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Objectives To evaluate occupational variation in the incidence of the malignant neoplasm of the renal pelvis in the population of the Nordic countries: Denmark, Iceland, Finland, Norway and Sweden. Materials and methods The study cohort comprised 14.9 million individuals. Data on occupational history were obtained from national censuses. Standardized incidence ratios (SIRs) were calculated for each occupation. Results The highest SIRs were found in seamen (1.51, 95% confidence interval [CI] 1.23-1.82), printers (1.39, 95% CI 1.11-1.71), welders (1.37, 95% CI 1.03-1.78), and public safety workers (1.35, 95% CI 1.12-1.62). The lowest SIRs were observed in forestry workers (0.47, 95% CI 0.35-0.62), gardeners (0.72, 95% CI 0.62-0.83) and woodworkers (0.81, 95% CI 0.72-0.91). Conclusions The study suggests that there is an association between profession and risk of malignancy of the renal pelvis. The possible associations between exposure to asbestos, heavy metals and welding fumes, and risk of developing the disease should be studied further.

The current study aims to provide stronger evidence to aid in our understanding of the role of cumulative occupational exposure to (softwood-dominated) mixed wood dust in aetiology of nasal cancer. We included broad exposure occurred in a range of wood-processing occupation across varied industries in four Nordic countries. A population-based case-control study was conducted on all male cases with nasal adenocarcinoma (393 cases), other types of nasal cancer (2,446) and nasopharyngeal cancer (1,747) diagnosed in Finland, Sweden, Norway and Iceland between 1961 and 2005. For each case, five male controls, who were alive at the time of diagnosis of the case (index date), were randomly selected, matched by birth-year and country. Cumulative exposures (CE)s to wood dust and formaldehyde before the index date were quantified based on a job-exposure matrix linked to occupational titles derived from population censuses. Hazard ratios (HRs) for the CE of wood dust were estimated by conditional logistic regression, adjusted for CE to formaldehyde and 95% confidence intervals (CIs) were calculated. There was an increasing risk of nasal adenocarcinoma related to wood dust exposure. The HR in the highest CE category of wood dust (≥ 28.82 mg/m3 -years) was 16.5 (95% CI 5.05-54.1). Neither nonadenocarcinoma of the nose nor nasopharyngeal cancer could be linked to wood dust exposure. CE to softwood-dominated mixed wood dusts is strongly linked with elevated risk in nasal adenocarcinoma but not with other types of nasal or nasopharyngeal cancer.

The aim of this study was to assess the effect of occupational solvent exposure on the risk of adult chronic lymphocytic leukemia (CLL). The current case-control study was nested in the Nordic Occupational Cancer Study (NOCCA) cohort. 20,615 CLL cases diagnosed in 1961-2005 in Finland, Iceland, Norway, and Sweden, and 103,075 population-based controls matched by year of birth, sex, and country were included. Occupational histories for cases and controls were obtained from census records in 1960, 1970, 1980/1981, and 1990. Exposure to selected solvents was estimated by using the NOCCA job-exposure matrix (NOCCA-JEM). Odds ratios (OR) and 95% confidence intervals (95% CI) were estimated by using conditional logistic regression models. Overall, nonsignificant CLL risk elevations were observed for methylene chloride, perchloroethylene, and 1,1,1-trichloroethane. Compared to unexposed, significantly increased risks were observed for cumulative perchloroethylene exposure ≤13.3 ppm-years (OR = 1.85, 95% CI 1.16-2.96) and average life-time perchloroethylene exposure ≤2.5 ppm (1.61, 95% CI 1.01-2.56) among women, and cumulative methylene chloride exposure ≤12.5 ppm-years (OR = 1.19, 95% CI 1.01-1.41) and 12.5-74.8 ppm-years (OR = 1.23, 95% CI 1.01-1.51) among men in an analysis with 5 years lag-time, though without dose-response pattern. Decreased CLL risk was observed for aliphatic and alicyclic hydrocarbon solvents and toluene. This study did not support associations for solvent exposure and CLL. Observed weak associations for methylene chloride, perchloroethylene, 1,1,1-trichloroethane exposures, aliphatic and alicyclic hydrocarbons and toluene were not consistent across sexes, and showed no gradient with amount of exposure.

To assess associations between occupation and risk of oesophageal adenocarcinoma (AC) and squamous-cell carcinoma (SCC), data from the Nordic Occupational Cancer Study, a large population-based cohort with long-term follow-up, was used. The Nordic Occupational Cancer Study includes 12.9 million individuals aged 30-64 years who participated in national censuses in Finland, Iceland, Norway and Sweden in 1960-1990. Individuals were assigned to one of the 54 occupational categories, and individuals with oesophageal cancer were identified through nationwide cancer registries with follow-up through 2005. Country-specific standardised incidence ratios (SIRs) with 95% confidence intervals (CIs) were estimated. During follow-up, 4,722 ACs and 14,496 SCCs were observed. Among men, increased risks of AC and SCC were observed among waiters (SIR = 2.58, 95% CI 1.41-4.32 and SIR = 3.22, 95% CI 2.30-4.38 for AC and SCC, respectively), cooks and stewards (1.72, 1.04-2.69 and 2.53, 1.94-3.25), seamen (1.52, 1.16-1.95 and 1.77, 1.53-2.05), food workers (1.51, 1.18-1.90 and 1.21, 1.03-1.42), miscellaneous construction workers (1.24, 1.04-1.48 and 1.39, 1.25-1.54) and drivers (1.16, 1.01-1.33 and 1.23, 1.13-1.34). Decreased risks of AC and SCC were observed among technical workers, physicians, teachers, religious workers and gardeners. The SIR for AC was significantly different from that for SCC in six occupational categories. Among women, increased risks among food workers and waiters and decreased risks among teachers, nurses and assistant nurses were observed for SCC only. In both sexes, increased risks were observed among waiters and food workers, and decreased risks were observed among teachers. This large cohort study indicates that the risk of oesophageal cancer varies by occupation, but not by histological type in most occupational categories.

Accepted manuscript version. Published version available at https://doi.org/10.1002/ijc.30593. The objective of the study was to assess the relationship between exposure to selected solvents and the risk of bladder cancer. This study is based on the Nordic Occupational Cancer (NOCCA) database and comprises 113,343 cases of bladder cancer diagnosed in Finland, Iceland, Norway and Sweden between 1961 and 2005 and 566,715 population controls matched according to country, sex and birth year. Census‐based occupational titles of the cases and controls were linked with the job exposure matrix created by the NOCCA project to estimate quantitative cumulative occupational exposures. A conditional logistic regression model was used to estimate hazard ratios (HRs) and their 95% confidence intervals (95% CI). Increased risks were observed for trichloroethylene (HR 1.23, 95% CI 1.12–1.40), toluene (HR 1.20, 95% CI 1.00–1.38), benzene (HR 1.16, 95% CI 1.04–1.31), aromatic hydrocarbon solvents (HR 1.10, 95% CI 0.94–1.30) and aliphatic and alicyclic hydrocarbon solvents (HR 1.08, 95% CI 1.00–1.23) at high exposure level versus no exposure. The highest excess for perchloroethylene was observed at medium exposure level (HR 1.12, 95% CI 1.02–1.23). The study provides evidence of an association of occupational exposure to trichloroethylene, perchloroethylene, aromatic hydrocarbon solvents, benzene and toluene and the risk of bladder cancer.

Background The possible associations between asphalt work and mortality from non-malignant diseases in a cohort of male Norwegian asphalt workers that formed part of the European asphalt worker mortality study are examined. Methods The mortality experience among 8,610 male workers ever employed in asphalt work was observed from 01.01.1970 until 12.31.1996, yielding 127,636 person years of observation. The cause-specific deaths observed in the study cohort were compared with the expected figures calculated from 5-year period- and age-specific national death rates. A study-specific job exposure matrix was used for individual–individual exposure estimates. Results Eight hundred and three workers died during the observation period (SMR = 0.92, 95% confidence intervals (CI) = 0.58, 1.40). The mortality from non-malignant respiratory diseases was elevated (SMR = 1.25, 95%CI = 0.97, 1.58) and was associated with years since first employment in the asphalt industry. Mortality from respiratory diseases was highest among the workers first employed in the 1960s. Among the different job types held by the workers the pavers and mastic asphalt workers had the highest mortality from respiratory diseases. A weak dose–response was found with cumulative exposure to PAH and bitumen fume and mortality from non-malignant respiratory diseases in analyses employing the job-exposure matrix. Overall mortality, the mortality from circulatory diseases (SMR = 0.93, 95%CI = 0.83, 1.03) and external causes (SMR = 0.90, 95%CI = 0.72, 1.11) was lower than expected. Conclusions Mortality from respiratory diseases was found somewhat elevated among the asphalt workers. There was some evidence of exposure–response with both bitumen fume and PAH exposure. PAH from coal tar contributes to the PAH exposure. Am. J. Ind. Med. 43:96–103, 2003. © 2003 Wiley-Liss, Inc.

Background The main objective of the present study was to investigate whether exposure to bitumen fumes could enhance the risk of cancer in asphalt workers. Methods A historical prospective cohort study was performed including 8,763 male asphalt workers from all main asphalt companies in Norway. Name, date of birth, and unique personal identification number, address, job type, and start and stop of employment in specific jobs was obtained for the workers. Information was complied from payroll and personnel records in the companies. The cohort was then linked to the Cancer Registry of Norway, which has complete records of individual cases of cancer in the Norwegian population since 1953. Follow-up was from 1 January 1970 to 31 December 1997. The 5-year age and period adjusted general male population in Norway served as reference population. Results Lung cancer was found elevated with standardized incidence ratio (SIR) = 1.3 (95% confidence intervals (CI) = 1.1, 1.7) in the overall analysis. Lung cancer was found more elevated in workers first exposed in the 1950s and 1960s and in mastic asphalt workers (SIR = 4.2, 95% CI = 1.2, 10, based on four cases) and pavers (SIR = 1.4, 95% CI = 1.0, 1.9). There was a deficiency in the incidence of malignant melanoma with 13 cases versus 26 expected. Conclusions Risk of lung cancer was found enhanced among the asphalt workers. Some of the enhanced risk could probably be explained by the smoking habits of the workers. Exposure to coal tar may also have contributed to the enhanced risk. Am. J. Ind. Med. 43:88–95, 2003. © 2003 Wiley-Liss, Inc.

The thesis covers the establishment and quality controls of two cohorts of civilian and military personnel serving in the Royal Norwegian Navy (RNoN) after January 1, 1950, and two studies among male members of the military cohort. For the civilian cohort, the criterion for inclusion was all civilians who have served at any time during 1950–2005 in the Navy, while the military cohort was limited to officers and enlisted personnel. All branches of the Navy were covered, hereunder the Fleet, the Coast Guard and the Coastal Artillery. By 1950, the Norwegian Fleet was either destroyed during the Second World War (WWII) or out-dated. The rebuilding of the Navy was yet to begin, and Norway had just become a member of the North Atlantic Treaty Organisation (NATO) at the Treaty foundation in 1949. With its border with the Soviet Union in the north Norway became of strategic importance, and the Cold War shaped the design of the Norwegian Defence. The present work started in 2002 with establishment of the cohorts. The registration work resulted in a military cohort of 29 056 persons (2.5% women) with an average of 6.2 years service in the Navy. The cohort of 8 378 civilians (39% women) had an average of 11 years in the Navy. Both cohorts were regarded as virtually complete. The first cohort study dealt with asbestos related cancers among Navy vessels crews. Asbestos has been commonly used in shipbuilding for heat and sound insulation, and for fireproofing. Until 1987, asbestos aboard the Navy vessels potentially caused exposure to 11 500 crew members. Engine room crews were considered to experience higher exposure intensity than other crews aboard. Asbestos is the only environmental factor known to cause malignant mesothelioma, and an elevated incidence of this disease served as an indicator of asbestos exposure. The incidence of other potentially asbestos related cancers (lung, laryngeal, pharyngeal, stomach and colorectal cancers) was evaluated according to duty station and mesothelioma incidence. Elevated incidence of mesothelioma was found among engine room crews only, and the time from first exposure to date of diagnosis ranged from 28 to 48 years (median 41). The mesothelioma incidence offered no consistent explanation to the variation in incidence of other potentially asbestos-related cancers. The second cohort study examined the cause-specific mortality and cancer incidence compared to the national rates. Internal comparisons between vessel crews and land-based personnel were performed. A military career implies adaptation to a rigid disciplinary system, handling of weaponry, and a life at remote locations causing separation from family members. In foreign navies, a higher than average alcohol consumption with a negative impact on occupational efficiency and adverse health outcome, has been reported. Special attention was thus given towards deaths from violent causes, alcohol related diseases (mental and behavioural disorders due to use of alcohol, liver cirrhosis) and incidence of alcohol-related cancers (mouth, pharynx, larynx, oesophagus and liver cancer). For the cohort as a whole, the overall mortality was 16% lower than in the general Norwegian male population. The physical and psychological screenings for military service and the demand for “keeping up” during service imply that the Navy personnel were highly selected and expected to be healthier than the general population. This phenomenon has been termed “healthy soldier effect”. Overall cancer incidence was 6% higher, mostly due to excess prostate cancer and malignant melanoma and non-melanoma skin cancers. Death from violent causes (accidents and suicide) was 36% lower than expected. Both overall mortality and cancer were higher among sailors than among land-based personnel. No increased risk of alcohol related cancers or mortality was found for the cohort as a whole, but a higher risk was found among those serving aboard the vessels than for land based personnel.