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Background: In the iron and steel industry, workers are potentially exposed to a number of carcinogens and are involved in a number of processes of a hazardous nature. The cancer morbidity of iron and steel workers from modern plants in a developing country is described., Methods: Cancer morbidity at two Korean iron and steel complexes was analyzed using Poisson regression methods. Work histories were merged with the national cancer registry for 44,974 workers who were followed from 1988-2001., Results: Four hundred sixty-four cancers, in 1% of the population, were diagnosed over 14 years. Based on national cancer rates, the cohort exhibited a healthy worker effect for all cancer (SIR = 0.87, 95% CI = 0.79-0.95) reflecting relative good health, particularly for lung cancer (SIR = 0.58, 95% CI = 0. 04-0.82), stomach cancer (SIR = 0.78, 95% CI = 0.64-0.93), and liver cancer (SIR = 0.83, 95% CI = 0.68-1.01). Lung cancer morbidity was significantly elevated at the affiliated plants versus the parent plants (SRR = 2.35, 95% CI = 1.07-4.92), and all-cancer morbidity was significantly elevated for maintenance workers compared to office and production workers (SRR = 1.27, 95% CI = 1.00-1.60). Lymphohematopoietic cancer incidence was higher in the coke plants (SRR = 3.46, 95% CI = 1.02-8.91) and stomach cancer incidence was higher in the maintenance departments (SRR = 1.66, 95% CI = 1.05-2.56)., Conclusions: This recent steelworker cohort exhibits possible excess cancer morbidity in some processing areas. Further follow-up of this cohort and alternate study designs such as case-control study will be needed to elucidate the relationship of exposure and health risks of iron and steel workers., (Copyright 2006 Wiley-Liss, Inc)

Background: The mortality experience of iron and steel workers from modern plants in developing countries has not been extensively described., Methods: Mortality at two Korean iron and steel manufacturing complexes was analyzed using Poisson regression methods with both direct and indirect standardization. Work histories were linked with a national mortality registry. Workers (44,974) hired beginning in 1968 were followed from 1992 to 2001., Results: The 806 deaths observed during 10 years of follow-up comprised 2% of the population at risk and represented a large healthy worker effect (HWE) for all causes (SMR = 0.59, 95% CI = 0.55-0.63) and for cancer (SMR = 0.79, 95% CI = 0.70-0.90). Mortality at subsidiaries was considerably higher than at the parent plants (SRR = 1.71, 95% CI = 1.47-1.99). Relative mortality rates declined with employment duration: > 20 years had significantly reduced mortality (SRR = 0.59, 95% CI = 0.43-0.82) compared to duration < 1 year (test for trend: P = 0.0006). Fatal injury deaths in the first year were highly elevated (SMR = 3.10, 95% CI = 2.17-4.26) declining to less than that expected after 5 years. Cancer mortality was elevated in stainless steel production (SRR = 3.26, 95% CI = 1.37-6.49) and overall mortality was elevated for work in plant maintenance departments (SRR = 1.17, 95% CI = 1.00-1.37), particularly for fatal injuries (SRR = 1.67, 95% CI = 1.29-2.14). All-cause mortality increased with employment duration in the steel-production departments, as did fatal injuries in material handling/construction., Conclusions: This steelworker cohort exhibits excess mortality in some process areas. More detailed retrospective exposure assessment and future follow-up of this cohort will better define health risks in the modern iron and steel manufacturing.