Unrecognized risks of nickel-related respiratory cancer among Canadian electrolysis workers

Objectives Nickel compounds, inclusive of water-soluble salts, have been classified as human carcinogens by the International Agency for Research on Cancer (IARC). Nickel producers have disputed the classification of soluble nickel compounds for three decades with reference to an alleged absence of excess respiratory cancer among Canadian nickel-exposed electrolysis workers. We evaluated historical data from two electrolytic refineries in Ontario, both included in prominent Canadian reports on occupational nickel-related cancer. Methods For Port Colborne nickel refinery (PCNR) and Copper Cliff copper refinery (CCCR), we identified process descriptions, exposure estimates, and original reports on cancer mortality using reference lists, libraries, and state archives. The documents were written or published between 1930 and 1992. Results For PCNR, a 1977 US National Institute of Occupational Safety and Health criteria document demonstrated an excess nasal cancer risk among electrolysis workers independent of furnace exposure. PCNR studies published after 1980 excluded 26% of long-term refiners who died from respiratory cancer according to earlier reports, and 42% of the workers had unknown vital status at the end of follow-up, biasing the standardized observed-to-expected mortality ratios downwards, most pronounced in recent reports and for workers without pension or company benefits. CCCR reports did not adequately address soluble nickel exposure in the evaluation of an observed occupational lung cancer excess. Conclusions While acknowledging important contributions to the recognition of nickel carcinogenicity from highly exposed Canadian refiners, we conclude that the claimed absence of nickel-related respiratory cancer among electrolysis workers has resulted from an arbitrary overemphasis of biased and inconclusive findings.