Abstract
Purpose
To study cancer mortality among Swedish pulp and paper mill workers by main mill pulping process and department, and to present the Swedish part of an international exposure measurements database.
Methods
A cohort of 18,163 male and 2,290 female workers at four sulfate and four sulfite mills, enrolled from 1939 to 1999, was followed up for mortality during 1952–2001. Standardized mortality ratios (SMRs) relative to the general Swedish population were calculated.
Results
There were 1,340 malignant cases out of 5,898 deaths. Total cancer mortality was not increased in either sulfate or sulfite mill workers, or by gender. Lung cancer mortality was increased among female workers (SMR 1.70, 95% CI 1.04–2.63), especially in paper production, but not among male workers (SMR 0.91, 95% CI 0.79–1.04). Exposure to wood dust and sulfur dioxide frequently exceeded occupational exposure limits.
Conclusions
Female paper production workers had an increased mortality from lung cancer.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
References
Andersson E, Nilsson T, Persson B, Wingren G, Torén K (1998) Mortality from asthma and cancer among sulfite mill workers. Scand J Work Environ Health 24:12–17
Andersson E, Hagberg S, Nilsson T, Persson B, Wingren G, Torén K (2001) A case-referent study of cancer mortality among sulfate mill workers in Sweden. Occup Environ Med 58:321–324
Andersson E, Nilsson R, Torén K (2002) Gliomas among men employed in the Swedish pulp and paper industry. Scand J Work Environ Health 28:333–340
Andersson E, Persson B, Bryngelsson IL, Magnuson A, Torén K, Wingren G et al (2007) Cohort mortality study of Swedish pulp and paper mill workers–nonmalignant diseases. Scand J Work Environ Health 33:470–478
Applebaum KM, Malloy EJ, Eisen EA (2007) Reducing healthy worker survivor bias by restricting date of hire in a cohort study of Vermont granite workers. Occup Environ Med 64:681–687
Band PR, Le ND, Fang R, Threlfall WJ, Astrakianakis G, Anderson JT et al (1997) Cohort mortality study of pulp and paper mill workers in British Columbia, Canada. Am J Epidemiol 146:186–194
Band PR, Le ND, Fang R, Astrakianakis G, Bert J, Keefe A et al (2001) Cohort cancer incidence among pulp and paper mill workers in British Columbia. Scand J Work Environ Health 27:113–119
Blair A, Stewart P, Lubin JH, Forastiere F (2007) Methodological issues regarding confounding and exposure misclassification in epidemiological studies of occupational exposures. Am J Ind Med 50:199–207
Carel R, Boffetta P, Kauppinen T, Teschke K, Andersen A, Jäppinen P et al (2002) Exposure to asbestos and lung and pleural cancer mortality among pulp and paper industry workers. J Occup Environ Med 44:579–584
Checkoway H, Pearce N, Kriebel D (2004) Research methods in occupational epidemiology, 2nd edn. Monographs in epidemiology and biostatistics, vol 34. Oxford University Press
Coble J, Lees P, Matanoski G (2001) Time trends in exposure measurements from OSHA compliance inspections of the pulp and paper industry. Appl Occup Environ Hygiene 16:263–270
Henneberger PK, Lax MB (1998) Lung cancer mortality in a cohort of older pulp and paper workers. Int J Occup Environ Health 4:147–154
Hussain A, McDuffie HH, Bickis MG, Pahwa P (2007) Case-control study on occupational risk factors for soft-tissue sarcoma. J Occup Environ Med 49:1386–1393
Jäppinen P, Pukkala E (1991) Cancer incidence among pulp and paper workers exposed to organic chlorinated compounds formed during chlorine pulp bleaching. Scand J Work Environ Health 17:356–359
Kauppinen T, Teschke K, Savela A, Kogevinas M, Boffetta P (1997) International data base of exposure measurements in the pulp, paper and paper product industries. Int Arch Occup Environ Health 70:119–127
Kauppinen T, Teschke K, Astrakianakis G, Boffetta P, Colin D, Keefe A et al (2002) Assessment of exposure in an international study on cancer risks among pulp, paper, and paper product workers. AIHA J 63:254–261
Korhonen K, Liukkonen T, Ahrens W, Astrakianakis G, Bofetta P, Burdorf A et al (2004) Occupational exposure to chemical agents in the paper industry. Int Arch Occup Environ Health 77:451–460
Kriebel D, Zeka A, Eisen EA, Wegman DH (2004) Quantitative evaluation of the effects of uncontrolled confounding by alcohol and tobacco in occupational cancer studies. Int J Epidem 33:1040–1045
Langseth H, Andersen A (1999) Cancer incidence among women in the Norwegian pulp and paper industry. Am J Ind Med 36:108–113
Langseth H, Andersen A (2000) Cancer incidence among male pulp and paper workers in Norway. Scand J Work Environ Health 26:99–105
Langseth H, Kjaerheim K (2004) Ovarian cancer and exposure among pulp and paper employees in Norway. Scand J Work Environ Health 30:356–361
Lee WJ, Teschke K, Kauppinen T, Andersen A, Jäppinen P, Szadkowska-Stanczyk I et al (2002) Mortality from lung cancer in workers exposed to sulfur dioxide in the pulp and paper industry. Environ Health Perspect 110:991–995
Matanoski GM, Kanchanaraksa S, Lees PS, Tao XG, Royall R, Francis M et al (1998) Industry-wide study of mortality of pulp and paper mill workers. Am J Ind Med 33:354–365
McLean D, Pearce N, Langseth H, Jäppinen P, Szadkowska-Stanczyk I, Persson B et al (2006) Cancer mortality in workers exposed to organochlorine compounds in the pulp and paper industry: an international collaborative study. Environ Health Perspect 114:1007–1012
Rosenberg C, Kontsas H, Tornaeus J, Mutanen P, Jäppinen P, Vainio H et al (1995) PCDD/PCDF levels in the blood of workers at a pulp and paper mill. Chemosphere 31:3933–3944
StataCorp (2005) Stata statistical software: release 8. StataCorp LP, College Station, TX
Szadkowska-Stańczyk I, Szymczak W (2001) Nested case-control study of lung cancer among pulp and paper workers in relation to exposure to dusts. Am J Ind Med 39:547–556
Szadkowska-Stańczyk I, Szymczak W, Szeszenia-Dabrowska N, Wilczyńska U (1998) Cancer risk in workers of the pulp and paper industry in Poland: a continued follow-up. Int J Occup Med Environ Health 11:217–225
Teschke K, Ahrens W, Andersen A, Boffetta P, Fincham S, Finkelstein M et al (1999) Occupational exposure to chemical and biological agents in the nonproduction departments of pulp, paper, and paper product mills: an international study. Am Ind Hyg Assoc J 60:73–83
Torén K, Hagberg S, Westberg H (1996a) Health effects of working in pulp and paper mills: exposure, obstructive airways diseases, hypersensitivity reactions, and cardiovascular diseases. Am J Ind Med 29:111–122
Torén K, Persson B, Wingren G (1996b) Health effects of working in pulp and paper mills: malignant diseases. Am J Ind Med 29:123–130
Wild P, Bergeret A, Moulin J-J, Lahmar A, Hours M (1998) Une étude de mortalité dans l’industrie française du papier et de la pâte à papier. Rev Epidemiol Santé Publique 46:85–92 In French
Wingren G, Kling H, Axelson O (1985) Gastric cancer among paper mill workers. J Occup Med 27:715
Acknowledgments
This study was supported by the Swedish Council for Worklife Research. The authors also gratefully acknowledge the technical assistance of Malte Nordqvist.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Andersson, E., Persson, B., Bryngelsson, IL. et al. Cancer mortality in a Swedish cohort of pulp and paper mill workers. Int Arch Occup Environ Health 83, 123–132 (2010). https://doi.org/10.1007/s00420-009-0446-1
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00420-009-0446-1