Mortality Among Hardmetal Production Workers

Morfeld, Peter; Groß, J. Valérie; Erren, Thomas C.; Noll, B.; Yong, Mei; Kennedy, Katrin J.; Esmen, Nurtan A.; Zimmerman, Sherri A.; Buchanich, Jeanine M.; Marsh, Gary M.

doi:10.1097/jom.0000000000001061

Cited by 15 publications

(6 citation statements)

References 14 publications

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“…The authors also evaluated RRs across levels of cumulative exposure with adjustment for occupational co-exposures, reporting no increase in lung cancer risk for the group of workers with the highest cumulative exposure (RR ¼ 0.78, 95% CI: 0.26-2.4). Morfeld et al (2017) reported an SMR of 0.93 (95% CI: 0.68-1.25) for German workers compared to the national population and a hazard ratio (HR) of 1.09 (95% CI: 0.01-18.81) for a 1-unit increment in cumulative nickel exposure, with adjustment for occupational co-exposures. McElvenny et al (2017) reported an SMR of 0.91 (95% CI: 0.15-1.92) for workers in the UK with at least 20 years of employment, with no adjustment for important potential confounders.…”

Section: Evaluation Of Study Resultsmentioning

confidence: 99%

“…Four cohorts were identified in the hardmetal production industry. These cohorts included multiple sites in the US (Marsh et al 2017a), UK (McElvenny et al 2017), Sweden (Svartengren et al 2017;Westberg et al 2017), and Germany (Morfeld et al 2017), where nickel was added as a trace element to hardmetal mixtures of tungsten carbide to impart specific properties and may also have been used as a binding agent, alone or in conjunction with cobalt. The ratio mean (i.e.…”

Section: Cohorts Of Workers Exposed To Metallic Nickelmentioning

confidence: 99%

“…We applied our study quality/RoB criteria for epidemiology studies (Table S1) to the 16 identified cohort studies that evaluated exposures to predominantly metallic nickel (Table 5). Of these, eight were categorized into Tier 1 (Cragle et al 1984;Sorahan 2004;Sorahan and Williams 2005;Egedahl and Collins 2009;Huvinen and Pukkala 2013;Morfeld et al 2017;Marsh et al 2017aMarsh et al , 2017b and the remaining eight studies were categorized into Tier 2. There are a number of common methodological limitations of the epidemiology studies, particularly with regard to the three key RoB criteria (exposure characterization, outcome assessment, and confounding), that affect the causal interpretation of study results.…”

Section: Study Quality Evaluationmentioning

confidence: 99%

“…Exposure-response relationships were examined for lung cancer in four studies by conducting statistical testing for trend (Sorahan 2004;Marsh et al 2017aMarsh et al , 2017bMorfeld et al 2017). None of these analyses indicated a statistically significant exposure-response relationship between duration of exposure, cumulative exposure, or exposure intensity and lung cancer mortality.…”

Section: Biological Gradientmentioning

confidence: 99%

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Systematic review of the potential respiratory carcinogenicity of metallic nickel in humans

Prueitt

Chang

et al. 2020

Critical Reviews in Toxicology

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The inhalation of dust containing certain nickel compounds has been associated with an increased risk of lung and nasal cancers in occupational studies of workers who process or refine sulfidic nickel ores and are exposed to relatively high levels of mixtures of water-soluble, sulfidic, oxidic, and/or metallic forms of nickel. We conducted a systematic review of the potential carcinogenicity of metallic nickel, focusing on cancers of the respiratory tract. We evaluated the quality and risk of bias (RoB) of the relevant epidemiology, experimental animal, and in vitro mechanistic studies using the National Toxicology Program's Office of Health Assessment and Translation (OHAT) RoB Rating Tool. We then used a systematic review protocol based on the OHAT approach to critically assess whether metallic nickel should be considered a human respiratory carcinogen. Our evaluation of the epidemiology studies indicates that there is no substantive evidence of increased respiratory cancer risk in workers exposed predominantly to metallic nickel. Animal evidence indicates that metallic nickel does not increase the incidence of respiratory tumors in rodents exposed by inhalation. The in vitro studies are limited in value, as they bypass normal clearance mechanisms. Nevertheless, the mechanistic evidence indicates that metallic nickel is not mutagenic but can induce DNA strand breaks under certain conditions. Based on a standard framework for assessing causality, we conclude that the evidence does not support a causal relationship between metallic nickel exposure and respiratory cancer in humans.

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Section: Evaluation Of Study Resultsmentioning

confidence: 99%

Section: Cohorts Of Workers Exposed To Metallic Nickelmentioning

confidence: 99%

Section: Study Quality Evaluationmentioning

confidence: 99%

Section: Biological Gradientmentioning

confidence: 99%

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Systematic review of the potential respiratory carcinogenicity of metallic nickel in humans

Prueitt

Chang

et al. 2020

Critical Reviews in Toxicology

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“…No association has been found between increased respiratory cancer risk and inhalation exposure to metallic nickel outside the nickel refineries, when local populations were used as controls [57,58]. More recent cohort studies support the lack of association between exposure to metallic nickel and excess respiratory cancer [59][60][61][62][63].…”

Section: Inhalation Exposure Routementioning

confidence: 95%

Concise Review of Nickel Human Health Toxicology and Ecotoxicology

Buxton¹,

Garman²,

Heim³

et al. 2019

Inorganics

151

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Nickel (Ni) metal and Ni compounds are widely used in applications like stainless steel, alloys, and batteries. Nickel is a naturally occurring element in water, soil, air, and living organisms, and is essential to microorganisms and plants. Thus, human and environmental nickel exposures are ubiquitous. Production and use of nickel and its compounds can, however, result in additional exposures to humans and the environment. Notable human health toxicity effects identified from human and/or animal studies include respiratory cancer, non-cancer toxicity effects following inhalation, dermatitis, and reproductive effects. These effects have thresholds, with indirect genotoxic and epigenetic events underlying the threshold mode of action for nickel carcinogenicity. Differences in human toxicity potencies/potentials of different nickel chemical forms are correlated with the bioavailability of the Ni2+ ion at target sites. Likewise, Ni2+ has been demonstrated to be the toxic chemical species in the environment, and models have been developed that account for the influence of abiotic factors on the bioavailability and toxicity of Ni2+ in different habitats. Emerging issues regarding the toxicity of nickel nanoforms and metal mixtures are briefly discussed. This review is unique in its covering of both human and environmental nickel toxicity data.

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Tungsten

Olalde,

Venezia

2023

Patty's Toxicology

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Tungsten is a rare metal with numerous applications, most notably in machine tools, catalysts, and superalloys. The physical and chemical properties of tungsten and its compounds of commercial importance (such as sodium tungstate, ammonium meta ‐ and para ‐tungstate, tungsten metal, tungsten carbide, and tungsten oxides), as well as tungsten industrialization, recycling, occupational exposure, and biomonitoring are discussed. Between 1970 and 1990, most tungsten toxicological investigations concerned the toxicity and health effects of cemented carbides, also known as hard metal, rather than tungsten and its compounds themselves. However, within the last decade a diversity of studies on the toxicity of the water soluble and bioavailable sodium tungstate, have been conducted to fill several toxicity knowledge gaps. Acute toxicity studies on several soluble (sodium tungstate, ammonium para ‐ and meta ‐tungstate) and sparingly water‐soluble (tungsten metal, tungsten oxides, tungsten carbide) substances reported low acute oral, dermal, and inhalation toxicity, as well as a lack of eye and dermal irritation and sensitization potential. Studies published within the last 5–7 years on sodium tungstate include oral repeated exposure, reproductive, developmental, neurotoxicological, and immunotoxicological endpoints. Several reports have incorrectly associated repeated exposure toxicity of hard metals with pure tungsten carbide. As the toxicity of hard metal does not represent the intrinsic toxicity of tungsten substances so it is discussed separately within this chapter.

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Mortality Among Hardmetal Production Workers

Abstract: This study does not provide evidence for elevated lung cancer risks. Methodologic limitations, incomplete ascertainment of death causes in particular, impede conclusions about exposure effects.

Cited by 15 publications

References 14 publications

Systematic review of the potential respiratory carcinogenicity of metallic nickel in humans

Systematic review of the potential respiratory carcinogenicity of metallic nickel in humans

Concise Review of Nickel Human Health Toxicology and Ecotoxicology

Tungsten

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