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distribution of these methods within the total cohort or within the stainless steel welding sub-cohort were not available. Expected numbers of cancers were based on national rates adjusted for age and calendar year period. For the total cohort, cancer incidence (all sites) was similar to the expected incidence (Observed 269, Expected 264, SIR 102, 95% CI 90 to 115). The number of lung cancer cases in this cohort was slightly increased (Observed 50, Expected 37.5, SIR 133, 95% CI 99 to 176). For the stainless steel welding sub-cohort, overall cancer incidence and lung cancer incidence were close to expectation. The observed number of cancers (all sites) was 41 (Expected 41.2, SIR 100) and the observed number of lung cancer cases was 6 (Expected 5.8, SIR 103). Three cases of pleural mesothelioma occurred in total cohort and one case in the stainless steel welding sub-cohort; the possibility of asbestos exposure was noted. This study did not demonstrate any increase either in overall cancer incidence or in lung cancer incidence among mixed stainless steel/mild steel welders. Hansen et al. 1996 Stainless steel welders and stainless steel grinders were included in the study population in an investigation of cancer incidence among Danish metal workers (Hansen et al. 1996). The total cohort comprised 10,059 workers, employed for at least one year during 1964-1984, with follow-up to 1986. The cohort comprised welders (stainless steel, mild steel, and mixed stainless steel/mild steel), stainless steel grinders, and other non-welding metal workers. Expected numbers of cancers were based on national incidence rates, adjusted for sex, age and calendar period. Lung cancer incidence was significantly increased in those subjects "ever employed in a welding company" (Observed 105, Expected 69.95, SIR 151, 95% CI 124 to 183). This excess remained, albeit slightly reduced, in the "ever employed as a welder" subcohort (Observed 51, Expected 36.84, SIR 138, 95% CI 103 to 181). Lung cancer incidence in different welding groups showed a non-significant increase in the "stainless steel only welders" (Observed 5, Expected 2.10, SIR 238, 95% CI), was close to expectation in the "stainless steel ever welders" (Observed 23, Expected 19.39, SIR 119, 95% CI 75 to 179), and was significantly increased in the "mild steel only welders" (Observed 28, Expected 17.42, SIR 161, 95% CI 107 to 233). Lung cancer incidence was also significantly increased in the "non-welding metal workers" (Observed 50, Expected 30.23, SIR 165, 96% CI 122 to 258). Lung cancer incidence in the welding cohort showed no consistent relationship with either duration of employment or time since first exposure. [Findings from this study relating to stainless steel grinders are shown separately in the appropriate section of this document.] This study provides evidence of increased risk of lung cancer in welders, although fails to clearly implicate or exclude either stainless steel welding or mild steel welding in the causation of these cancers. A sub-group of this cohort was included in the IARC study, reported previously (Simonato et al. 1991). 79
Moulin 1997 A meta-analysis involving 36 epidemiology studies of lung cancer risk in welders was conducted by Moulin (1997). The analysis involved case-referent studies and cohort studies. Combined relative risks were calculated according to the following welding categories: all or unspecified (19 studies); shipyard welding (14 studies); nonshipyard welding (7 studies); mild steel welding (4 studies); stainless steel welding (5 studies). When the combined relative risk of lung cancer was based on all studies within each category combined, for the "all or unspecified" welding category the relative risk was 138 (95% CI 129-148). The relative lung cancer risk in the stainless steel welding category, which was based on three case-referent studies and two cohort studies, was 150 (95% CI 110-205). This relative risk was the same as for the mild steel welding category (RR 150, 95% CI 118-191). Relative risks in the shipyard welding and non-shipyard welding categories, which were determined to control for asbestos as a confounding factor, were similar for both categories: shipyard welding (RR 130, 95% CI 114-148); non-shipyard welding (RR 135, 95% CI 115-158). Overall, the meta-analysis demonstrated an elevated relative risk of lung cancer in the 2all or unspecified" welding category, but no evidence to suggest that any increased risk is specifically associated with stainless steel welding. Summary of epidemiological investigations A number of investigations into cancer risks in workers engaged in the welding of stainless steel have been performed. These are summarised in Table 3.3. The lung cancer findings from many of these studies are based on small numbers and interpretation is also hindered by the absence of reliable exposure histories. Nevertheless, these studies provide no consistent pattern of excess lung cancer risk attributable specifically to stainless steel. In addition, a meta-analysis of lung cancer in welders (Moulin 1997) concluded that the elevated lung cancer rates in welders "cannot be explained by hexavalent chromium and nickel exposures among stainless steel welders". . 80
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MANUFACTURE, PROCESSING AND USE OF
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3.2 GRINDING OF STAINLESS STEEL ...
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Within the review, each section is
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Results from a single intra-muscula
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studies are often based on small nu
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The toxicological database for fume
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PEFR peak expiratory flow rate PSD
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Table 1.1 Identity of stainless ste
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There are several different systems
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method have been used in some of th
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grade was tested, an austenitic sta
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pick-up of nickel and chromium when
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Human data Patch-testing studies Se
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does not allow any conclusions to b
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Schriver et al. (1976) reported a c
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Other studies reviewed in this sect
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Human data on the effects of prolon
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Exposure to stainless steel powder
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Prolonged exposure Information on t
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In view of the chemical/physical pr
Page 41 and 42: Figure 2.1 Production of stainless
Page 43 and 44: Table 2.1 Manufacture of stainless
Page 45 and 46: 2.3 Toxicokinetics Toxicokinetics i
Page 47 and 48: survey, there was no evidence of an
Page 49 and 50: The "exposure" variable used by the
Page 51 and 52: Table 2.2 Epidemiological studies o
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Page 55 and 56: 3 STAINLESS STEEL PROCESSING This s
Page 57 and 58: Arc voltage or arc length Arc volta
Page 59 and 60: 3.1.2 Information on exposure Weldi
Page 61 and 62: Reference Akesson & Skerfving (1985
Page 63 and 64: Table 3.2 Elemental composition of
Page 65 and 66: These levels decreased, although ch
Page 67 and 68: treatment group and no effects were
Page 69 and 70: esponses in terms of irritancy, fib
Page 71 and 72: MMA/SS) at approximately 400 mg/m 3
Page 73 and 74: Exposure measure 60 Welders a (n=52
Page 75 and 76: was relatively heterogeneous. No de
Page 77 and 78: used included respiratory symptoms,
Page 79 and 80: Keskinen et al. (1980) reported on
Page 81 and 82: Positive results were reported with
Page 83 and 84: Welding method Electrode Base metal
Page 85 and 86: A significant increase in chromatid
Page 87 and 88: treated with MIG/SS fume. One lung
Page 89 and 90: The mortality experiences of the tw
Page 91: Moulin et al. 1993b Mortality was s
Page 95 and 96: Table 3.3. Epidemiological studies
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Page 99 and 100: Bonde et al. (1990) investigated fe
Page 101 and 102: out stainless steel welding in the
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Page 105 and 106: Effects on reproduction No studies
Page 107 and 108: Table 3.4 Grinding of stainless ste
Page 109 and 110: Reference Process Work piece materi
Page 111 and 112: No deaths occurred in any treatment
Page 113 and 114: Human data No studies are available
Page 115 and 116: mg of dust per animal. In another t
Page 117 and 118: (Observed 8, Expected 4.7, SMR 170,
Page 119 and 120: Table 3.5 Epidemiological studies o
Page 121 and 122: Carcinogenicity The carcinogenicity
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Page 125 and 126: 112 APPENDIX 1 22.7.94 Official Jou
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Page 129 and 130: Escales F, Galante J, Rostoker W. B
Page 131 and 132: IARC. Monographs on the evaluation
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Page 135 and 136: Simonato L, Fletcher AC, Andersen A
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Page 139 and 140: Bondemark L, Kurol J, Wennberg A. O
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Hooftman RN, Arkesteyn CW, Roza P.
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Koshi K, Yagami T. Chromosomes of c
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Merritt K, Brown SA. Release of hex
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Pereira ML. Studies on the permeabi
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Stern RM . Detecting a possible inc
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Toyoshima M, Sato A, Taniguchi M, I
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