Journal
AMERICAN JOURNAL OF EPIDEMIOLOGY
Volume 179, Issue 11, Pages 1301-1311Publisher
OXFORD UNIV PRESS INC
DOI: 10.1093/aje/kwu049
Keywords
cancer; chemical industry; formaldehyde; mortality; myeloid leukemia; nasopharyngeal cancer; occupational exposure
Categories
Funding
- Colt Foundation [CF/03/10]
- MRC [MC_UP_A620_1018, MC_UU_12011/5] Funding Source: UKRI
- Medical Research Council [MC_UP_A620_1018, MC_UU_12011/5] Funding Source: researchfish
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The International Agency for Research on Cancer controversially has classified formaldehyde as causing nasopharyngeal carcinoma and myeloid leukemia. To provide further information on this question, we extended follow-up of a cohort of 14,008 chemical workers at 6 factories in England and Wales, covering the period 1941-2012. Mortality was compared with national death rates for England and Wales, and associations with incident upper airway cancer and leukemia were explored in nested case-control analyses. We observed excess deaths from cancers of the esophagus (100 observed vs. 93.1 expected), stomach (182 vs. 141.4), rectum (107 vs. 86.8), liver (35 vs. 26.9), and lung (813 vs. 645.8), but none of these tumors exhibited a clear exposure-response relationship. Nested case-control analyses of 115 men with upper airway cancer (including 1 nasopharyngeal cancer), 92 men with leukemia, and 45 men with myeloid leukemia indicated no elevations of risk in the highest exposure category (high exposure for a parts per thousand yen1 year). When the 2 highest exposure categories were combined, the odds ratio for myeloid leukemia was 1.26 (95% confidence interval: 0.39, 4.08). Our results provide no support for an increased hazard of myeloid leukemia, nasopharyngeal carcinoma, or other upper airway tumors from formaldehyde exposure. These results indicate that any excess risk of these cancers, even from relatively high exposures, is at most small.
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