Mortality from solid tumors among workers in formaldehyde industries: An update of the NCI cohort

Background Formaldehyde, a widely used chemical, is considered a human carcinogen. Methods We extended follow-up of the largest industrial cohort of workers in formaldehyde industries (n=25,619) by 10 years through 2004. Standardized mortality ratios (SMRs) and rate ratios (RRs) were calculated for deaths from solid tumors using quantitative formaldehyde exposure estimates. Results During 998,239 person-years, 13,951 deaths occurred. With one additional death, previously observed excesses for nasopharyngeal cancer (n=10) persisted for peak, average intensity and cumulative exposure; RRs in the highest exposure categories were 7.66 (95% CI: 0.94, 62.34), P-trend=0.005, 11.54 (95% CI: 1.38, 96.81), P-trend=0.09, and 2.94 (95% CI: 0.65, 13.28), P-trend=0.06, respectively. For all cancer, solid tumors and lung cancer, SMRs among exposed workers were elevated, but internal analyses revealed no positive associations with formaldehyde exposure. Conclusions Consistent with previous analyses of this cohort, this update continues to suggest a link between formaldehyde exposure and nasopharyngeal cancer. Am. J. Ind. Med. 56:1015-1026, 2013. (c) 2013 Wiley Periodicals, Inc.