exposure in the paper and pulp industry contributes to lung carcinogenesis (15,16).…”