Cancer incidence among workers in soft paper mills: A cohort study

Abstract

Objectives: To elucidate whether occupational exposure to soft paper dust increases the incidence of cancer.Methods: We studied 7988 workers in Swedish soft paper mills from 1960 to 2008, of whom 3233 (2 187 men and 1046 women) had more than 10 years of employment. They were divided into high exposure (>5 mg/m 3 for >1 year) or lower exposure to soft paper dust based on a validated job-exposure matrix. They were followed from 1960 to 2019, and person-years at risk were stratified according to gender, age, and calendar-year. The expected numbers of incident tumors were calculated using the Swedish population as the reference, and standardized incidence ratios (SIR) with 95% confidence intervals (95% CI) were assessed.Results: Among high-exposure workers with more than 10 years of employment, there was an increased incidence of colon cancer (SIR 1.66, 95% CI 1.20−2.31), small intestine cancer (SIR 3.27, 95% CI 1.36−7.86), and thyroid gland cancer (SIR 2.68, 95% CI 1.11−6.43), as well as lung cancer (SIR 1.56, 95% CI 1.12−2.19). Among the lower-exposed workers there was an increased incidence of connective tissue tumors (sarcomas) (SIR 2.26, 95% CI 1.13−4.51) and pleural mesothelioma (SIR 3.29, 95% CI 1.37−7.91). Conclusion:Workers in soft paper mills with high exposure to soft paper dust have an increased incidence of large and small intestine tumors. Whether the increased risk is caused by paper dust exposure or some unknown associated factors is unclear. The increased incidence of pleural mesothelioma is probably linked to asbestos exposure. The reason for increased incidence of sarcomas is unknown.

The Influence of Sex and/or Gender on the Occurrence of Colorectal Cancer in the General Population in Developed Countries: A Scoping Review

“…The International Agency for Research on Cancer (IARC) has categorized agents by organ type, some of which may stem from occupational exposures and cause cancers of digestive tract [56]. This link has been confirmed by some studies for specific occupational exposure to silica [57] and specific professions such as firefighters [58], veterinarians until 1990 [59], and paper mill workers [60]. Nevertheless, interpreting the relation between occupational exposure and cancer incidence in these studies remains challenging due to the lack of integration of associated risk factors in the analyses.…”