Mortality from non-malignant diseases in a cohort of female pulp and paper workers in Norway

Abstract

Objectives: The objective of the present study was to investigate the risk of death from non-malignant diseases in female pulp and paper workers in Norway. Methods: A total of 3143 women first employed between 1920-93 were included in the study cohort. Information about each cohort member was obtained from personnel record files in the mills in order to identify employment periods and job categories. Data on cause and date of death were added by linkage to the Cause of Death Register using unique personal identification numbers. The follow up period was 1951-2000. Standardised mortality ratios (SMRs) with 95% confidence intervals (95% CIs) were calculated using the national female mortality rates as reference. Poisson regression analysis was used to examine internal relations between the duration of employment in paper departments and the risk of death from selected causes. Relative risks (RRs) and 95% CIs were calculated. Results: The study showed a significantly increased risk for total non-malignant mortality (SMR = 1.14, 95% CI 1.05 to 1.24), mainly due to increased mortality from ischaemic heart disease (SMR = 1.22, 95% CI 1.03 to 1.43) and cerebrovascular diseases (SMR = 1.16, 95% CI 0.94 to 1.42). Analysis by department showed the highest risk of death in paper department workers with short term employment. Internal analyses showed a 5% and 9% increase in risk of dying from ischaemic heart disease and respiratory diseases, respectively, among paper department workers exposed to paper dust. The risk decreased with increasing duration of employment. Conclusion: The increased risk of ischaemic heart diseases and respiratory diseases seen among employees of paper departments may be related to exposure to paper dust. F ew studies have addressed mortality from non-malignant diseases among women in industrial jobs. The reason for this may be that women traditionally have been in the minority in these occupational groups, their employment and follow up periods may have been shorter, and they are often assumed to hold less exposed jobs than men. In many countries women entered the workforce later than men did. In Norway the percentage of women working outside the home was less than 30% in 1960, less than 40% in 1980, increasing to almost 70% in 1990.1 Increasing employment in industries where women were largely excluded in the past necessitates studies on female workers mainly because gender differences might cause different disease outcome in men and women. [2][3][4] Worldwide, men have constituted the main part of the workforce in the pulp and paper industry, and most studies have reported results only for men or, in some cases, for both genders merged. 5 The pulp and paper industry is a very old industry in Norway, operating since 1870. Women have through all times constituted approximately one tenth of the workforce among paper workers and the classical workplace has been in paper departments as paper sorters. Many girls started work at a very young age; in 1910 one half of them were aged under 20 years. 6 A n...

Mortality among 24,865 workers exposed to polychlorinated biphenyls (PCBs) in three electrical capacitor manufacturing plants: A ten-year update

“…Increased mortality among short-term workers has been reported, particularly for causes of death associated with disorders that might affect employment or with an unhealthy lifestyle. Those who are only briefly in a workplace might leave because of sensitization to work materials, and possibly the beginning of work-related chronic conditions (Langseth and Kjaerheim, 2006), or shorter durations of employment might be associated with more pre-employment hospitalizations for alcohol use, accidents, and the effects of violence (Kolstad and Olsen, 1999). We have no lifestyle or hospitalization information for our cohort.…”

Cohort mortality study of Swedish pulp and paper mill workers—nonmalignant diseases

“…Some other studies on pulp and paper mill workers have not only reported an increased (21)(22) but also a decreased risk for cardiovascular mortality (23)(24)(25)(26)(27). A recent published study on nonmalignant mortality among female pulp and paper mill workers showed increased mortality for ischemic heart disease (SMR 1.22, 95% CI 1.03-1.43), but the highest risk occurred for short-term workers in the paper department (5). In that study, mortality from cerebrovascular diseases was insignificantly increased (SMR 1.16, 95% CI 0.94-1.42).…”

“…There have been reports of increased mortality due to ischemic heart Andersson et al disease among pulp and paper mill workers (1,(3)(4)(5), but myocardial infarction, specifically, has rarely been studied. Mill workers exposed to sulfur dioxide have been reported to have increased mortality from nonmalignant respiratory diseases and asthma (6,7), and also from lung cancer (8).…”

Asthma Mortality in Male Workers of the Dye Industry in Korea

“…Langseth and Kjaerheim observed 3,143 women from 1951 to 2000 who were first employed in the pulp and paper industry between 1920 and 1993 7) . Mortality due to non-malignant respiratory diseases (SMR=1.13, 95% CI 0.86-1.47) and the mortality due to chronic obstructive pulmonary disease (COPD) including asthma (SMR=1.21, 95% CI 0.77-1.57) were elevated slightly, but only 5 deaths from asthma were observed from 1960 to 2000 versus the 5.8 expected deaths.…”

“…Asthma can be lifethreatening, but few studies have examined the occupational mortality of the disease. Some studies, however, have elucidated the relationship by occupation, and others by industry, such as in pulp and paper workers, sulfite mill workers, and ferroalloy plants [6][7][8][9] . We investigated the excess risk of death due to asthma in dye workers.…”