A mortality study among workers in a French aluminium reduction plant.

OBJECTIVE: A mortality study on the association between lung cancer and occupational exposure to polycyclic aromatic hydrocarbons (PAHs) was carried out in a French aluminium reduction plant. This study updated a previous mortality study.
METHOD: The historical cohort included every male worker who had been employed in the plant for at least 1 year between 1950 and 1994. Workers were followed-up for mortality from 1968 to 1994. Causes of death were obtained from death certificates. Standardised mortality ratios (SMRs) and 95% confidence intervals (CI) were computed using regional mortality rates as external reference to compare observed and expected numbers of deaths, adjusted for gender, age and calendar time.
RESULTS: The cohort comprised 2,133 men, of whom 335 died during the follow-up period. The observed mortality was lower than expected for all causes of death (SMR = 0.81, CI 0.72-0.90) and for lung cancer (observed = 19, SMR = 0.63, CI 0.38 0.98). No lung cancer excess was observed in workshops where PAH exposure was likely to have occurred, and no trend was observed according to duration of exposure and time since first exposure. This low lung cancer mortality could be partly explained by a marked healthy worker effect and a possible negative confounding by smoking. An excess was observed for bladder cancer (observed = 7, SMR = 1.77, CI 0.713.64) in the whole cohort, that was higher among workers employed in workshops where PAH exposure was likely to have occurred (observed = 6, SMR = 2.15, CI 0.79-4.68). In addition, an SMR higher than unity was observed for "psychoses and neuro-degenerative diseases" (observed = 6, SMR = 2.39, CI 0.88-5.21), that could not be related to occupational aluminium exposure.
CONCLUSION: No lung cancer risk was detected. Non-significant excesses were observed for bladder cancer and for psychoses and neuro-degenerative diseases.