Skip to main content
PMC home page
Occupational and Environmental Medicine logoLink to Occupational and Environmental Medicine
. 2001 May;58(5):321–324. doi: 10.1136/oem.58.5.321

A case-referent study of cancer mortality among sulfate mill workers in Sweden

E Andersson 1, S Hagberg 1, T Nilsson 1, B Persson 1, G Wingren 1, K Toren 1
PMCID: PMC1740130  PMID: 11303081

Abstract

OBJECTIVES—To investigate whether workers in Swedish sulfate mills have an increased risk of death from certain malignancies that have previously been linked to the pulping process.
METHODS—Subjects of the study (n=2480) were men aged 40-75 at death during 1960-89 in the parishes surrounding four sulfate mills. Exposure assessment was based on information from the personnel files in the mills— 35% of the subjects were recognised there, and work categories were created.
RESULTS—Among all sulfate mill workers, the odds ratio (OR) (90% confidence interval (90% CI)) for death from lung cancer was 1.6 (1.1 to 2.3), pleural mesotheliomas 9.5 (1.9 to 48), brain tumours 2.6 (1.2 to 5.3), and liver or biliary tract cancer 2.3 (1.0 to 5.2). There was an increased mortality from leukaemia among workers in the soda recovery plant (5.9 (2.6 to 13)) and bleaching plant and digester house (2.8 (1.0 to 7.5)).
CONCLUSIONS—Sulfate mill workers were at increased risk of dying from lung cancer and pleural mesotheliomas, probably due to exposure to asbestos. Increased risks of brain tumours and cancers of the liver or biliary tract were also found but the aetiology is not obvious.


Keywords: epidemiology; pulp and paper industry; brain neoplasm

Full Text

The Full Text of this article is available as a PDF (100.5 KB).

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Andersson E., Nilsson T., Persson B., Wingren G., Torén K. Mortality from asthma and cancer among sulfite mill workers. Scand J Work Environ Health. 1998 Feb;24(1):12–17. doi: 10.5271/sjweh.273. [DOI] [PubMed] [Google Scholar]
  2. Axelson O. Elucidation of some epidemiologic principles. Scand J Work Environ Health. 1983 Jun;9(3):231–240. doi: 10.5271/sjweh.2415. [DOI] [PubMed] [Google Scholar]
  3. Band P. R., Le N. D., Fang R., Threlfall W. J., Astrakianakis G., Anderson J. T., Keefe A., Krewski D. Cohort mortality study of pulp and paper mill workers in British Columbia, Canada. Am J Epidemiol. 1997 Jul 15;146(2):186–194. doi: 10.1093/oxfordjournals.aje.a009250. [DOI] [PubMed] [Google Scholar]
  4. Bertazzi P. A., Zocchetti C., Pesatori A. C., Guercilena S., Consonni D., Tironi A., Landi M. T. Mortality of a young population after accidental exposure to 2,3,7,8-tetrachlorodibenzodioxin. Int J Epidemiol. 1992 Feb;21(1):118–123. doi: 10.1093/ije/21.1.118. [DOI] [PubMed] [Google Scholar]
  5. Correa A., Stewart W. F., Yeh H. C., Santos-Burgoa C. Exposure measurement in case-control studies: reported methods and recommendations. Epidemiol Rev. 1994;16(1):18–32. doi: 10.1093/oxfordjournals.epirev.a036142. [DOI] [PubMed] [Google Scholar]
  6. Inskip P. D., Linet M. S., Heineman E. F. Etiology of brain tumors in adults. Epidemiol Rev. 1995;17(2):382–414. doi: 10.1093/oxfordjournals.epirev.a036200. [DOI] [PubMed] [Google Scholar]
  7. Järvholm B., Malker H., Malker B., Ericsson J., Sällsten G. Pleural mesotheliomas and asbestos exposure in the pulp and paper industries: a new risk group identified by linkage of official registers. Am J Ind Med. 1988;13(5):561–567. doi: 10.1002/ajim.4700130504. [DOI] [PubMed] [Google Scholar]
  8. Kheifets L. I., Afifi A. A., Buffler P. A., Zhang Z. W. Occupational electric and magnetic field exposure and brain cancer: a meta-analysis. J Occup Environ Med. 1995 Dec;37(12):1327–1341. doi: 10.1097/00043764-199512000-00002. [DOI] [PubMed] [Google Scholar]
  9. MANTEL N., HAENSZEL W. Statistical aspects of the analysis of data from retrospective studies of disease. J Natl Cancer Inst. 1959 Apr;22(4):719–748. [PubMed] [Google Scholar]
  10. Malker H. S., McLaughlin J. K., Malker B. K., Stone B. J., Weiner J. A., Ericsson J. L., Blot W. J. Biliary tract cancer and occupation in Sweden. Br J Ind Med. 1986 Apr;43(4):257–262. doi: 10.1136/oem.43.4.257. [DOI] [PMC free article] [PubMed] [Google Scholar]
  11. Matanoski G. M., Kanchanaraksa S., Lees P. S., Tao X. G., Royall R., Francis M., Lantry D. Industry-wide study of mortality of pulp and paper mill workers. Am J Ind Med. 1998 Apr;33(4):354–365. doi: 10.1002/(sici)1097-0274(199804)33:4<354::aid-ajim5>3.0.co;2-u. [DOI] [PubMed] [Google Scholar]
  12. McLaughlin J. K., Malker H. S., Blot W. J., Malker B. K., Stone B. J., Weiner J. A., Ericsson J. L., Fraumeni J. F., Jr Occupational risks for intracranial gliomas in Sweden. J Natl Cancer Inst. 1987 Feb;78(2):253–257. [PubMed] [Google Scholar]
  13. Milham S., Jr, Demers R. Y. Mortality among pulp and paper workers. J Occup Med. 1984 Nov;26(11):844–846. doi: 10.1097/00043764-198411000-00016. [DOI] [PubMed] [Google Scholar]
  14. Milham S., Jr Neoplasia in the wood and pulp industry. Ann N Y Acad Sci. 1976;271:294–300. doi: 10.1111/j.1749-6632.1976.tb23124.x. [DOI] [PubMed] [Google Scholar]
  15. Pasqualetti P., Casale R., Colantonio D., Collacciani A. Occupational risk for hematological malignancies. Am J Hematol. 1991 Oct;38(2):147–149. doi: 10.1002/ajh.2830380216. [DOI] [PubMed] [Google Scholar]
  16. Prescott E., Osler M., Hein H. O., Borch-Johnsen K., Lange P., Schnohr P., Vestbo J. Gender and smoking-related risk of lung cancer. The Copenhagen Center for Prospective Population Studies. Epidemiology. 1998 Jan;9(1):79–83. [PubMed] [Google Scholar]
  17. Sala-Serra M., Sunyer J., Kogevinas M., McFarlane D., Antó J. M. Cohort study on cancer mortality among workers in the pulp and paper industry in Catalonia, Spain. Am J Ind Med. 1996 Jul;30(1):87–92. doi: 10.1002/(SICI)1097-0274(199607)30:1<87::AID-AJIM15>3.0.CO;2-4. [DOI] [PubMed] [Google Scholar]
  18. Schwartz E. A proportionate mortality ratio analysis of pulp and paper mill workers in New Hampshire. Br J Ind Med. 1988 Apr;45(4):234–238. doi: 10.1136/oem.45.4.234. [DOI] [PMC free article] [PubMed] [Google Scholar]
  19. Torén K., Blanc P. D. The history of pulp and paper bleaching: respiratory-health effects. Lancet. 1997 May 3;349(9061):1316–1318. doi: 10.1016/S0140-6736(96)10141-0. [DOI] [PubMed] [Google Scholar]
  20. Torén K., Hagberg S., Westberg H. Health effects of working in pulp and paper mills: exposure, obstructive airways diseases, hypersensitivity reactions, and cardiovascular diseases. Am J Ind Med. 1996 Feb;29(2):111–122. doi: 10.1002/(SICI)1097-0274(199602)29:2<111::AID-AJIM1>3.0.CO;2-V. [DOI] [PubMed] [Google Scholar]
  21. Torén K., Persson B., Wingren G. Health effects of working in pulp and paper mills: malignant diseases. Am J Ind Med. 1996 Feb;29(2):123–130. doi: 10.1002/(SICI)1097-0274(199602)29:2<123::AID-AJIM2>3.0.CO;2-T. [DOI] [PubMed] [Google Scholar]
  22. Wingren G., Persson B., Thorén K., Axelson O. Mortality pattern among pulp and paper mill workers in Sweden: a case-referent study. Am J Ind Med. 1991;20(6):769–774. doi: 10.1002/ajim.4700200608. [DOI] [PubMed] [Google Scholar]

Articles from Occupational and Environmental Medicine are provided here courtesy of BMJ Publishing Group

RESOURCES