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Relationships between alumina and bauxite dust exposure and cancer, respiratory and circulatory disease
  1. M C Friesen1,2,
  2. L Fritschi3,
  3. A Del Monaco1,
  4. G Benke1,
  5. M Dennekamp1,
  6. N de Klerk4,
  7. J L Hoving1,5,
  8. E MacFarlane1,
  9. M R Sim1
  1. 1
    Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Australia
  2. 2
    Environmental Health Sciences, University of California Berkeley, Berkeley, California, USA
  3. 3
    Western Australian Institute for Medical Research, Sir Charles Gairdner Hospital, Nedlands, Australia
  4. 4
    Telethon Institute for Child Health Research and School of Population Health, University of Western Australia, Perth, Australia
  5. 5
    Coronel Institute of Occupational Health, University of Amsterdam, Amsterdam, The Netherlands
  1. Correspondence to Malcolm R Sim, Monash Centre for Occupational and Environmental Health (MonCOEH), Department of Epidemiology and Preventive Medicine, Faculty of Medicine, Nursing and Health Sciences, Monash University, Alfred Hospital, Commercial Road, Melbourne, Victoria 3004 Australia; Malcolm.sim{at}


Objectives: To examine the associations between alumina and bauxite dust exposure and cancer incidence and circulatory and respiratory disease mortality among bauxite miners and alumina refinery workers.

Methods: This cohort of 5770 males has previously been linked to national mortality and national and state cancer incidence registries (1983–2002). In this paper, Poisson regression was used to undertake internal comparisons within the cohort based on subgroups of cumulative exposure to inhalable bauxite and alumina dust. Exposure was estimated using job histories and historical air monitoring data.

Results: There was no association between ever bauxite exposure and any of the outcomes. There was a borderline significant association between ever alumina exposure and cerebrovascular disease mortality (10 deaths, RR 3.8, 95% CI 1.1 to 13). There was some evidence of an exposure–response relationship between cumulative bauxite exposure and non-malignant respiratory disease mortality (seven deaths, trend p value: 0.01) and between cumulative alumina exposure and cerebrovascular disease mortality (trend p value: 0.04). These associations were based on very few cases and for non-malignant respiratory disease the deaths represented a heterogeneous mixture of causes. There was no evidence of an excess risk for any cancer type with bauxite or alumina exposure.

Conclusions: These preliminary findings, based on very few cases, suggest that cumulative inhalable bauxite exposure may be associated with an excess risk of death from non-malignant respiratory disease and that cumulative inhalable alumina dust exposure may be associated with an excess risk of death from cerebrovascular disease. Neither exposure appears to increase the risk of incident cancers.

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  • Additional tables are published online only at

  • Funding This study was funded by Alcoa of Australia Ltd.

  • Competing interests None.

  • Provenance and peer review Not commissioned; externally peer reviewed.