Cancer mortality among woodworkers

Our plain-English summary of Cancer mortality among woodworkers, by S.D. Stellman, L. Garfinkel (American Journal of Industrial Medicine, 1984).

The study

• Authors: S.D. Stellman, L. Garfinkel
• Journal: American Journal of Industrial Medicine
• Published: 1984;5(5):343-57
• Cited by: 44 articles, as counted by NIH iCite
• Read it: PubMed · Publisher

Abstract

The mortality experience of 10,322 men employed in woodworking industries was compared with that of 406,798 nonwoodworkers. All subjects were enrolled in an American Cancer Society study and followed prospectively from 1959 through 1972. Age-adjusted rates of death from all causes and from all cancers were not higher in the woodworker group, but excess rates were observed for cancers of the lung, stomach, and bladder, as well as nonmelanoma skin cancer and possibly leukemia. Woodworkers experienced significantly decreased rates of colon-rectum cancer and coronary heart disease. The elevated cancer rates could not be explained by cigarette smoking habits. If anything, there is evidence to suggest a possible interaction between employment in woodworking trades and heavy cigarette smoking, in increasing the risk of lung and bladder cancer.

In plain English

This prospective cohort study drew on an American Cancer Society study that enrolled people in 25 US states starting in 1959. It compared deaths among 10,322 men who described their job as woodworking, mostly carpenters and joiners, with deaths among 406,798 other men in the same study, followed from July 1960 to June 1972. Overall death rates and total cancer death rates were not higher among woodworkers. Woodworkers as a group had raised standardized mortality ratios (SMRs) for stomach cancer (149) and bladder cancer (142), and lowered SMRs for colon-rectum cancer (75) and coronary heart disease (95). Carpenters and joiners had an SMR of 120 for lung cancer. The authors reported that smoking did not explain the stomach cancer excess. The lung and bladder cancer excess appeared mainly among men smoking a pack or more a day. Woodworkers were identified only by their self-reported job, and how long they had worked was unknown. The authors suggested that asbestos exposure among carpenters and joiners was a possible explanation for part of the excess lung and stomach cancer.

We wrote this plain-English summary from the full article with the help of AI, and a second AI model checked each sentence against the article. It is not the authors' wording; the abstract and the article are their own account.

What the study did and found

• Design: Prospective cohort study comparing woodworkers with nonwoodworkers in the same American Cancer Society study, using standardized mortality ratios (SMRs)
• Who was studied: Men in an American Cancer Society study enrolled from October 1959 in 25 US states. The comparison was 10,322 woodworkers (102,062 person-years) with 406,798 nonwoodworkers (4,130,217 person-years). Only men who said they were not sick and were alive on July 1, 1960 were included, and they were followed to June 30, 1972.
• Exposure: Employment in woodworking, identified from each man's self-reported present (or, if retired, previous) occupation across 33 job titles. These were grouped as carpentry and joinery (7,157), lumber and sawmill (2,409), and furniture and cabinetry (735). Levels of wood dust and other exposures were not measured.
• Main results:
  • Compared with nonwoodworkers, woodworkers did not have higher age-adjusted death rates from all causes or from all cancers.
  • Stomach cancer: 44 deaths among all woodworkers, SMR 149 (p less than 0.01). Among carpenters and joiners: 36 deaths, SMR 170 (p less than 0.01).
  • Bladder cancer: 29 deaths among all woodworkers, SMR 142 (p less than 0.05). Among carpenters and joiners: 20 deaths, SMR 134 (not marked significant).
  • Lung cancer: 135 deaths among all woodworkers, SMR 113 (not marked significant). Among carpenters and joiners: 101 deaths, SMR 120 (p less than 0.05).
  • Colon-rectum cancer was lower among all woodworkers: 57 deaths, SMR 75 (p less than 0.05).
  • Coronary heart disease was lower: 1,008 deaths among all woodworkers, SMR 95 (p less than 0.05). Among carpenters and joiners: 706 deaths, SMR 93 (p less than 0.05).
  • Leukemia was raised among carpenters (SMR 140). In the table this SMR is not marked as statistically significant.
  • Two nasal cavity cancer deaths occurred among carpenters and joiners, more than three times the expected number. The authors said this was too few for a meaningful statistical test.
  • No increase in Hodgkin disease or other lymphatic cancers was found among woodworkers: 3 Hodgkin disease deaths (4.5 expected) and 17 non-Hodgkin lymphoma deaths (24.4 expected, p=0.075).
  • Among lumber and sawmill workers there were 23 accidental deaths, SMR 147 (p less than 0.05).
  • The authors stated that smoking or other confounding factors did not explain the stomach cancer excess in woodworkers.
  • Lung and bladder cancer risk differed little between woodworkers and nonwoodworkers who smoked less than a pack a day. The excess was pronounced among those smoking a pack or more a day.
• The authors' conclusion: The authors suggested that carpenters and joiners had the most pronounced risks of the three woodworker subgroups and are the most likely to be exposed to asbestos. They proposed asbestos as a possible explanation for part of the excess lung and stomach cancer.
• Limitations the authors state:
  • Occupation was self-reported, which is potentially less precise than classification by an industrial hygienist. Exposure levels to wood dust and the types of wood handled were not known.
  • How long the men had worked in wood industries was unknown.
  • Men may have held other occupations during their lives.
  • Tissue specimens were not examined, so lung cancer types and acute versus chronic leukemia could not be distinguished.
  • Bladder cancer deaths in the lumber/sawmill and furniture/cabinetry subgroups were few, and those SMRs were not statistically significant.

Topics

Medical terms in this study, explained in our Lexicon: Habit.

Related studies

• Nonmalignant respiratory disease mortality among woodworkers participating in the American Cancer Society Cancer Prevention Study-II (CPS-II) — P.A. Demers, S.D. Stellman, et al. (1998)
• Cancer mortality and wood dust exposure among participants in the American Cancer Society Cancer Prevention Study-II (CPS-II) — S.D. Stellman, P.A. Demers, et al. (1998)
• Extended mortality follow-up among men and women in a U.S. furniture workers union — B.A. Miller, A. Blair, et al. (1994)
• Occupational exposure to wood dust and risk of lung cancer: the ICARE study — M. Matrat, L. Radoï, et al. (2019)
• Mortality of older construction and craft workers employed at department of energy (DOE) nuclear sites: follow-up through 2011 — K. Ringen, J. Dement, et al. (2015)
• Cause-specific mortality in relation to chrysotile-asbestos exposure in a Chinese cohort — S. Lin, X. Wang, et al. (2012)

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