title: Update of cancer incidence among workers at a copper/nickel smelter and nickel refinery.
abstract: OBJECTIVE
  To assess cancer risk among nickel-exposed workers.
  
  
  METHODS
  We updated cancer incidence among 1388 workers employed for at least 3 months at a copper/nickel smelter and nickel refinery in Harjavalta, Finland. There were 1155 workers exposed to nickel during the period 1960-1985 in the smelter (566 workers), repair shop (239 workers), or refinery (418 workers). Cancer incidence was followed through the files of the Finnish Cancer Registry up to 31 December 1995. For overall cancer and for a priori selected specific cancer types the ratio of observed to expected numbers of cases was computed as a standardized incidence ratio (SIR), controlled for age, gender, and calendar period and using the region-specific rates as a reference.
  
  
  RESULTS
  The overall cancer incidence among both nickel-exposed and unexposed subcohorts was at the expected level. A small increase in lung cancer incidence, which reached statistical significance among workers with a latency exceeding 20 years, was observed among the smelter workers exposed to insoluble nickel compounds. Among workers in the refinery, who were exposed primarily to nickel sulfate at levels below 0.5 mg/m3 as well as to low concentrations of other nickel compounds, there was an increased risk for nasal cancer (SIR 41.1, 95% CI 4.97-148), positively associated with latency and duration of employment, and an excess risk for stomach (SIR 4.98, 95% CI 1.62-11.6) and lung (SIR 2.61, 95% CI 0.96-5.67) cancers.
  
  
  CONCLUSIONS
  Since elevated nasal and lung cancer risks were confined to the refinery, where the primary exposure was to nickel sulfate, it is likely that nickel sulfate is mainly responsible for the elevated respiratory cancer risk. We cannot rule out whether the excess stomach cancer risk is a chance finding, or related to the working environment.
authors.affiliation: Finnish Cancer Registry, Helsinki, Finland. ahti.anttila@cancer.fi
authors.forename: A
authors.initials: A
authors.lastname: Anttila
authors.forename: E
authors.initials: E
authors.lastname: Pukkala
authors.forename: A
authors.initials: A
authors.lastname: Aitio
authors.forename: T
authors.initials: T
authors.lastname: Rantanen
authors.forename: S
authors.initials: S
authors.lastname: Karjalainen
mesh_terms: D000328:Adult; D000368:Aged; D000395:Air Pollutants, Occupational / Q000009:adverse effects*; D015331:Cohort Studies; D003300:Copper / Q000009:adverse effects*; D003430:Cross-Sectional Studies; D004305:Dose-Response Relationship, Drug; D005260:Female; D005387:Finland / Q000453:epidemiology; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000139:chemically induced* / Q000453:epidemiology; D009532:Nickel / Q000009:adverse effects*; D009784:Occupational Diseases / Q000139:chemically induced* / Q000453:epidemiology; D012042:Registries / Q000706:statistics & numerical data; D012306:Risk
chemical_list: D000395:Air Pollutants, Occupational; C029938:nickel sulfate; C022838:nickel chloride; D003300:Copper; D009532:Nickel