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  • Workers in Australian prebake aluminium smelters: update on risk of mortality and cancer incidence in the Healthwise cohort

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Original research
Workers in Australian prebake aluminium smelters: update on risk of mortality and cancer incidence in the Healthwise cohort
  1. Anthony Del Monaco1,2,
  2. Christina Dimitriadis1,2,
  3. Sophia Xie3,4,
  4. Geza Benke1,2,
  5. Malcolm Ross Sim1,2,
  6. Karen Walker-Bone1,2,5
  1. 1 Monash Centre for Occupational and Environmental Health, Monash University, Melbourne, Victoria, Australia
  2. 2 School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
  3. 3 Peter Maccullum Cancer Centre, Peter Maccullum Cancer Institute, Melbourne, Victoria, Australia
  4. 4 Chronic Disease and Ageing, Monash University, Melbourne, Victoria, Australia
  5. 5 MRC Versus Arthritis Centre for Musculoskeletal Health and Work, University of Southampton, Southampton, UK
  1. Correspondence to Professor Karen Walker-Bone, Monash University, Clayton, VIC 3800, Australia; Karen.Walker-Bone{at}Monash.edu

Abstract

Objectives To investigate mortality and the rates of incident cancer among a cohort of aluminium industry workers.

Methods Among 4507 male employees who worked in either of two Australian prebake smelters for at least 3 months, data linkage was undertaken with the Australian National Death Index and Australian Cancer Database. Standardised Mortality Ratios (SMRs) and Standardised Incidence Rates (SIRs) were estimated for the whole cohort and for: production; maintenance and office workers. SMRs and SIRs were calculated by time since first employment.

Results Among production workers, there was an excess risk of mortality from mesothelioma (SMR 2.8, 95% CI 1.3 to 5.2), lung (SMR 1.4, 95% CI 1.0 to 1.8), prostate (SMR 1.9, 95% CI 1.3 to 2.7) and liver cancer (SMR 2.0, 95% CI 1.1 to 3.4) and the SIR was also increased for overall respiratory cancers, specifically lung cancers. An excess risk of death from stomach cancer (SMR 2.9, 95% CI 1.2 to 6.1) and Alzheimer’s disease (SMR 3.4, 95% CI 1.1 to 7.9) was seen among maintenance workers. The overall risk of death was similar to that of the Australian general population, as was mortality from cancers overall and non-malignant respiratory disease.

Conclusions No excess risk of death from bladder cancer or non-malignant respiratory disease was found. Excess lung cancer mortality and incidence may be explained by smoking and excess mortality from mesothelioma may be explained by asbestos exposure. An excess risk of mortality from liver and prostate cancer has been shown in production workers and requires further investigation.

  • Cancer
  • Mortality
  • Mesothelioma

Data availability statement

Data may be obtained from a third party and are not publicly available. Linkage data were obtained from the Australian Institute for Health and Welfare and permission would need to be obtained from them for additional data usage.

https://doi.org/10.1136/oemed-2022-108605

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    Data availability statement

    Data may be obtained from a third party and are not publicly available. Linkage data were obtained from the Australian Institute for Health and Welfare and permission would need to be obtained from them for additional data usage.

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    Footnotes

    • Twitter @kwb_doc

    • Contributors MS was awarded funding for the study and conceived the design. ADM, CD and GB undertook the data collection and analyses and provisional report writing. KW-B drafted the manuscript. All co-authors reviewed and approved the manuscript for submission. KW-B takes responsibility for the overall content as guarantor.

    • Funding The Healthwise study was funded by Alcoa of Australia Ltd (PO Box 252, ApplecrossWA 6953) (Award Number: Not applicable). The sponsor had no direct involvement in study design, the collection, analysis, and interpretation of data, the writing of the report or in the decision to submit the paper for publication.

    • Competing interests None declared.

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

    • Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.