title: Cancer mortality in workers exposed to organochlorine compounds in the pulp and paper industry: an international collaborative study.
abstract: The objective of this study was to evaluate cancer mortality in pulp and paper industry workers exposed to chlorinated organic compounds. We assembled a multinational cohort of workers employed between 1920 and 1996 in 11 countries. Exposure to both volatile and nonvolatile organochlorine compounds was estimated at the department level using an exposure matrix. We conducted a standardized mortality ratio (SMR) analysis based on age and calendar-period-specific national mortality rates and a Poisson regression analysis. The study population consisted of 60,468 workers. Workers exposed to volatile organochlorines experienced a deficit of all-cause [SMR = 0.91; 95% confidence interval (CI), 0.89-0.93] and all-cancer (SMR = 0.93; 95% CI, 0.89-0.97) mortality, with no evidence of increased risks for any cancer of a priori interest. There was a weak, but statistically significant, trend of increasing risk of all-cancer mortality with increasing weighted cumulative exposure. A similar deficit in all-cause (SMR = 0.94; 95% CI, 0.91-0.96) and all-cancer (SMR = 0.94; 95% CI, 0.89-1.00) mortality was observed in those exposed to nonvolatile organochlorines. No excess risk was observed in cancers of a priori interest, although mortality from Hodgkin disease was elevated (SMR = 1.76; 95% CI, 1.02-2.82) . In this study we found little evidence that exposure to organochlorines at the levels experienced in the pulp and paper industry is associated with an increased risk of cancer, apart from a weak but significant association between all-cancer mortality and weighted cumulative volatile organochlorine exposure.
authors.affiliation: International Agency for Research on Cancer, Lyon, France; Center for Public Health Research, Massey University, Wellington, New Zealand.
authors.forename: David
authors.initials: D
authors.lastname: McLean
authors.forename: Neil
authors.initials: N
authors.lastname: Pearce
authors.forename: Hilde
authors.initials: H
authors.lastname: Langseth
authors.forename: Paavo
authors.initials: P
authors.lastname: Jäppinen
authors.forename: Irena
authors.initials: I
authors.lastname: Szadkowska-Stanczyk
authors.forename: Bodil
authors.initials: B
authors.lastname: Persson
authors.forename: Pascal
authors.initials: P
authors.lastname: Wild
authors.forename: Reiko
authors.initials: R
authors.lastname: Kishi
authors.forename: Elsebeth
authors.initials: E
authors.lastname: Lynge
authors.forename: Paul
authors.initials: P
authors.lastname: Henneberger
authors.forename: Maria
authors.initials: M
authors.lastname: Sala
authors.forename: Kay
authors.initials: K
authors.lastname: Teschke
authors.forename: Timo
authors.initials: T
authors.lastname: Kauppinen
authors.forename: Didier
authors.initials: D
authors.lastname: Colin
authors.forename: Manolis
authors.initials: M
authors.lastname: Kogevinas
authors.forename: Paolo
authors.initials: P
authors.lastname: Boffetta
mesh_terms: D006801:Humans; D006843:Hydrocarbons, Chlorinated / Q000008:administration & dosage* / Q000633:toxicity; D009369:Neoplasms / Q000139:chemically induced / Q000401:mortality*; D009784:Occupational Diseases / Q000139:chemically induced / Q000401:mortality; D016273:Occupational Exposure; D010209:Paper; D012307:Risk Factors; D013997:Time Factors
chemical_list: D006843:Hydrocarbons, Chlorinated