Am J Ind Med

Cancer risks among workers exposed to metalworking fluids: a systematic review.

Calvert GM. Ward E. Schnorr TM. Fine LJ.
Division of Surveillance, Hazard Evaluations and Field Studies, National Institute for Occupational Safety and Health, Centers for Disease Control and Prevention, Cincinnati, Ohio 45226, USA. jac6@cdc.gov
Metalworking fluids (MWFs) are commonly used in a variety of industrial machining and grinding operations. The National Institute for Occupational Safety and Health (NIOSH) estimates that more that one million workers are exposed to MWFs. NIOSH conducted a comprehensive and systematic review of the epidemiologic studies that examined the association between MWF exposure and cancer. Substantial evidence was found for an increased risk of cancer at several sites (larynx, rectum, pancreas, skin, scrotum, and bladder) associated with at least some MWFs used prior to the mid-1970s. This paper provides the evidence pertaining to cancer at these sites. Cancer at those sites found to have more limited or less consistent evidence for an association with MWF (stomach, esophagus, lung, prostate, brain, colon, and hematopoietic system) will not be discussed in this paper but are discussed in the recent NIOSH Criteria for a Recommended Standard-Occupational Exposure to MWFs. Because the changes in MWF composition that have occurred over the last several decades may not be sufficient to eliminate the cancer risks associated with MWF exposure, reductions in airborne MWF exposures are recommended.

Mortality studies of metalworking fluid exposure in the automobile industry: VI. A case-control study of esophageal cancer.

Year 1998
Sullivan PA. Eisen EA. Woskie SR. Kriebel D. Wegman DH. Hallock MF. Hammond SK. Tolbert PE. Smith TJ. Monson RR.
Department of Work Environment, University of Massachusetts Lowell, Massachusetts.
BACKGROUND: Results are reported from a nested case-control study of 60 esophageal cancer deaths among 46,384 automobile manufacturing workers potentially exposed to metalworking fluids (MWF) in machining and grinding operations. METHODS: By using incidence-density sampling, controls were selected with a sampling ratio of 20:1 from among co-workers who remained at risk by the age of death of the case, matched on race, gender, plant, and year of birth. Conditional logistic regression was used to evaluate the risk associated with cumulative exposure (mg/m3-years) to each of three types of metalworking fluid (straight, soluble, and synthetic MWF), as well as with years of exposure to selected components of MWF, including nitrosamines, sulfur, biocides, and several metals. RESULTS: Esophageal cancer was found to be significantly associated with exposure to both soluble and synthetic MWF in grinding operations. The odds ratios (ORs) for grinding with soluble MWF were elevated at 2.5 or greater in all categories of cumulative exposure, although the exposure-response trend was statistically significant only when exposure was measured as duration. Those with 12 or more years exposure to soluble MWF in grinding operations experienced a 9.3-fold relative risk of esophageal cancer mortality (95% CI = 2.1-42.1). The OR for ever grinding with synthetic MWF was 4.1 (95% CI = 1.1-15.0). Elevated risk was also associated with two agents found in both synthetic and soluble fluids, nitrosamines, and biocides. For exposure to nitrosamines, the OR was 5.4 (95% CI = 1.5-19.9); for biocides the OR was 3.8 (95% CI = 0.8-18.9). However, because the same workers were exposed to grinding with synthetics, nitrosamines and biocides, it was not possible to separate the specific risks associated with these components.

Prevalence of infectious diseases and associated symptoms in wastewater treatment workers.

Year 1998
Khuder SA. Arthur T. Bisesi MS. Schaub EA.
Department of Occupational Health, Medical College of Ohio, Toledo 43699-0008, USA. skhuder@vortex.mco.edu
Wastewater treatment workers (WWTW) are potentially exposed to a variety of infectious agents and toxic materials. We conducted a retrospective epidemiological study to examine the prevalence of infectious diseases and associated symptoms in WWTW. From a possible 242 WWTW, 150 completed a questionnaire that provided data pertaining to the diagnosis of an infectious disease or the prevalence of associated symptoms over a 12-month period. Comparison data were obtained from questionnaires completed by 54 college maintenance and oil refinery workers. The WWTW exhibited a significantly higher prevalence of gastroenteritis, gastrointestinal symptoms (specifically abdominal pain), and headaches. No significant differences were found with regard to respiratory and other symptoms. Employees classified by exposure categories did not exhibit significant differences in the prevalence of symptoms. While significant differences were found with regard to the health status of WWTW and controls, it appears that these risks are confined to symptoms and infectious diseases associated with the gastrointestinal system and are not inclusive of all such symptoms or diseases.