title: Risk of cancer in workers exposed to styrene at eight British companies making glass-reinforced plastics.
abstract: OBJECTIVE
  To provide further information on the risks of lymphohaematopoietic (LH) and other cancers associated with styrene.
  
  
  METHODS
  We extended follow-up to December 2012 for 7970 workers at eight companies in England which used styrene in the manufacture of glass-reinforced plastics. Mortality was compared with that for England and Wales by the person-years method, and summarised by SMRs with 95% CIs. A supplementary nested case-control analysis compared styrene exposures, lagged by 5 years, in 122 incident or fatal cases of LH cancer and 1138 matched controls.
  
  
  RESULTS
  A total of 3121 cohort members had died (2022 since the last follow-up). No elevation of mortality was observed for LH cancer, either in the full cohort (62 deaths, SMR 0.90, 95% CI 0.69 to 1.15), or in those with more than background exposure to styrene (38 deaths, SMR 0.82, 95% CI 0.58 to 1.14). Nor did the case-control analysis suggest any association with LH cancer. In comparison with background exposure, the OR for non-Hodgkin's lymphoma/chronic lymphocytic leukaemia in workers with high exposure (estimated 8-h time-weighted average of 40-100 ppm) for ≥1 year was 0.54 (95% CI 0.23 to 1.27). Mortality from lung cancer was significantly elevated, and risk increased progressively across exposure categories, with an SMR of 1.44 (95% CI 1.10 to 1.86) in workers highly exposed for ≥1 year.
  
  
  CONCLUSIONS
  We found no evidence that styrene causes LH cancer. An association with lung cancer is not consistently supported by other studies. It may have been confounded by smoking, but would be worth checking further.
authors.affiliation: MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton, UK.
authors.forename: David
authors.initials: D
authors.lastname: Coggon
authors.affiliation: MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton, UK.
authors.forename: Georgia
authors.initials: G
authors.lastname: Ntani
authors.affiliation: MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton, UK.
authors.forename: E Clare
authors.initials: EC
authors.lastname: Harris
authors.affiliation: MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton, UK.
authors.forename: Keith T
authors.initials: KT
authors.lastname: Palmer
mesh_terms: D000328:Adult; D016022:Case-Control Studies; D004739:England / Q000453:epidemiology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007221:Industry; D007938:Leukemia / Q000139:chemically induced / Q000401:mortality; D008223:Lymphoma / Q000139:chemically induced / Q000401:mortality; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000139:chemically induced* / Q000401:mortality; D009784:Occupational Diseases / Q000139:chemically induced* / Q000401:mortality; D016273:Occupational Exposure / Q000009:adverse effects*; D009790:Occupations / Q000145:classification; D010969:Plastics; D012307:Risk Factors; D013343:Styrenes / Q000633:toxicity*; D013997:Time Factors
chemical_list: D010969:Plastics; D013343:Styrenes
keywords: Styrene; glass-reinforced plastics; lung cancer; non-Hodgkin lymphoma