Lung cancer could have been avoided

Most cases of lung cancer at Falconbridge Nikkelverk A/S could have been prevented if the workers had not inhaled nickel compounds.

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Text: Kjell Arne Bakke

Until 2000, the incidence of lung cancer was 2.5-3 times higher among nickel workers than among other Norwegian men.

These are among the conclusions in the thesis that researcher and doctor Tom Kristian Grimsrud at the Cancer Registry of Norway defended during a doctoral disputation on 3 September in Oslo.

Lung cancer is one of the most common cancers in Norway, and tobacco smoking plays an important role in the development of the disease. This also applies to nickel workers, but according to Grimsrud, their smoking habits are not significantly different from other Norwegian men. However, the harmful effects of nickel are an additional burden for this occupational group.

Grimsrud's thesis is entitled "Risk of lung cancer among nickel-refinery workers: Exposures and the effect of different forms of nickel". Here he examines occupational influences and risk of lung cancer among nickel workers at Falconbridge Nikkelverk A/S in Kristiansand.

267 cases of lung cancer

In the period 1953-2000, 267 cases of lung cancer occurred among the company's employees and pensioners.

"This means that nickel workers have 2.5-3 times higher incidence than the average of Norwegian men," says the researcher at the Cancer Registry of Norway on the occasion of the public defence.

It has been questioned whether influences other than nickel and tobacco smoking may have contributed to the high incidence of lung cancer among nickel workers.

"This has now been investigated, but we have not found evidence that asbestos dust, sulphuric acid or cobalt can explain the excess frequency in this group of workers. However, arsenic and hazardous work outside the nickel plant may have contributed to a modest extent, Grimsrud explains.

The working environment improved

He says that the working environment improved significantly after a major restructuring of production in 1978, but it is still too early to see results in the form of less lung cancer. On the contrary, the figures indicate that the workers may also have been exposed to unfortunate nickel effects in the first years after 1978.

Tom Kristian Grimsrud's doctoral work summarises research over several years. The thesis is based on information about work and the working environment at the company and data from the Cancer Registry. In addition, valuable information has been provided by the company's employees and their immediate families, mainly people living in the Kristiansand area.

The analyses were carried out at the Cancer Registry of Norway with financial support from the Norwegian Cancer Society, the Working Environment Fund in the Confederation of Norwegian Business and Industry and Nikkelverk.

Defending his thesis on 3 September

Tom Kristian Grimsrud defends the thesis during a public defence on 3 September at 10.15 in the auditorium at the National Institute of Occupational Health (Stami) in Oslo. As opponents, some of the world's foremost researchers on occupational cancer will meet.

His first opponent, Professor Julian Peto of the Institute of Cancer Research at the Royal Cancer Hospital in London, worked in the 1980s and 1990s on cancer problems among Welsh nickel workers. Peto is an internationally highly respected researcher and represents long and heavy English traditions in cancer epidemiology (cancer prevalence and causes).

The second opponent is Dr Patricia Stewart. She works at one of the premier U.S. institutions for the study of environmental cancer, the U.S. National Cancer Institute, Occupational and Environmental Epidemiology Branch.

The chair of the assessment committee is the renowned Norwegian toxicologist, Dr Erik Dybing, Director of the Division of Environmental Medicine at the Norwegian Institute of Public Health.