title: Relationships between alumina and bauxite dust exposure and cancer, respiratory and circulatory disease.
abstract: OBJECTIVE
  To examine the associations between alumina and bauxite dust exposure and cancer incidence and circulatory and respiratory disease mortality among bauxite miners and alumina refinery workers.
  
  
  METHODS
  This cohort of 5770 males has previously been linked to national mortality and national and state cancer incidence registries (1983-2002). In this paper, Poisson regression was used to undertake internal comparisons within the cohort based on subgroups of cumulative exposure to inhalable bauxite and alumina dust. Exposure was estimated using job histories and historical air monitoring data.
  
  
  RESULTS
  There was no association between ever bauxite exposure and any of the outcomes. There was a borderline significant association between ever alumina exposure and cerebrovascular disease mortality (10 deaths, RR 3.8, 95% CI 1.1 to 13). There was some evidence of an exposure-response relationship between cumulative bauxite exposure and non-malignant respiratory disease mortality (seven deaths, trend p value: 0.01) and between cumulative alumina exposure and cerebrovascular disease mortality (trend p value: 0.04). These associations were based on very few cases and for non-malignant respiratory disease the deaths represented a heterogeneous mixture of causes. There was no evidence of an excess risk for any cancer type with bauxite or alumina exposure.
  
  
  CONCLUSIONS
  These preliminary findings, based on very few cases, suggest that cumulative inhalable bauxite exposure may be associated with an excess risk of death from non-malignant respiratory disease and that cumulative inhalable alumina dust exposure may be associated with an excess risk of death from cerebrovascular disease. Neither exposure appears to increase the risk of incident cancers.
authors.affiliation: Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Australia.
authors.forename: M C
authors.initials: MC
authors.lastname: Friesen
authors.forename: L
authors.initials: L
authors.lastname: Fritschi
authors.forename: A
authors.initials: A
authors.lastname: Del Monaco
authors.forename: G
authors.initials: G
authors.lastname: Benke
authors.forename: M
authors.initials: M
authors.lastname: Dennekamp
authors.forename: N
authors.initials: N
authors.lastname: de Klerk
authors.forename: J L
authors.initials: JL
authors.lastname: Hoving
authors.forename: E
authors.initials: E
authors.lastname: MacFarlane
authors.forename: M R
authors.initials: MR
authors.lastname: Sim
mesh_terms: D000328:Adult; D000537:Aluminum Oxide / Q000009:adverse effects*; D002561:Cerebrovascular Disorders / Q000209:etiology* / Q000401:mortality; D015331:Cohort Studies; D004391:Dust / Q000032:analysis; D006801:Humans; D019570:Inhalation Exposure / Q000009:adverse effects / Q000032:analysis; D008297:Male; D008669:Metallurgy; D008875:Middle Aged; D008906:Mining; D009369:Neoplasms / Q000209:etiology* / Q000401:mortality; D009784:Occupational Diseases / Q000209:etiology* / Q000401:mortality; D016273:Occupational Exposure / Q000009:adverse effects / Q000032:analysis; D012140:Respiratory Tract Diseases / Q000209:etiology* / Q000401:mortality; D018570:Risk Assessment / Q000379:methods; D014904:Western Australia / Q000453:epidemiology; D055815:Young Adult
chemical_list: D004391:Dust; D000537:Aluminum Oxide