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Int. J. Environ. Res. Public Health 2011, 8(6), 2009-2019; doi:10.3390/ijerph8062009

Cancer Incidence and Mortality in Swedish Sterilant Workers Exposed to Ethylene Oxide: Updated Cohort Study Findings 1972–2006

Division of Occupational and Environmental Medicine, Department of Laboratory Medicine, Lund University, SE-221 85 Lund, Sweden
Occupational and Environmental Medicine, Skåne University Hospital, SE-221 85 Lund, Sweden
Competence Centre for Clinical Research, Lund University, SE-221 85 Lund, Sweden
Author to whom correspondence should be addressed.
Received: 4 May 2011 / Accepted: 28 May 2011 / Published: 3 June 2011
(This article belongs to the Special Issue Occupational Cancer)
View Full-Text   |   Download PDF [304 KB, uploaded 19 June 2014]


Objectives: To assess whether cancer incidence, mainly from lymphohaematopoietic tumours and breast cancer, and mortality were increased in a cohort of Swedish sterilant workers exposed to low levels of ethylene oxide (EtO), updated with 16 more years of follow up. Methods: The mortality and cancer incidence 1972–2006 experienced by a cohort of 2,171 male and female workers employed for at least one year in two plants producing medical equipment sterilised with EtO were investigated. Individual cumulative exposure to EtO was assessed by occupational hygienists. Cause-specific standardized rate ratios were calculated using the regional general population as a comparison for mortality (SMR) and cancer incidence (SIR). Internal Poisson-regression analyses were performed for selected causes. Results: The median cumulative exposure to EtO was 0.13 ppm-years. The overall cancer incidence was close to unity (SIR 0.94, 95% CI 0.82–1.08). Eighteen cases of lymphohaematopoietic cancer were observed (SIR 1.25, 95% CI 0.74–1.98). A healthy worker effect was indicated from a significantly decreased overall mortality and mortality from cardiovascular diseases. Internal analyses found significantly increased rate ratios for breast cancer for the two upper quartiles of cumulative exposure as compared to the lowest 50% of the cohort (IRR 2.76, 95% CI 1.20–6.33 and IRR 3.55, 95% CI 1.58–7.93). Conclusions: The findings from this updated study indicate limited or low risks for human cancer due to occupational exposure from ethylene oxide at the low cumulative exposure levels in this cohort. However a positive exposure-response relation with breast cancer was observed though. View Full-Text
Keywords: cohort study; leukaemia; breast cancer cohort study; leukaemia; breast cancer
This is an open access article distributed under the Creative Commons Attribution License (CC BY 3.0).

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Mikoczy, Z.; Tinnerberg, H.; Björk, J.; Albin, M. Cancer Incidence and Mortality in Swedish Sterilant Workers Exposed to Ethylene Oxide: Updated Cohort Study Findings 1972–2006. Int. J. Environ. Res. Public Health 2011, 8, 2009-2019.

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