title: Nonmalignant mortality among workers in six Norwegian aluminum plants.
abstract: OBJECTIVE
  This study investigated the associations between exposure to fluorides and polycyclic aromatic hydrocarbons (PAH) and mortality from nonmalignant diseases among workers in the Norwegian primary aluminum industry.
  
  
  METHODS
  Mortality among 10,857 men, employed for more than 3 years in 1 of 6 aluminum plants, was investigated from 1962 to 1996, giving 239,246 person-years during follow-up. Ajob-exposure matrix covering all 6 plants was used to estimate the individual exposure to total fluorides and particulate PAH. The observed cause-specific deaths were compared with expected figures calculated from national rates. Dose-response relations were investigated by internal comparisons using Poisson regression and by stratified analyses for standardized mortality ratio. Potential confounding by smoking was investigated in subanalyses restricted to 3 of the plants for which information on smoking habits was accessible.
  
  
  RESULTS
  Mortality from circulatory disease was slightly lower than expected [SMR 0.95, 95% confidence interval (95%CI) 0.9-1.0], while there was an increased mortality from asthma, emphysema, and chronic bronchitis combined, SMR 1.2 (95% CI 1.0-1.5). Mortality from these diseases was associated with cumulative exposure to fluorides. The rate ratio in the internal analysis rose steadily to 2.5 (95% CI 1.5-4.3) for the upper exposure category. No association was observed between cumulative fluoride exposure or PAH exposure and circulatory mortality.
  
  
  CONCLUSIONS
  The study showed an association between exposure to potroom emissions measured by fluorides and mortality from asthma, emphysema, and chronic bronchitis combined.
authors.affiliation: The Cancer Registry of Norway, Oslo. pr@kreftregisteret.no
authors.forename: P
authors.initials: P
authors.lastname: Romundstad
authors.forename: A
authors.initials: A
authors.lastname: Andersen
authors.forename: T
authors.initials: T
authors.lastname: Haldorsen
mesh_terms: D000535:Aluminum; D002423:Cause of Death; D005459:Fluorides / Q000009:adverse effects*; D006801:Humans; D007221:Industry; D008297:Male; D009664:Norway / Q000453:epidemiology; D009784:Occupational Diseases / Q000139:chemically induced / Q000453:epidemiology / Q000401:mortality*; D011083:Polycyclic Compounds / Q000009:adverse effects*; D012907:Smoking
chemical_list: D011083:Polycyclic Compounds; D000535:Aluminum; D005459:Fluorides