Cohort Mortality Study of Swedish Pulp and Paper Mill Workers-Nonmalignant Diseases

• Published in: Scandinavian Journal of Work, Environment ＆ Health Environment ＆ Health, 2007-12, Vol.33 (6), p.470-478
• Main Authors: ANDERSSON, Eva, PERSSON, Bodil, BRYNGELSSON, Ing-Liss, MAGNUSON, Anders, TOREE, Kjell, GUN WINGREN, WESTBERG, Hakan
• Format: Article
• Language: English
• Subjects: Adult; Aged; Arbets- och miljömedicin; Asthma; Biological and medical sciences; Cancer; Cardiology. Vascular system; Cardiomyopathies; cardiovascular; Clinical Medicine; Cohort analysis; Coronary heart disease; Diabetes; diabetes mellitus; Diabetes. Impaired glucose tolerance; Diseases of the osteoarticular system; Dust; Employment; Endocrine pancreas. Apud cells (diseases); Endocrinopathies; Etiopathogenesis. Screening. Investigations. Target tissue resistance; exposure database; Female; Folkhälsomedicinska forskningsområden; Follow-Up Studies; Gender; Heart; Heart attacks; Humans; Inflammatory joint diseases; Klinisk medicin; Lung Diseases - mortality; Male; Medical sciences; MEDICIN; MEDICINE; Middle Aged; Mills; Morbidity; Mortality; Myocardial infarction; Myocardial Infarction - mortality; Myocardial ischemia; Myocarditis. Cardiomyopathies; Occupational and Environmental Medicine; Occupational Exposure - adverse effects; Occupational Exposure - statistics & numerical data; Occupational Exposure/adverse effects/statistics & numerical data; Occupational medicine; Occupations; Paper mills; Public health medicine research areas; Pulp & paper industry; Pulp & paper mills; Pulp and paper industry; Pulp mills; Pulping; Respiratory diseases; Respiratory system; Retrospective Studies; Rheumatoid arthritis; Shift work; Social medicine; Socialmedicin; sulfate pulping; Sulfates; Sulfite mills; sulfite pulping; Sulfites; Sulfur; Sweden - epidemiology; Womens health; Wood; Yrkesmedicin
• ISSN: 0355-3140; 1795-990X; 1795-990X
• DOI: 10.5271/sjweh.1173

Objectives The aim of this study was to determine mortality among pulp and paper mill workers according to the main mill pulping process, department, and gender, particular reference being given to diseases of the circulatory and respiratory systems. Methods The cohort of 18 163 men and 2291 women employed between 1939 and 1999 and with > 1 year of employment was followed for mortality from 1952 to 2001 (acute myocardial infarction from 1969). Standardized mortality ratios (SMR) with 95% confidence intervals (95% CI) were estimated by comparing the observed number of deaths with the expected number for the entire Swedish population. Exposure was assessed from personnel files in the mills. Data from an exposure measurement database are also presented. Results There were 5898 deaths in the cohort. Total mortality had an SMR of 1.02 (95% CI 0.98-1.06) for the men in the sulfate mills and an SMR of 0.93 (95% CI 0.90-0.97) for the men in the sulflte mills. Mortality from acute myocardial infarction was increased among the men in both the sulfate and sulfite mills [SMR 1.22 (95% CI 1.12-1.32) and SMR 1.11 (95% CI 1.02-1.21), respectively] and by department in sulfate pulping (SMR 1.29,95% CI 1.07-1.54), paper production (SMR 1.26,95% CI 1.06-1.49), and maintenance (SMR 1.16, 95% CI 1.02-1.30). Mortality from cerebrovascular disease, diabetes mellitus, and nonmalignant respiratory diseases was not increased. Conclusions Death from acute myocardial infarction, but not cerebrovascular diseases, was increased in this cohort and was probably related to a combination of different occupational exposures (eg, dust, sulfur compounds, shift work, and noise).