Cancer smelter worker

In a historical cohort mortality study of 1,990 primary lead smelter workers, an SMR of 2.04 for mortality from renal cancer was calculated (Selevan et al. 1985). The cohort consisted of workers who had worked at least 1 year, with at least 1 day of employment at the smelter between 1940 and 1965. The cohort had been heavily exposed to lead and in 1976 the PbB levels averaged 56.3 pg/dL. Exposures to cadmium and arsenic were generally minor. A follow-up study of this cohort was conducted from 1977 through 1988 (Steenland et al. 1992). Analysis of the follow-up study revealed an excess of kidney cancer, particularly in the high-lead group (SMR 2.39). Although, as the authors indicate, the study is... 

Cocco P, Carta P, Flore C, et al. 1996. Mortality of lead smelter workers with the glucose-6-phosphate dehydrogenase-deficient phenotype. Cancer Epidemiol Biomarkers Prev 5(3) 223-225. 

Gerhardsson L, Hagmar L, Rylander L, et al. 1995a. Mortality and cancer incidence among secondary lead smelter workers. Occup Environ Med 52 667-672. 

Lundstrom NG, Nordberg G, Englyst V, et al. 1997. Cumulative lead exposure in relation to mortality and lung cancer morbidity in a cohort of primary smelter workers. Scand J Work Environ Health 23(l) 24-30. 

Another large retrospective cohort study followed 3916 smelter workers and reported an overall standardized mortality ratio of 372." Lung cancer mortality was related to intensity of exposure but not to duration. Histologic types of lung carcinomas were similar to those seen in smokers. 

Jarup L, Pershagen G, Wall S Cumulative arsenic exposure and lung cancer in smelter workers a dose-response study. AmJ Ind Med 15 31-41, 1989... 

Rosenman KD, Stanbury M Risk of cancer among former chromium smelter workers. AmJlndMed29-A9 SQ0, 1996... 

Arsenic causes both skin and lung cancer. Skin cancer was observed over 100 years ago in patients treated with arsenical compounds, and lung cancer was seen in smelter workers who chronically inhaled arsenic dust. Although arsenic is an established human carcinogen, it has been difficult to confirm and study in animal models. Arsenic readily crosses the placenta, but there appears to be increased methylation of arsenic to its organic form, which reduces its toxicity to the fetus. 

More recently, an association between environmental exposure to arsenic and development of lung cancer has been proposed. Ferreccio et al. (2000) conducted a case-control study of a Chilean population exposed to arsenic in their drinking water. The odds ratio for lung cancer, which was adjusted for several confounders (e.g. smoking and copper smelter workers) ranged from 1 for exposures < lOpgl 1 to 9 for concentrations of 200-400 pgl-1 (65-year average exposure). 

Armstrong VBG, Tremclay CG, Cyr D, et al. 1986. Estimating the relationship between exposure to tar volatiles and the incidence of bladder cancer in aluminum smelter workers. Scand J Work Environ Health 12 486-493. 

Dufresne A, Loosereewanich P, Armstrong B, et al. 1996. Inorganic particles in the lungs of five aluminum smelter workers with pleuro-pulmonary cancer. Am Ind Hyg Assoc J 57 370-375. 

In a study of 228 Swedish copper smelter workers, it was found that the age standardized rate ratio for lung cancer death was 3.0 for arsenic-exposed nonsmokers, 4.9 for smokers not occupationally exposed to arsenic, and 14.6 for arsenic-exposed smokers, demonstrating a multiplicative effect of the combined exposure. I122l... 

Gerhardsson L, Brune D, Nordberg G, et al. 1986. Selenium and other trace elements in lung tissue in smelter workers relationship to the occurrence of lung cancer. Acta Pharmacol Toxicol 59 (Suppl7) 256-259. 

It has been well established by a variety of epidemiologic studies that inorganic arsenic can cause human cancer. This is in spite of the fact that animal studies have not yet shown arsenic to be carcinogenic. Evidence comes from studies of smelter workers, which have demonstrated Increased lung cancer risks (2.3). In addition, ingestion of arsenic has been shown to cause cancer of the skin and other sites in studies of exposure to naturally occurring arsenic in drinking water in Taiwan (4.5), and studies of patients who have consumed medicinal arsenic (6.7). 

The risk of cancer among former chromium smelter workers was found to be significantly increased, despite cessation of exposure. Proportionate cancer mortality ratios (PCMR) for lung cancer were calculated as 1.51 for white men and 1.34 for black men. The PCMR for nasal cavity/ sinus cancer was 5.18 (Rosenman and Stan-bury 1996). However, a group of workers in stainless steel production with low exposure to various forms of chromium did not show clinical changes in the nasal mucosa or symptoms of nasal diseases, except for... 

K Welch, I Higgins, M Oh, C Burchfield. Arsenic exposure, smoking, and respiratory cancer in copper smelter workers. Arch Environ Health 37 325-335, 1982. 

Limg cancer Lead-only smelter workers (n = 1,992) compared with unexposed population... 

Stomach cancer Meta-analysis of occupationally exposed battery and smelter workers... 

Lundstrom, N.G., V. Englyst, L. Gerhardsson, T. Jin, and G. Nordberg. 2006. Lung cancer development in primary smelter workers A nested case-referent study. J. Oc-cup. Environ. Med. 48(4) 376-380. 

Tumorigenidty The risk of death and the incidence of cancers with quantitative exposure to benzene-soluble fraction, benzo(a) pyrene, fluoride, and inhalable dust have been studied in two 4316 male prebake smelter workers using cancer incidence registries and follow-up for 20 years [35. There were smoking-adjusted monotonic relationships between the risk of respiratory cancer and cumulative inhalable dust exposure, cumulative fluoride exposure, and cumulative benzo (fl)pyrene exposure. The exposure-response trends were stronger when examined across the exposed categories. There was a monotonic but not statistically significant trend between cumulative benzo(fl)pyrene exposure and stomach cancer. Bladder cancer was not associated with benzo(fl)pyrene or benzene exposure. No other cancers or deaths were associated with these exposures. 

Table 17.1 depicts nine reports on findings of increased lung cancer incidences and mortdities in both battery and smelter workers with elevated Pb exposures and one report derived from Pb exposure monitoring analysis. These cohorts and other subjects were from Britain, Finland, Italy, Sweden, and the United States. Pb exposures were indexed by actual environmental measurements in air or measurements of Pb in blood and urine. A job-exposure matrix approach was employed in part of one study using a nested case—control approach. 

Swedish smelter workers Cohort study N = 3,979 workers >1 year employed, 1928—1979 subcohort N= 1,992 workers in Pb department mortality 1955-1987 PbB mean, 1950 62 pg/dl 1987 33 (xg/dl Total cohort lung cancers = 39 SMR = 280 (200-380) high-exposure group lung cancers = 19 SMR = 280 (180-450) Lundstrom etal. (1997)... 

Swedish smelter workers 3,979 workers, primary Cu—Pb smelter, follow-up 1958—1987. Subcohort 1 710 workers in Pb department and elsewhere Subcohort 2 383 workers only employed in Pb department Cumulative blood Pb index PbB x work duration Subcohort 1 lung cancer cases = 10 SIR = 240 (120-450) Subcohort 2 lung cancer cases = 5 SIR = 360 (120-830) Englyst et al. (2001)... 

Swedish smelter workers Nested case-control study N = 3,979 primary smelter workers workers with lung cancer (N = 46) compared with 141 age-matched male controls Follow-up of earlier reports Cancer cases showed a higher smoking rate versus controls. OR = 4.0 (1.6—10.1, 0.003). Air As, but not air Pb indices higher among the smokers with lung cancer smoking and cumulative workplace As exposure accounted for the cancers Lundstrom et al. (2006)... 

---