Document 6RjXN3bwrk811b7pBmzjz00J1
FILE NAME Reynolds Metals RM
DATE 1976
DOC RM018
DOCUMENT DESCRIPTION Unpublished Presentation from Conference - Cancer Experience of Workers Employed in the Steel and Aluminum Industries
8 CANCER EXPERIENCE OF WORKERS EMPLOYED IN THE STEEL AND ALUMINUM INDUSTRIES
.
D. J. William Lloyd Sc
1
,
Richard A. Lemen M.S.
Claudia Miller M.S.
David P. Brown M.P.H.2M.P.H.2
RECEIVE DEC 13 197
.
J. P. Hughes M.I
Our purpose in
preparing this presentation was fold
First we wanted to call
attention to the reported high risk of
various cancers within certain sections of the steel
industries
and aluminum
Second we wanted to use this
material to point out
the need for
systematic industry studies of
aluminum and
other industries which might
hopefully lead to the identification
of
previously unrecognized
occupational carcinogens
exposures environment In recent years much
attention has been given to the study
of cancer due to occupational
and a great variety of
agents in the industrial
have been implicated as
human carcinogens Table 1
We are all now aware for
example
of the lung cancers and
mesotheliomas that result from asbestos
exposure the bladder
cancers induced by exposure to
nepthy- lamine benzidine and other aromatic amines and the
chloride of the liver due to vinyl
exposure to name
angiosarcomas only a few
Unfortunately millions of workers have been needlessly exposed
to these agents and
consequently many have suffered and died from
bccupational cancers because of the
long delay between the first
introduction of
agents
into the
workplace
the
first suspicion
of cancer hazard and the
systematic development of evidence
1. United Steelworkers of
2 Industry Studies America CIO CLC
Branch DSHEFS NIOSH
Presented at the International
on
Health
&
Safety
in
the
Netalworkers
Metal
Federation
World
Augus1t6 - 19 1976..
Industry :
Oslow
Norway
mee
ee,
a
oe
10
Conferen
.
mee ae tie
Lee
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considered necessary to demonstrate the carcinogenicity of such
agents A more detailed discussion of this delay period and
alternative approaches to early identification of occupational
_
carcinogens is given elsewhere Of particular interest to
the present discussion is the long delay between the first obser-
vation of human cancers induced by combustion products of bitum-
inous risks
coal and the development of evidence describing the cancer among men employed at coke plants in the steel industry 999
a period of two hundred years
,
;
,
.
in In 1962 the United States
_
Public Health Service
colla-
Biostatistics boration with the Department of
University of
Pittsburgh .
School of Public Health and three major steel firms
initiated a study to analyze the mortality experience of men
employed in the steel industry in 1953. The purpose of this study
was to determine wwhetherhether particular patterns of mortality among
workers employed at certain trades or at certain work processes
might provide leads to causative
The methodological approaches to
agents for this study
occupational diseases
and many of the find-
ings have been presented in a series of papers published in the
Journal of
Using
employment
3-312-12
Occupational Medicine
detailed work histories going back to
with the steel firms it was possible
original
to determine
specific rates
within the
industry
of mortality for more than
and for a great variety of
60 work
trades
areas
As
shown in Table II unusual patterns of site specific cancer have
been
. lung
noted for several work
amaonrgeas cancer risk observed
Because of the
coke plant workers
unusually
and the
high
variety of cancer sites in excess for men employed in this area more detailed analysis of this experience was undertaken As
we
-
ew
8
ee
tee
ao.
:
So
eee
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seen in Table III the greatest risk is noted for those with
longest exposure and those employed where exposure to emissions is greatest topside The United States Department of Labor has
now proposed a standard to protect workers from these emissions
The detailed evidence indicatitnhge high risk of specific cancers
among men employed at the coke plant the demonstration of
a relationship between level of exposure to coke oven emissions and
the level of discase response was crucial in reaching this decision
As noted previously the initial evidence suggesting that
carcinogenic agents are produced during the carbonization or com-
bustion of bituminous coal was presented by Percivall Pott in 1775
Since that time a great amount of information indicating excess
cancer of several sites among workers in other coal combustion or
carbonization
occupations
has
been
noted and
fact
a
report
of
official years statistics from England and Wales for the producermen 1938 showed an excess lung cancer mortality for gas
1921 -
chimney
sweeps
and
several categories
of
gas
works
13
employees
The excess indicated for gas stokers and coke oven chargers was
approximately three Although many of us might agree that
such a high level of risk would be sufficient evidence for initia-
tion of controls by standard setting agencies workers have
continued to be exposed to carcinogens in these environments and
awaited have suffered and died from a variety of cancers while we
the more definitive studies of defined cohorts
_
In trying to assess the extent of the cancer problem in the
aluminum industry we find the same situation as we noted for gas
workers
_
and
coke
oven
workers
thirty
years
ago
That is review
of death certificates shows that persons employed in the industry
.
ao poe
sO
RMC0082882
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are at high risk of developing cancer Furthermore men
in certain work areas with exposures related to those at
coke plant appear to be at greatest risk
employed
the
' During the electrolytic reduction of alumina to aluminum a
variety of toxic substances are released which may contaminate
.
the workroom air Among these substances hydrogen fluoride fluori
fume and dust and carbon monoxide are potential contaminants ~ )
tar whose biological effects are recognized In addition coal
.
pitch
volatiles
are
also released in the process
either
in the
anode preparation area for baked anodes or in the pot
Soderberg lines where
baking cells are used
Investigators from the Soviet Union 14-15 have reported a
significantly higher mortality for all cancers and for specific
sites such as lung bronchi and pleura and have reported an
_ increased incidence of skin cancer among workers in the aluminum
electrolyzer shops in comparison with the general population
in the same cities Unfortunately neither of these studies is
;
sufficiently documented to allow firm conclusions
Milham has reported an increase in proportionate mortality
from total cancer cancer of the pancreas respiratory system and malignant lymphomas among aluminum workers in Washington
State Table IV He suggests that the simultaneous increase
in pancreatic cancer and lymphoma among aluminum millworkers millworkers
not seen in other occupational groups may be related to
tar pitch volatiles rather than to metal exposures
coal
has
The National Institute for Occupational
recently conducted environmental surveys
Safety and Health of aluminum reduc-
tion facilities in East and Northwest United States monitoring
hazardous for coal
surveys tar pitch volatiles and a variety of other
potentially
substances 17 These
included reduction
Anodes plants using baked anodes the vertical pin Soderberg
and
horizontal pin Soderberg anodes The findings indicate that the concentration of coal tar pitch volatiles CTPV as measured by
the benzene soluble fraction technique were almost all elevated
0.2mg above the current OSHA standard of 0.2mg
|
CTPV for an 8 hour
weighted average The levels were highest in the Soderberg
potrooms
the anode
baked presumably because the pitch is heated and
in these potrooms In contrast the lowest
off
measure-
baked ments were in the potrooms using
anodes
This type of
carbon anode already has
reduction area Table V
the pitch baked off before use in
provides a review of these surveys
the
. In a 1976 study of chronic respiratory disease among aluminum
reduction workers sputum cytology was utilized
determine
to
the
respiratory degree of abnormal cells in the
tract as an early
indication of cancer 18 Because of certain limitations of that
study the authors were
unwilling to draw any conclusions regarding
the
carcinogenic risks among the study group as compared to
However matched controls
review of the results from that study
leads us to conclude that the evidence of potential carcinogenic
risk for potroom workers is certainly quite consistent with the
> previously mentioned mortality observations When consideration
is given to the sputum cytology classification of moderate atypia
or higher a significant
the study group 30/390
.01 difference is
and the control group
observed
5/195
between
Morcover
when consideration is restricted to cases of suspicious and
evi ae
eS
Me ta
-.
vee
8,
te ee ete
wt
- RTMCX00T8I2N8E8R4
-6-
positive cancer there are 6/390 meeting such criteria in the
group study
compared to 0/193 in the control group
It also
should be noted that the control group in this study had a
greater exposure to known carcinogens according to prior work
history so that differences in cancer risks are underestimated
Other studies on workers exposed to recognized pulmonary carcin-
ogens have used sputum cytology and demonstrated its validity as
an
early
indicator
of
19
cancer
20
CONCLUSION
Available evidence from three independent sources suggests an increased cancer risk at one or more sites
strongly
for
aluminum reduction workers and we have been unable to identify any negative reports on this question Furthermore it has been
noted that these workers like the coke oven workers are exposed
to coal tar pitch volatiles many of whose constituents are recog-
nized to be carcinogenic While some would conclude that this is
sufficient evidence to initiate action for control of the aluminum
reduction environment others would argue that more detailed study
. should be undertaken before such decisions are made The situatior
you the
may note is analogous to what we observed in the
coke oven workers It would be most unfortunate
1930's with
if we were to
wait another forty years before addressing this problem
At the same time it must be recognized that agencies of
government demand more extensive evidence of excess cancer risk
'
.
before setting standards for control of such work environments
That being the case we would strongly suggest to these agencies
that depth epidemiological cohort studies of industry
workers be initiated as speedily as possible
oo
Src
Te
mo
~.
.
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-
REFERENCES
1 Lloyd J.W. Occupational and Industrial
on Environmental
Hazards Symposium
Carcinogenesis Proceedings of the Eleventh Canadian Research Conference pp 58-66 Toronto Canada
May 7 1976
'
Wagoner J. K. Occupational years since Percivall Pott 1-4 May 28 1976
carcinogenesis The two hundred
Ann New York Acad Sci 271
Lloyd J.W. workers I. June 1969
Ciocco A. Methodology
Long mortality study of steel-
Journal of Occ Med 11 299-310 |
; .
.
study Robinson H. Long mortality
Mortality by level of income in whites of Occ Med 11 411-416 August 1969
of and
steelworkers II whites Journal
Redmond C.K. Smith E.M. Lloyd J.W. Rush H.W.
mortality study of steelworkers III
term
of Occ Med 11
Follow Journal 513-521 October 1969
Lloyd J.W. Lundin
term mortality study
area Journal of Occ
F.E. Redmond C.K. Geiser P.B. of steelworkers IV Mortality by Med 12 151-157 May 1970 -
Long-
work
Long steelworkers Respiratory Journal Lloyd53-68 February mortality study 7
Respiratory
13
J.W.
Respiratory
cancercancer
in
in
coke
coke
plant plant
1971
of
workers
workers
V.
of Occ Med
.8
"
Redmond C.K. Ciocco A. Lloyd J.W. and Rush H.W.
term mortality study of steelworkeVrIs
LongMortality from
malignant neoplasms among coke oven workers
Med 14 621-629 August 1972
Journal of Occ
;
.
10. 11 12
H.W. Long mortality study of steelworkers VII
patterns among crane operators 16
Mortality
608-614 September 1974
Gustin _ Redmond C.K.
J. Kamon E. term mortality
experience of steelworkers VIII Mortality patterns of
hearth steelworkers A preliminary report
open Journal of Occ
Med 17 40-43 January 1975
.
Mazumdar S. Lerer T. Redmond C.K.
of
term mortality
study
steelworkers IX Mortality patterns
sheet
*
and tin mill workers
December 1975
among
Journal of Occ Med 17 751-755
7
Rockette H.E. Redmond C.K. term mortality of
steelworkers X Mortality patterns among masons In Press
. .
=
.
"
-. aerated
. -
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23
Kennaway E.L. . 1 Kennaway N.M. A furth
incidence of cancer of the lung and larynx 260-298 1947
. .
study of the Brit J. Cancer 1
14
Konstantinov F.G. Kuz'minykh A.I. Tarry substances and benzpyrene in the air of electrolytic shops of aluminum works and their carcinogenic significance Hygiene and Sanitation 36 368-373 January 1971
Litvinov N.N. Goldberg M.S. Kimina S.N. Morbidity and mortality in man caused by pulmonary cancer and its relation
to the pollution of the atmosphere in the areas of aluminum plants Acta Unionis Internationalis Contra Cancrum 19 742-745 1963
16 .17
18
19
Milham S. Jr. Cancer mortality patterns
exposure to metals Ann New York Acad
May 28 1976 .
associated Sci 271
mo
with
243-249
.
Bierbaum Shuler P.J.
P.J. Environmental
aluminum reduction plants U. S.
surveys of
Publication No.
NIOSHI
Department of HEW NIOSH 74-101 April 1974
Schweid Discher
cytology
Sci 271
D.P. Breitenstein B.D.
among aluminum potroom workers 239-242 May 28 1976
A.I. Sputum
Ann New York Acad
| ;
Lemen R.A. Johnson W.M. Wagoner J.K. Archer V.E. Saccomanno C. Cytologic observations and cancer incidence
following exposure to BCME Ann New York Acad Sci 271 71-89 May 28 1976
20 Frost J.K. et al Pulmonary cytologic alterations in toxic
environmental inhalation Human Pathology 4 521-536 1973
.
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TABLE V -
Comparison of Time Weight.ed Average THA
Pitch Volatile Results in Aluminum Reduction Facilities in the Eastern United States Versus
'. Those in the Northwestern United States
;
t
Eastern Facilities
Number of
3
Concentration mg
Samples
_ -
Northwestern Facilities
Number of
_ Samples
Concentration me
Baked
Potrooms
:
Tappers
setters Pot reliner
arbon Plant
Ball mill opr Press opr
Mixer opr
ertical Pin
derberg
Potrooms
Potnan
Tapper
33 33
1
1 1
244
244
0.5
0.3
2.4
2.9 0.6
;
2.2 12.0
.
722
29
363 363 363
5 vi
- 5 vi
.
0.1-0.5 0.4
0.2 . 0.1
0.3
0.3 0.3
rbon Plant
, .
.
-
Hixer Operator
- 1
2.6
.
2.
10.1
rizontal In Soderberg
Potrooms
Potman
Flex raisers
Pin pullers Channel hangers
Tappers
Pot reliners
.
.
212121
212121 212121 212121
212121
212121
my
.7
. 4.5 18.5
. 2.5 3.5
2.0-3.4
8.3
:
<
.
he
10
h k 5 5
0.5
0.3
0.4 0.5
0.3
0.1
ter
.
Shuler P.J. and Bierbaum P.J 1974 EnvironmentalEnvironmental Surveys of Aluminum
Reduction Plants Health
U. S. Department of Health Education and Helfare Public
HEW
Service National Institute for Occupational Safety and Health
Publication Number NIOSH 74-101 page 26
2+ ENS
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