Cohort study on cancer mortality among workers in the pulp and paper industry in Catalonia, Spain.

We examined mortality in a retrospective follow-up study of 3,241 workers employed between 1970-1992, in four pulp and paper mills in Catalonia, Spain. Vital status was determined for 95% of the cohort. Exposure was reconstructed using job histories and a company exposure questionnaire. Standardized mortality ratios (SMR) were derived using mortality rates of Spain as the reference. For all workers, mortality from all causes (SMR = 76; 95%; confidence intervals [CI] = 65-88; 189 deaths) and all malignant neoplasms (SMR = 93; CI = 72-119; 65 deaths) were less than the expected. Excess risk was observed for mortality from all neoplasms in females (SMR = 168; CI = 84-303; 11 deaths), for large intestine cancer in both sexes (SMR = 250; CI = 115-525; 8 deaths), particularly after 10 years of employment and latency (SMR = 355; CI = 154-701; 8 deaths), and for breast cancer in females (SMR = 286; CI = 77-732; 4 deaths). These findings suggest that workers employed in the pulp and paper industry may have an excess risk of specific cancers.