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Cancer incidence and mortality in Swedish sterilant workers exposed to ethylene oxide: updated cohort study findings 1972-2006.

Mikoczy, Zoli LU ; Tinnerberg, Håkan LU ; Björk, Jonas LU and Albin, Maria LU (2011) In International Journal of Environmental Research and Public Health 8(6). p.2009-2019
Abstract
OBJECTIVES:

To assess whether cancer incidence, mainly from lymphohaematopoietic tumours and breast cancer, and mortality were increased in a cohort of Swedish sterilant workers exposed to low levels of ethylene oxide (EtO), updated with 16 more years of follow up.



METHODS:

The mortality and cancer incidence 1972-2006 experienced by a cohort of 2,171 male and female workers employed for at least one year in two plants producing medical equipment sterilised with EtO were investigated. Individual cumulative exposure to EtO was assessed by occupational hygienists. Cause-specific standardized rate ratios were calculated using the regional general population as a comparison for mortality (SMR) and cancer... (More)
OBJECTIVES:

To assess whether cancer incidence, mainly from lymphohaematopoietic tumours and breast cancer, and mortality were increased in a cohort of Swedish sterilant workers exposed to low levels of ethylene oxide (EtO), updated with 16 more years of follow up.



METHODS:

The mortality and cancer incidence 1972-2006 experienced by a cohort of 2,171 male and female workers employed for at least one year in two plants producing medical equipment sterilised with EtO were investigated. Individual cumulative exposure to EtO was assessed by occupational hygienists. Cause-specific standardized rate ratios were calculated using the regional general population as a comparison for mortality (SMR) and cancer incidence (SIR). Internal Poisson-regression analyses were performed for selected causes.



RESULTS:

The median cumulative exposure to EtO was 0.13 ppm-years. The overall cancer incidence was close to unity (SIR 0.94, 95% CI 0.82-1.08). Eighteen cases of lymphohaematopoietic cancer were observed (SIR 1.25, 95% CI 0.74-1.98). A healthy worker effect was indicated from a significantly decreased overall mortality and mortality from cardiovascular diseases. Internal analyses found significantly increased rate ratios for breast cancer for the two upper quartiles of cumulative exposure as compared to the lowest 50% of the cohort (IRR 2.76, 95% CI 1.20-6.33 and IRR 3.55, 95% CI 1.58-7.93).



CONCLUSIONS:

The findings from this updated study indicate limited or low risks for human cancer due to occupational exposure from ethylene oxide at the low cumulative exposure levels in this cohort. However a positive exposure-response relation with breast cancer was observed though. (Less)
Please use this url to cite or link to this publication:
author
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
leukaemia, cohort study, breast cancer
in
International Journal of Environmental Research and Public Health
volume
8
issue
6
pages
2009 - 2019
publisher
Multidisciplinary Digital Publishing Institute (MDPI)
external identifiers
  • wos:000292022500016
  • pmid:21776215
  • scopus:79959859111
ISSN
1660-4601
DOI
10.3390/ijerph8062009
language
English
LU publication?
yes
id
5dfb7151-b98c-4559-8d26-9807a9d9d948 (old id 2058413)
alternative location
http://www.ncbi.nlm.nih.gov/pubmed/21776215?dopt=Abstract
date added to LUP
2011-08-01 13:24:27
date last changed
2017-09-24 03:15:49
@article{5dfb7151-b98c-4559-8d26-9807a9d9d948,
  abstract     = {OBJECTIVES: <br/><br>
To assess whether cancer incidence, mainly from lymphohaematopoietic tumours and breast cancer, and mortality were increased in a cohort of Swedish sterilant workers exposed to low levels of ethylene oxide (EtO), updated with 16 more years of follow up.<br/><br>
<br/><br>
METHODS:<br/><br>
The mortality and cancer incidence 1972-2006 experienced by a cohort of 2,171 male and female workers employed for at least one year in two plants producing medical equipment sterilised with EtO were investigated. Individual cumulative exposure to EtO was assessed by occupational hygienists. Cause-specific standardized rate ratios were calculated using the regional general population as a comparison for mortality (SMR) and cancer incidence (SIR). Internal Poisson-regression analyses were performed for selected causes.<br/><br>
<br/><br>
RESULTS:<br/><br>
The median cumulative exposure to EtO was 0.13 ppm-years. The overall cancer incidence was close to unity (SIR 0.94, 95% CI 0.82-1.08). Eighteen cases of lymphohaematopoietic cancer were observed (SIR 1.25, 95% CI 0.74-1.98). A healthy worker effect was indicated from a significantly decreased overall mortality and mortality from cardiovascular diseases. Internal analyses found significantly increased rate ratios for breast cancer for the two upper quartiles of cumulative exposure as compared to the lowest 50% of the cohort (IRR 2.76, 95% CI 1.20-6.33 and IRR 3.55, 95% CI 1.58-7.93).<br/><br>
<br/><br>
CONCLUSIONS:<br/><br>
The findings from this updated study indicate limited or low risks for human cancer due to occupational exposure from ethylene oxide at the low cumulative exposure levels in this cohort. However a positive exposure-response relation with breast cancer was observed though.},
  author       = {Mikoczy, Zoli and Tinnerberg, Håkan and Björk, Jonas and Albin, Maria},
  issn         = {1660-4601},
  keyword      = {leukaemia,cohort study,breast cancer},
  language     = {eng},
  number       = {6},
  pages        = {2009--2019},
  publisher    = {Multidisciplinary Digital Publishing Institute (MDPI)},
  series       = {International Journal of Environmental Research and Public Health},
  title        = {Cancer incidence and mortality in Swedish sterilant workers exposed to ethylene oxide: updated cohort study findings 1972-2006.},
  url          = {http://dx.doi.org/10.3390/ijerph8062009},
  volume       = {8},
  year         = {2011},
}