Nonmalignant mortality among workers in six Norwegian aluminum plants

Abstract

Objectives This study investigated the associations between exposure to fluorides and polycyclic aromatic hydrocarbons (PAH) and mortality from nonmalignant diseases among workers in the Norwegian primary aluminum industly. Methods Mortality among 10 857 men, employed for more than 3 years in 1 of 6 aluminum plants, was investigated from 1962 to 1996, giving 239 246 person-years during follow-up. A job-exposure matrix covering all 6 plants was used to estimate the individual exposure to total fluorides and particulate PAH. The observed causespecific deaths were compared with expected figures calculated from national rates. Dose-response relations were investigated by internal colnparisons using Poisson regression and by stratified analyses for standardized mortality ratio. Potential confounding by smoking was investigated in subanalyses restricted to 3 of the plants for which information on smoking habits was accessible. Results Mortality from circulatory disease was slightly lower than expected [SMR 0.95,95% confidence interval (95%CI) 0.9-1.01, while there was an increased mortality from asthma, emphysema, and chronic bronchitis combined, SMR 1.2 (95% CI 1.0-1.5). Mortality from these diseases was associated with cumulative exposure to fluorides. The rate ratio in the internal analysis rose steadily to 2.5 (95% CI 1.5-4.3) for the upper exposure category. No association was observed between cumulative fluoride exposure or PAH exposure and circulatory mortality. C O~C~U S~O~S The study showed an association between exposure to potroom emissions measured by fluorides and mortality from asthma, emphysema, and chronic bronchitis combined.

Relationship between cardiopulmonary mortality and cancer risk and quantitative exposure to polycyclic aromatic hydrocarbons, fluorides, and dust in two prebake aluminum smelters

“…By isolating CTPV exposure to these areas of the plant, the proportion of workers in the higher CTPV exposed jobs is greatly reduced compared to Söderberg smelters. In contrast, the cumulative fluoride exposure levels observed in this cohort were similar to the Norwegian smelter fluoride levels [11,12,15].…”

“…In addition to lung and bladder cancer, exposures in Söderberg smelters have also been associated with nonHodgkin lymphoma and pancreatic, stomach and kidney cancers [9][10][11][12][13][14], and with other chronic diseases, including fluoride exposure with respiratory disease mortality [12,15] and CTPV exposure with chronic obstructive pulmonary disease mortality [13,14] and heart disease mortality [16,17]. However, these findings have not been consistent across studies.…”

Respiratory Disorders in Aluminum Smelter Workers

“…In another Norwegian study, Romundstad et al20 investigated mortality from nonmalignant diseases among subjects who had been employed for 3 years or more in six Norwegian aluminum smelters (Table 3). Exposure data on total fluorides were available, and data on smoking habits were available in three of the plants.…”

Construction of a Job Exposure Matrix to Dust, Fluoride, and Polycyclic Aromatic Hydrocarbons in the Norwegian Aluminum Industry using Prediction Models

“…Several subsequent studies have shown an association between exposure to potroom fumes and asthma-like symptoms as well as bronchial responsiveness (Kongerud and Samuelsen, 1991; Søyseth et al , 1994; Abramson et al , 2010). Moreover, some studies have shown an increased mortality from chronic obstructive disease among potroom workers (Rønneberg, 1995; Romundstad et al , 2000a,b; Gibbs et al , 2007; Gibbs and Sevigny, 2007). However, the results of lung cancer studies in the aluminum industry have been inconclusive (Armstrong et al , 1994; Romundstad et al , 2000a,b; Gibbs et al , 2007).…”

“…Moreover, some studies have shown an increased mortality from chronic obstructive disease among potroom workers (Rønneberg, 1995; Romundstad et al , 2000a,b; Gibbs et al , 2007; Gibbs and Sevigny, 2007). However, the results of lung cancer studies in the aluminum industry have been inconclusive (Armstrong et al , 1994; Romundstad et al , 2000a,b; Gibbs et al , 2007). The association between bladder cancer and exposure to benzo(a)pyrene in primary aluminum plants is well accepted (Gibbs and Labrèche, 2014).…”