Abstract
Ethylene oxide, important as an intermediate product in the chemical industry and for sterilising hospital equipment, is mutagenic in several organisms; carcinogenicity has been suspected although this had not been supported by clinical data. Ethylene oxide has been produced by a Swedish company since the beginning of the 1940s. This paper describes a cohort study of the mortality and the cancer incidence among full-time exposed workers in ethylene oxide production, a group of maintenance workers with intermittent exposure and a group of unexposed controls. Investigation of the production processes in the building at different times has shown that workers were exposed to ethylene dichloride, ethylene chlorohydrin, ethylene, and small amounts of bis-(2-chloroethyl) ether as well as to ethylene oxide and traces of other chemicals. The full-time exposed cohort shows a considerable excess mortality deriving mainly from increased mortality from tumours and also from diseases of the circulatory system. The cancer incidence study, including living persons with malignancies, showed a significant excess in the full-time cohort. Of the 16 patients with tumours in the two more exposed cohorts there were three cases of leukaemia, six of tumours in the alimentary tract and four of urogenital malignancy. The excess mortality and cancer incidence cannot be attributed to any particular chemical in the production process, but ethylene oxide and ethylene dichloride are the prime suspects.
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- Benditt E. P. Implications of the monoclonal character of human atherosclerotic plaques. Beitr Pathol. 1976 Sep;158(4):405–416. doi: 10.1016/s0005-8165(76)80137-0. [DOI] [PubMed] [Google Scholar]
- Byrén D., Engholm G., Englund A., Westerholm P. Mortality and cancer morbidity in a group of Swedish VCM and PCV production workers. Environ Health Perspect. 1976 Oct;17:167–170. doi: 10.1289/ehp.17-1475258. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Calleman C. J., Ehrenberg L., Jansson B., Osterman-Golkar S., Segerbäck D., Svensson K., Wachtmeister C. A. Monitoring and risk assessment by means of alkyl groups in hemoglobin in persons occupationally exposed to ethylene oxide. J Environ Pathol Toxicol. 1978 Nov-Dec;2(2):427–442. [PubMed] [Google Scholar]
- Dyer A. R., Stamler J., Berkson D. M., Lindberg H. A., Stevens E. High blood-pressure: a risk factor for cancer mortality? Lancet. 1975 May 10;1(7915):1051–1056. doi: 10.1016/s0140-6736(75)91826-7. [DOI] [PubMed] [Google Scholar]
- Ehrenberg L., Hiesche K. D., Osterman-Golkar S., Wenneberg I. Evaluation of genetic risks of alkylating agents: tissue doses in the mouse from air contaminated with ethylene oxide. Mutat Res. 1974 Aug;24(2):83–103. doi: 10.1016/0027-5107(74)90123-7. [DOI] [PubMed] [Google Scholar]
- Ehrenberg L., Osterman-Golkar S., Segerbäck D., Svensson K., Calleman C. J. Evaluation of genetic risks of alkylating agents. III. Alkylation of haemoglobin after metabolic conversion of ethene to ethene oxide in vivo. Mutat Res. 1977 Nov;45(2):175–184. doi: 10.1016/0027-5107(77)90017-3. [DOI] [PubMed] [Google Scholar]
- Hogstedt C., Malmqvist N., Wadman B. Leukemia in workers exposed to ethylene oxide. JAMA. 1979 Mar 16;241(11):1132–1133. [PubMed] [Google Scholar]
- JOYNER R. E. CHRONIC TOXICITY OF ETHYLENE OXIDE. A STUDY OF HUMAN RESPONSES TO LONG-TERM LOW-LEVEL EXPOSURES. Arch Environ Health. 1964 May;8:700–710. doi: 10.1080/00039896.1964.10663741. [DOI] [PubMed] [Google Scholar]
- Nordén A., Scherstén B., Thulin T., Pero R. W., Bryngelsson C., Mitelman F. Letter: Hypertension related to D.N.A. repair synthesis and carcinogen uptake. Lancet. 1975 Nov 29;2(7944):1094–1094. doi: 10.1016/s0140-6736(75)90471-7. [DOI] [PubMed] [Google Scholar]
- Van Duuren B. L., Orris L., Nelson N. Carcinogenicity of epoxides, lactones, and peroxy compounds. II. J Natl Cancer Inst. 1965 Oct;35(4):707–717. [PubMed] [Google Scholar]
- Viadana E., Bross I. D., Houten L. Cancer experience of men exposed to inhalation of chemicals or to combustion products. J Occup Med. 1976 Dec;18(12):787–792. doi: 10.1097/00043764-197612000-00003. [DOI] [PubMed] [Google Scholar]
- WALPOLE A. L. Carcinogenic action of alkylating agents. Ann N Y Acad Sci. 1958 Apr 24;68(3):750–761. doi: 10.1111/j.1749-6632.1958.tb42638.x. [DOI] [PubMed] [Google Scholar]