Table 3.
Cancer risks from formaldehyde exposures in three recently updated occupational cohorts
| Study | NCI cohort < 1966–2004 | UK cohort (1941–2012) | US garment worker cohort (1955–2008) | ||||||
|---|---|---|---|---|---|---|---|---|---|
| Exposure (ppm) | Median average intensity: 0.3 and range 0.01–4.3. Exposure to ≥ 1 occurred in 15 % and 24 % had peak exposures at ≥ 4 | Range <0.1 to >2 | Geometric mean: 0.15 and geometric standard deviation 1.90. Past exposures may have been about 4 ppm, see text | ||||||
| Risk estimatea | ICD-8 | O | SMR | ICD-9 | O | SMR | ICD-10 | O | SMR |
| All cancers | 140–209 | 3146b | 1.07* | 140–208 | 2241 | 1.10* | – | 1021 | 0.96 |
| Solid cancers | 140–199 | 2878b | 1.09 * | – | – | – | – | – | – |
| Nose and nasal sinuses | 160 | 3b | 0.90 | – | 2 | 0.71 | C30–C31 | 0 | 0 |
| Pharynx | – | 17 | 1.20 | C09–C14 | 6 | 0.88 | |||
| Nasopharynx | 147 | 9b | 1.84 | – | 1 (E: 1.7) | 0.59 | C11 | 0 | 0 |
| Buccal cavity | 140–149 | 74b | 1.15 | – | 7 | 1.08 | C03–C08 C46.2 |
6 | 1.42 |
| Larynx | 161 | 42b | 1.23 | – | 22 | 1.22 | C32 | 4 | 0.77 |
| Lung | 162 | 1130b | 1.14* | – | 813 | 1.26 * | C33–C34c | 267 | 1.04 |
| Bone | 170 | 8b | 1.36 | – | – | – | – | ||
| Prostate | 185 | 261b | 1.07 | – | 147 | 0.80* | – | – | – |
| Pancreas | 157 | 111b | 0.76 * | – | 91 | 1.04 | – | – | – |
| Breast | 174 | 28b | 0.64 * | – | – | – | – | – | – |
| Hodgkin’s disease | 201 | 25 | 1.42 | – | – | – | C81 | 4 | 0.95 |
| Non-Hodgkin’s lymphoma | 200 | 94 | 0.85 | – | 53 | 1.06 | C46.3 | 44 | 1.13 |
| 202 | C82–C85 | ||||||||
| C88.0 | |||||||||
| C88.3 | |||||||||
| C91.4 | |||||||||
| C96 | |||||||||
| Multiple myelomas | 203 | 48 | 0.94 | – | 28 | 0.99 | C88.7 | 23 | 1.24 |
| C88.9 | |||||||||
| C90 | |||||||||
| Leukaemia | 204–207 | 116 | 1.02 | – | 54 | 1.02 | C91–C95 | 36 | 1.04 |
| Ex91.4 | |||||||||
| Myeloid leukaemia | 205 | 44 | 0.90 | – | 36 | 1.20 | C92 | 21 | 1.28 |
| Lymphatic leukaemia | 204 | 36 | 1.15 | – | – | – | C91–C91.9 Ex 91.4 |
6 | 0.71 |
| Stomach | – | – | – | – | 182 | 1.29 * | – | – | – |
| Digestive system | 150–159 | 759b | 1.07 | – | 126 | 0.95d | – | – | – |
The US National Cancer Institute (NCI) cohort comprised 25,619 workers employed in 10 U.S. formaldehyde producing or using facilities. Workers were employed prior to January 1 1966 and were followed up through 31 December 2004 (Beane Freeman et al. 2009; Beane Freeman et al. 2013; number of death was 13,951 [11,346 among exposed and 2605 among unexposed (Beane Freeman et al. 2013)]. Exposures were from Beane Freeman et al. (2009). A British (UK) cohort from six British factories, comprising 14,008 men followed up from 1941 through December 2012; number of death were 7378 (Coggon et al. 2014). The US National Institute for Occupational Safety and Health had established a cohort with 11,034 employees in three garment facilities (US garment worker cohort); number of death was 3915. The study was updated through 31 December 2008 (Meyers et al. 2013)
aStandardized mortality ratio (SMR) was obtained by comparison with the national death rates. The number of observed death due to the type cancer among exposed workers is indicated by “O” and the expected number of cases by “E” where relevant for calculation of SMR. When a 95 % confidence interval does not include 1.00, this is indicated by * and bold. Excluded is indicated with Ex. The International Classification of Diseases is indicated by 8th revision (ICD-8), 9th revision (ICD-9) and the 10th (ICD-10). Not given is indicated by “–”
bBeane Freeman et al. (2013)
cComprising the trachea, bronchus and lung
dLarge intestine