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. 2004 Jan;61(1):2–7.

Mortality analyses in a cohort of 18 235 ethylene oxide exposed workers: follow up extended from 1987 to 1998

K Steenland 1, L Stayner 1, J Deddens 1
PMCID: PMC1757803  PMID: 14691266

Abstract

Aims: To extend mortality follow up from 1987 to 1998 for cohort of 18 235 men and women exposed to ethylene oxide.

Methods: Standard mortality follow up, life table and Cox regression analysis.

Results: There were 2852 deaths, compared with 1177 in the earlier 1987 follow up. There was no overall excess of haematopoietic cancers combined or of non-Hodgkin's lymphoma. However, internal exposure-response analyses found positive trends for haematopoietic cancers which were limited to males (15 year lag). The trend in haematopoietic cancer was driven by lymphoid tumours (non-Hodgkin's lymphoma, myeloma, lymphocytic leukaemia), which also have a positive trend with cumulative exposure for males with a 15 year lag. Haematopoietic cancer trends were somewhat weaker in this analysis than trends in the earlier follow up, and analyses restricted to the post-1987 data did not show any significant positive trends (exposure levels dropped sharply in the early 1980s). Breast cancer did not show any overall excess, although there was an excess in the highest cumulative exposure quartile using a 20 year lag. Internal exposure-response analyses found positive trend for breast cancer using the log of cumulative exposure with a 20 year lag.

Conclusions: There was little evidence of any excess cancer mortality for the cohort as a whole, with the exception of bone cancer based on small numbers. Positive exposure-response trends for lymphoid tumours were found for males only. Reasons for the sex specificity of this effect are not known. There was also some evidence of a positive exposure-response for breast cancer mortality.

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Selected References

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  1. Gardner M. J., Coggon D., Pannett B., Harris E. C. Workers exposed to ethylene oxide: a follow up study. Br J Ind Med. 1989 Dec;46(12):860–865. doi: 10.1136/oem.46.12.860. [DOI] [PMC free article] [PubMed] [Google Scholar]
  2. Hagmar L., Welinder H., Lindén K., Attewell R., Osterman-Golkar S., Törnqvist M. An epidemiological study of cancer risk among workers exposed to ethylene oxide using hemoglobin adducts to validate environmental exposure assessments. Int Arch Occup Environ Health. 1991;63(4):271–277. doi: 10.1007/BF00386377. [DOI] [PubMed] [Google Scholar]
  3. Harris N. L., Jaffe E. S., Diebold J., Flandrin G., Muller-Hermelink H. K., Vardiman J., Lister T. A., Bloomfield C. D. World Health Organization classification of neoplastic diseases of the hematopoietic and lymphoid tissues: report of the Clinical Advisory Committee meeting-Airlie House, Virginia, November 1997. J Clin Oncol. 1999 Dec;17(12):3835–3849. doi: 10.1200/JCO.1999.17.12.3835. [DOI] [PubMed] [Google Scholar]
  4. Hertz-Picciotto I., Smith A. H. Observations on the dose-response curve for arsenic exposure and lung cancer. Scand J Work Environ Health. 1993 Aug;19(4):217–226. doi: 10.5271/sjweh.1480. [DOI] [PubMed] [Google Scholar]
  5. Hogstedt C., Aringer L., Gustavsson A. Epidemiologic support for ethylene oxide as a cancer-causing agent. JAMA. 1986 Mar 28;255(12):1575–1578. [PubMed] [Google Scholar]
  6. Hornung R. W., Greife A. L., Stayner L. T., Steenland N. K., Herrick R. F., Elliott L. J., Ringenburg V. L., Morawetz J. Statistical model for prediction of retrospective exposure to ethylene oxide in an occupational mortality study. Am J Ind Med. 1994 Jun;25(6):825–836. doi: 10.1002/ajim.4700250607. [DOI] [PubMed] [Google Scholar]
  7. Norman S. A., Berlin J. A., Soper K. A., Middendorf B. F., Stolley P. D. Cancer incidence in a group of workers potentially exposed to ethylene oxide. Int J Epidemiol. 1995 Apr;24(2):276–284. doi: 10.1093/ije/24.2.276. [DOI] [PubMed] [Google Scholar]
  8. Stayner L., Steenland K., Greife A., Hornung R., Hayes R. B., Nowlin S., Morawetz J., Ringenburg V., Elliot L., Halperin W. Exposure-response analysis of cancer mortality in a cohort of workers exposed to ethylene oxide. Am J Epidemiol. 1993 Nov 15;138(10):787–798. doi: 10.1093/oxfordjournals.aje.a116782. [DOI] [PubMed] [Google Scholar]
  9. Steenland K., Deddens J. A. Increased precision using countermatching in nested case-control studies. Epidemiology. 1997 May;8(3):238–242. doi: 10.1097/00001648-199705000-00002. [DOI] [PubMed] [Google Scholar]
  10. Steenland K., Deddens J., Piacitelli L. Risk assessment for 2,3,7,8-tetrachlorodibenzo-p-dioxin (TCDD) based on an epidemiologic study. Am J Epidemiol. 2001 Sep 1;154(5):451–458. doi: 10.1093/aje/154.5.451. [DOI] [PubMed] [Google Scholar]
  11. Steenland K., Deddens J., Stayner L. Diesel exhaust and lung cancer in the trucking industry: exposure-response analyses and risk assessment. Am J Ind Med. 1998 Sep;34(3):220–228. doi: 10.1002/(sici)1097-0274(199809)34:3<220::aid-ajim3>3.0.co;2-z. [DOI] [PubMed] [Google Scholar]
  12. Steenland K., Mannetje A., Boffetta P., Stayner L., Attfield M., Chen J., Dosemeci M., DeKlerk N., Hnizdo E., Koskela R. Pooled exposure-response analyses and risk assessment for lung cancer in 10 cohorts of silica-exposed workers: an IARC multicentre study. Cancer Causes Control. 2001 Nov;12(9):773–784. doi: 10.1023/a:1012214102061. [DOI] [PubMed] [Google Scholar]
  13. Steenland K., Spaeth S., Cassinelli R., 2nd, Laber P., Chang L., Koch K. NIOSH life table program for personal computers. Am J Ind Med. 1998 Nov;34(5):517–518. doi: 10.1002/(sici)1097-0274(199811)34:5<517::aid-ajim14>3.0.co;2-4. [DOI] [PubMed] [Google Scholar]
  14. Steenland K., Stayner L., Greife A., Halperin W., Hayes R., Hornung R., Nowlin S. Mortality among workers exposed to ethylene oxide. N Engl J Med. 1991 May 16;324(20):1402–1407. doi: 10.1056/NEJM199105163242004. [DOI] [PubMed] [Google Scholar]
  15. Steenland Kyle, Whelan Elizabeth, Deddens James, Stayner Leslie, Ward Elizabeth. Ethylene oxide and breast cancer incidence in a cohort study of 7576 women (United States). Cancer Causes Control. 2003 Aug;14(6):531–539. doi: 10.1023/a:1024891529592. [DOI] [PubMed] [Google Scholar]
  16. Teta M. J., Sielken R. L., Jr, Valdez-Flores C. Ethylene oxide cancer risk assessment based on epidemiological data: application of revised regulatory guidelines. Risk Anal. 1999 Dec;19(6):1135–1155. doi: 10.1023/a:1007086728854. [DOI] [PubMed] [Google Scholar]
  17. Tompa A., Major J., Jakab M. G. Is breast cancer cluster influenced by environmental and occupational factors among hospital nurses in Hungary? Pathol Oncol Res. 1999;5(2):117–121. doi: 10.1053/paor.1999.0182. [DOI] [PubMed] [Google Scholar]

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