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Mortality Among Workers Employed in the Titanium Dioxide Production Industry in Europe

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Abstract

Objectives: To assess the risk of lung cancer mortality related to occupational exposure to titanium dioxide (TiO2).

Methods: A mortality follow-up study of 15,017 workers (14,331 men) employed in 11 factories producing TiO2 in Europe. Exposure to TiO2 dust was reconstructed for each occupational title; exposure estimates were linked with the occupational history. Observed mortality was compared with national rates, and internal comparisons were based on multivariate Cox regression analysis.

Results: The cohort contributed 371,067 person-years of observation (3.3% were lost to follow-up and 0.7% emigrated). 2652 cohort members died during the follow-up, yielding standardized mortality ratios (SMRs) of 0.87 (95% confidence interval [CI] 0.83–0.90) among men and 0.58 (95% CI 0.40–0.82) among women. Among men, the SMR of lung cancer was significantly increased (1.23, 95% CI 1.10–1.38); however, mortality from lung cancer did not increase with duration of employment or estimated cumulative exposure to TiO2 dust. Data on smoking were available for over one third of cohort members. In three countries, the prevalence of smokers was higher among cohort members compared to the national populations.

Conclusions: The results of the study do not suggest a carcinogenic effect of TiO2 dust on the human lung.

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References

  1. Considine DM (1974) Chemical and Process Technology Encyclopedia, New York: McGraw-Hill, pp. 1102–1104.

    Google Scholar 

  2. Stenbäck F, Rowland J, Sellakumar A (1976) Carcinogenicity of benzo[a]pyrene and dusts in the hamster lung (instilled intratracheally with titanium oxide, aluminium oxide, carbon and ferric oxide). Oncol 33: 29–34.

    Google Scholar 

  3. International Agency for Research on Cancer (1991) Titanium dioxide. In: IARC Monographs on the Evaluation of Carcinogenic Risks to Humans. Vol. 47. Lyon: IARC, pp. 307–326.

  4. Heinrich U (1994) Carcinogenic effects of solid particles. In: Mohr U, Dungworth DL, Mauderly JL, Oberdöster G, eds. Toxic and Carcinogenic Effects of Solid Particles in the Respiratory Tract. Washington, DC: ILSI Press, pp. 57–73.

    Google Scholar 

  5. Heinrich U Fuhst R, Rittinghausen S, et al. (1995) Chronic inhalation exposure of Wistar rats and two different strains of mice to diesel engine exhaust, carbon black, and titanium dioxide. Inhal Toxicol 7: 553–556.

    Google Scholar 

  6. Bermudez E, Mangum JB, Asgharian B, et al. (2002) Long-term pulmonary responses of three laboratory rodent species to subchronic inhalation of pigmentary titanium dioxide particles. Toxicol Sci 70: 86–97.

    Google Scholar 

  7. Oberdöster G (1994) Extrapolation of results from animal inhalation studies with particles to humans? In: Mohr U, Dungworth DL, Mauderly JL, Oberdöster G, eds. Toxic and Carcinogenic Effects of Solid Particles in the Respiratory Tract. Washington, DC: ILSI Press, pp. 335–353.

    Google Scholar 

  8. Chen JL, Fayerweather WE (1988) Epidemiologic study of workers exposed to titanium dioxide. J Occup Med 30: 937–942.

    Google Scholar 

  9. Fayerweather WE, Karns ME, Gilby PG, Chen JL (1992) Epidemiologic study of lung cancer mortality in workers exposed to titanium tetrachloride. J Occup Med 34: 164–169.

    Google Scholar 

  10. Boffetta P, Gaborieau V, Nadon L, Parent MF, Weiderpass E, Siemiatycki J (2001) Exposure to titanium dioxide and risk of lung cancer in a population-based study from Montreal. Scand J Work Environ Health 27: 227–232.

    Google Scholar 

  11. Fryzek JP, Chadda B, Marano D, et al. (2003) A cohort mortality study among titanium dioxide manufacturing workers in the United States. J Occup Environ Med 45: 400–409.

    Google Scholar 

  12. Boffetta P, Soutar A, Weiderpass E, et al. (2003) Historical Cohort Study of Workers Employed in the Titanium Dioxide Production Industry in Europe. Results of Mortality Follow-up. Final Report. Stockholm: Department of Medical Epidemiology, Karolinska Institutet.

    Google Scholar 

  13. Rajan B, Alesbury R, Carton B, et al. (1997) European proposal for core information for the storage and exchange of workplace exposure measurements on chemical agents. Appl Occup Environ Hyg 12: 31–39.

    Google Scholar 

  14. Ritchie PJ, Cherrie JW (2001) The development of a prototype database for the voluntary reporting of occupational exposure data on chemicals. Appl Occup Environ Hyg 16: 295–299.

    Google Scholar 

  15. Comité Européen de Normalisation (1993) Document CEN/ TC137/WG3/N150 or Revision Therof: Workplace Atmospheres: Assessment of Performance of Instruments for Measurement of Airborne Particles. Brussels: CEN.

  16. Cherrie JW, Schneider T, Spankie S, Quinn M (1996) A new method for structured, subjective assessments of past concentrations. Occup Hyg 3: 75–83.

    Google Scholar 

  17. Cherrie JW, Schneider T (1999) Validation of a new method for structured subjective assessment of past concentrations. Ann. Occup. Hyg 43: 235–246.

    Google Scholar 

  18. Semple SE, Proud LA, Tannahill SN, Tindall ME, Cherrie JW (2001). A training exercise in subjectively estimating inhalation exposures. Scand J Work Environ Health 27: 395–401.

    Google Scholar 

  19. Nicholaides-Bouman A, Wald N, Forey B, Lee P (1993) International Smoking Statistics. A Collection of Historical Data from 22 Economically Developed Countries, Oxford: Oxford University Press.

    Google Scholar 

  20. Forey B, Hamling J, Lee P, Wald N (2002) International Smoking Statistics. 2nd edn. A Collection of Historical Data from 30 Economically Developed Countries, Oxford: Oxford University Press.

    Google Scholar 

  21. Checkoway H, Pearce NE, Crawford-Brown DJ (1989) Research Methods in Occupational Epidemiology, New York: Oxford University Press.

    Google Scholar 

  22. DerSimonian R, Laird N (1986) Meta-analysis in clinical trials. Controlled Clin Trials 7: 177–188.

    Google Scholar 

  23. Rittgen W, Becker N (2000) SMR analysis of historical followup studies with missing death certificates. Biometrics 56: 1164–1169.

    Google Scholar 

  24. Cox DR (1972) Regression models and life tables (with discussion). J R Stat Soc B 34: 187–220.

    Google Scholar 

  25. Kolstad HA, Olsen J (1999) Why do short term workers have high mortality? Am J Epidemiol 149: 347–352.

    Google Scholar 

  26. Garabrant DH, Fine LJ, Oliver C, Bernstein L, Peters JM (1987) Abnormalities of pulmonary function and pleural disease among titanium metal production workers. Scand J Work Environ Health 13: 47–51.

    Google Scholar 

  27. Lindblad P, Adami HO (2002) Kidney cancer. In: Adami HO, Hunter D, Trichopoulos D, eds. Textbook of Cancer Epidemiology. New York: Oxford University Press, pp. 467–485.

    Google Scholar 

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Boffetta, P., Soutar, A., Cherrie, J.W. et al. Mortality Among Workers Employed in the Titanium Dioxide Production Industry in Europe. Cancer Causes Control 15, 697–706 (2004). https://doi.org/10.1023/B:CACO.0000036188.23970.22

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  • DOI: https://doi.org/10.1023/B:CACO.0000036188.23970.22

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