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Cohort Mortality Study of Pulp and Paper Mill Workers in British Columbia, Canada

Source:American Journal of Epidemiology, Vol. 146, No. 2, pages 186-194, 42 references, 1997

ABSTRACT:

"A study of cancer mortality among workers in the British Columbia (BC) pulp and paper industry was conducted. The cohort consisted of 3,157 males employed for at least 1 year (yr) on January 1, 1950 or later at 14 pulp and paper mills in BC. A total of 20,373 workers worked in facilities that utilized the kraft process, 5,249 worked in facilities using the sulfite process, and 4,535 were employed in facilities that used both processes. The subjects were followed until the end of December 1991 at which time their vital status was determined. Standardized mortality ratios (SMRs) for causes of death of the decedents were computed using mortality rates of the general male Canadian population as the reference. In the total cohort, 4,074 deaths from all causes occurred, yielding an SMR of 0.92, a significantly decreased risk. A total of 1,052 cancer deaths, representing an SMR of 1.02, occurred. Deaths from cancer of the esophagus, pleura, kidneys, and eyes were significantly increased, SMRs of 1.37, 2.65, 1.40, and 3.41, respectively. These risks were increased in workers who were employed at the facilities for more than 15yr. Among workers employed exclusively in the kraft process, 439 cancer deaths occurred, SMR 0.94. Mortality from cancers of the pleura and bone was nonsignificantly increased, SMRs 2.51 and 2.23, respectively. These excess risks were present for work durations longer than 15yr. For workers employed in the sulfite process only, 351 cancer deaths occurred, SMR 1.15, a significantly increased risk. Mortality from cancers of the pancreas, lung, and brain was significantly increased, SMRs 1.56, 1.32, and 1.72, respectively. When work durations of 15yr or longer were considered, these SMRs decreased. A significantly increased risk for Hodgkin's disease, however, was now detected, SMR 4.79. For workers employed in both the kraft and sulfite processes, 262 cancer deaths occurred, yielding an SMR of 1.8. Mortality from nonHodgkin's lymphoma (NHL) was significantly increased, SMR 1.71. Mortality from esophagus, gallbladder, and kidney cancer was nonsignificantly increased, SMRs 1.77, 1.86, and 1.56, respectively. These associations did not vary with duration of employment. The authors conclude that employment in the pulp and paper industry appears to be associated with increased risks for esophageal, pleural, kidney, brain, and gallbladder cancer, NHL, and Hodgkin's disease. These may be related to exposures to carcinogens such as asbestos (1332214), biocides, formaldehyde (50000), and hypochlorites."