title: Upper aerodigestive cancer in battery manufacturers and steel workers exposed to mineral acid mists.
abstract: OBJECTIVE
  To assess the risk of cancer from inhalation of mineral acid mists.
  
  
  METHODS
  A cohort study and nested case-control study of upper aerodigestive tumours were carried out in men employed since 1950 at two battery plants and two steel works in Britain. The cohort was identified from personnel records and included 2678 men with definite exposure to acid mists (mainly sulphuric acid), 367 with possible exposure, and 1356 who were unexposed. Mortality was compared with that in the national population by the person-years method. Cases of upper aerodigestive cancer were identified from death certificates and cancer registrations, and their exposure to acids was compared with that of age matched controls (five per case) from the same plant by conditional logistic regression.
  
  
  RESULTS
  In follow up to 31 December 1993, 93% of men were traced, including 1277 who had died. Among the men definitely exposed to acid mists, overall mortality was less than in the national population (standardised mortality ratio (SMR) 0.92, 95% confidence interval (95% CI) 0.85-0.98) as was mortality from all cancers (SMR 0.92, 95% CI 0.79-1.05) and specifically from cancer of the larynx (SMR 0.48, 95% CI 0.01-2.70) and lung (SMR 0.98, 95% CI 0.78-1.22). A total of 15 incident or fatal cases of upper aerodigestive cancer were identified during follow up. When these men were compared with controls, risk was moderately increased in those who had worked for at least five years in jobs entailing exposures to sulphuric or hydrochloric acid in excess of 1 mg/m3 (OR 2.0, 95% CI 0.4-10).
  
  
  CONCLUSIONS
  These findings are consistent with those from other studies which have indicated a hazard of upper aerodigestive cancer from acid mists. However, they indicate that any risk from exposures to sulphuric and hydrochloric acid below 1 mg/m3 is small.
authors.affiliation: MRC Environmental Epidemiology Unit, University of Southampton, Southampton General Hospital.
authors.forename: D
authors.initials: D
authors.lastname: Coggon
authors.forename: B
authors.initials: B
authors.lastname: Pannett
authors.forename: G
authors.initials: G
authors.lastname: Wield
mesh_terms: D000336:Aerosols; D016022:Case-Control Studies; D015331:Cohort Studies; D004067:Digestive System Neoplasms / Q000139:chemically induced / Q000401:mortality*; D011211:Electric Power Supplies; D006801:Humans; D006851:Hydrochloric Acid / Q000009:adverse effects; D007822:Laryngeal Neoplasms / Q000401:mortality; D008297:Male; D008669:Metallurgy; D009369:Neoplasms / Q000401:mortality; D016273:Occupational Exposure / Q000009:adverse effects*; D012142:Respiratory Tract Neoplasms / Q000139:chemically induced / Q000401:mortality*; D018570:Risk Assessment; D013464:Sulfuric Acids / Q000009:adverse effects*; D006113:United Kingdom / Q000453:epidemiology
chemical_list: D000336:Aerosols; D013464:Sulfuric Acids; D006851:Hydrochloric Acid