Journal Information
Vol. 9. Issue 50.
Pages 287-294 (September - October 1995)
Vol. 9. Issue 50.
Pages 287-294 (September - October 1995)
Open Access
Mortalidad en trabajadores de la siderurgia del país vasco*
Mortality among Steelworkers in the Basque Country, Spain
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Félix Urbaneja Arrúe1,**, Juan José Aurrekoetxea Agirre2, Victor Echenagusía Capelastegui3
1 Unidad de Salud Laboral. Departamento de Sanidad del Gobierno Vasco. Bilbao
2 Unidad de Salud Laboral. Departamento de Sanidad del Gobierno Vasco. San Sebastián
3 Servicio Médico de Altos Hornos de Vizcaya S.A. Sestao
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La mayor parte de los estudios de mortalidad en trabajadores de la industria siderúrgica constata una frecuencia más elevada de muerte por cáncer, fundamentalmente por cáncer de pulmóny, en menor medida, por cáncer digestivo y genitourinario. En España no disponemos de tasas de mortalidad por ocupación o actividad que permitan contrastar esos datos. Para hacer una primera evaluación del riesgo de muerte asociado al trabajo en siderurgia, se realizó un estudio de la mortalidad proporcional en los trabajadores activos y retirados de la siderurgia integral «Altos Hornos de Vizcaya» muertos durante el periodo de 1986–1993. Los 1553 sujetos que componían la muestra del estudio se obtuvieron del registro de mortalidad de la compañía de seguros. Se comparó la causa de la muerte con la de la población general de la Comunidad Autónoma del País Vasco mediante el cálculo de la Razón de Mortalidad Proporcional y la OR de Mortalidad ajustadas por edad.

Se encontró un exceso de muertes por cáncer en general (OR = 1.26; IC: 1,11–1,42), por cáncer de estómago (OR = 1,50; IC: 1,14–1,98) y por cáncer renal (OR= 1,89; IC: 1,14–3,14) que coinciden con los hallazgos de otros autores. No se observó una mortalidad significativamente mayor de la esperada por cáncer de pulmón (OR = 1,13; IC: 0,91–1,40), cáncer de vejiga (OR = 1,13; IC: 0,74–1,72) y enfermedad respiratoria crónica (OR = 0,94; IC: 0,73–1,20). Llama la atención el exceso de muertes por cáncer hepático (OR = 1,56; IC: 1,06–2,28) y por cáncer de localizatión no especificada (OR = 1,85; IC: 1,45–2,36). Esto último puede ser debido a sesgos de ciasificación que afectan al estudio. En sentido contrario, estos mismos sesgos y otros sesgos de selectión que se discuten, podrían estar subestimando la mortalidad por cáncer de pulmón. El exceso de muertes por cáncer de estómago y de riñón hallado permite plantear la hipótesis de una relación causal con determinados agentes cancerígenos, no bien identificados, existentes en el medio de trabajo de una siderurgia.

Palabras clave:
Siderurgia
Mortalidad
Cáncer
Summary

Most of mortality studies among steelworkers pointed out an increased frequency on cancer mortality, above all by lung cancer, and, in a lower proportion, by cancers of digestive and genitourinary systems. In Spain mortality rates are not published by occupation and economic activity to contrast these observations. It was carried out a proportionate mortality study among active or retired workers from an steel mill, Altos Hornos de Vizcaya, died from 1986 to 1993, to make a preliminary death risk assessment associated with job in the steel industry. A sample of 1553 men was drawn from the mortality register of a private Insurance Company. Death causes within the sample and in general population of the Autonomous Community of the Basque Country were compared using a proportionate analysis. Mortality odds ratios (OR) were also computed.

The results show an excess of cancer mortality (OR = 1.26, IC: 1.11–1.42), stomach cancer (OR = 1.50, IC: 1.14–1.98) and renal cancer (OR = 1.89; IC: 1.14–3.14) as it has been stated by other authors. It has not been found an increased mortality risk from lung cancer (OR = 1.13, IC: 0.91–1.40), bladder cancer (OR = 1.13, IC: 0.74–1.72) and chronic respiratory disease (OR = 0.94, IC: 0.73–1.20). There is also an excess of liver cancer (OR = 1.56, IC: 1.06–2.28) and cancer of non specified location (OR = 1.85, IC: 1.45–2.36). This can be due to classification bias that affects the study. On the other hand, these and other selection bias, discussed in this paper, could underestimate the lung cancer mortality. We can not conclude that, among the workers of the study, the mortality from several kind of cancer is not associated to occupational exposure. Furthermore, this excess of stomach and kidney cancer mortality may lead us to pose the hypotnesis of cause-effect relationship with some not well identified carcinogens present at the steel working place.

Key words:
Steelworkers
Mortality
Cancer
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Bibliografía
[1.]
Ch.E. Bates, L.D. Scheel.
Processing emissions and occupational health in the ferrous foundry industry.
Am Ind Hyg Assoc J, 35 (1974), pp. 452-462
[2.]
M. Vigil.
Tecnología del hierro y el acero.
Medicina de Empresa, 23 (1989), pp. 3-51
[3.]
International Agency for Research on Cancer.
IARC Monographs on the evaluation of carcinogenic risks to humans. Overall evaluations of carcinogenicity.
[4.]
S. Tola, R.S. Koskela, S. Hernberg, E. Järvinen.
Lung cancer mortality among iron foundry workers.
J Occup Med, 21 (1979), pp. 753-760
[5.]
W.G. Palmer, W.D. Scott.
Lung cancer in ferrous foundry workers: A review.
Am Ind Hyg Assoc J, 42 (1981), pp. 329-340
[6.]
J.W. Lloyd, F.E. Lundin, C.K. Redmond, P.B. Geiser.
Long-term mortality study of steelworkwers. IV. Mortality by work area.
J Occup Med, 12 (1970), pp. 151-157
[7.]
J.W. Lloyd.
Long-term mortality study of steelworkwers. V. Respiratory cancer in coke plant workers.
J Occup Med, 13 (1971), pp. 53-68
[8.]
C.K. Redmond, A. Ciocco, J.W. Lloyd, H.W. Rush.
Long-term mortality study of steelworkers. VI. Mortality from malignant neoplasms among coke oven workers.
J Occup Med, 14 (1972), pp. 621-629
[9.]
R.S. Koskela, S. Hernberg, R. Käravä, E. Järvinen, M. Nurminen.
A mortality study of foundry workers.
Scand J Work Environ Health, 2 (1976), pp. 73-89
[10.]
E.S. Gibson, R.H. Martin, J.N. Lockington.
Lung cancer mortality in a steel foundry.
J Occup Med, 19 (1977), pp. 807-812
[11.]
M. Jacobsen, P.L. Collings, A. Darby, D.B. Hurley, A.K. Jack, R.C. Steele.
Mortality of men employed in the British steel industry: A prospective study.
[12.]
A.C. Fletcher, A. Ades.
Lung cancer mortality in a cohort of English foundry workers.
Scand J Work Environ Health, 10 (1984), pp. 7-16
[13.]
T. Sorahan, A.M. Faux, M.A. Cooke.
Mortality among a cohort of United Kingdom steel foundry workers with special reference to cancers of the stomach and lung, 1946–90.
Occup Environ Med, 51 (1994), pp. 316-322
[14.]
P. Decoufle, D.J. Wood.
Mortality patterns among workers in a grey iron foundry.
Am J Epidemiol, 109 (1979), pp. 667-676
[15.]
M. Neuberger, M. Kundi.
Occupational dust exposure and cancer mortality -results of a prospective study.
Arch Geschwulstforch, 61 (1991), pp. 47-53
[16.]
D. Andjelkovich, R.M. Mathew, R.B. Richardson, R.J. Levine.
Mortality of iron foundry workers: I. Overall findings.
J Occup Med, 32 (1990), pp. 529-540
[17.]
J.J. Moulin, P. Wild, B. Mantout, M. Fournier-Beltz, J.M. Mur, G. Smagghe.
Mortality from lung cancer and cardiovascular disease among stainless-steel producing workers.
Cancer Causes Control, 4 (1993), pp. 75-81
[18.]
P. Breslin.
Mortality among foundryman in steel mills.
Dusts and disease, pp. 439-447
[19.]
N. Chau, J.P. Bertrand, J.M. Mur, A. Patris, J.J. Moulin, Q.T. Pham.
Mortality in retired coke oven plant workers.
Br J Ind Med, 50 (1993), pp. 127-135
[20.]
J.F. Hurley, R.M. Archibald, P.L. Collings, et al.
The mortality of coke workers in Britain.
Am J Ind Med, 4 (1981), pp. 691-704
[21.]
G.M. Swaen, J.J.M. Slangen, A. Volovics, R.B. Hayes, T. Scheffers, F. Sturmans.
Mortality of coke plant workers in the Netherlands.
Br J Ind Med, 48 (1991), pp. 130-135
[22.]
E. Egan-Baum, B.A. Miller, R.J. Waxweiler.
Lung cancer and other mortality patterns among foundrymen.
Scand J Work Environ Health, 7 (1981), pp. 147-155
[23.]
S. Milham.
Occupational mortality in Washington State, 1950–1979.
Cincinati, pp. 83-116
[24.]
W.J. Blot, L.M. Brown, L.M. Pottern, B.J. Stone, J.F. Fraumeni.
Lung cancer among long-term steel workers.
Am J Epidemiol, 117 (1983), pp. 706-716
[25.]
H. Becher, W. Jedrychowski, E. Flak, K. Gomola, J. Wahrendorf.
Lung cancer, smoking andemployement in foundries.
Scand J Work Environ Health, 15 (1989), pp. 38-42
[26.]
P.B. Burns, G.M. Swanson.
The Occupational Incidence Surveillance Study (OCISS): risk of lung cancer by usual occupation and industry in the Detroit metropolitan area.
Am J Ind Med, 19 (1991), pp. 655-671
[27.]
K.-H. Jökel, W. Ahrens, H.-E. Wichmann, H. Becher, U. Bolm-Audorff, I. Jahn, B. Molik, E. Greiser, J. Timm.
Occupational and environmental hazards associated with lung cancer.
Int J Epidemiol, 21 (1992), pp. 202-213
[28.]
OMS.
Clasificación internacioral de enfermedades. 9ª revisión.
Modificación clínica,
[29.]
R.R. Monson.
Occupational epidemiology.
Boca Raton, 2nd e.d,
[30.]
J.W.J. Van der Gulden, A.L.M. Verbeek.
Re: A simple method to calculate the confidence interval of a standardized mortality ratio (SMR).
Am J Epidemiol, 136 (1992), pp. 1170-1171
[31.]
O.S. Miettinen, J.-D. Wang.
An alternative to the proportionate mortality ratio.
Am J Epidemiol, 114 (1981), pp. 144-148
[32.]
F.J. Jongeneelen.
Biological exposure limit for occupational exposure to coal tar pitch volatiles at cokeovens.
Int Arch Occup Health, 63 (1992), pp. 511-516
[33.]
International Agency for Research on Cancer. IARC Monographs on the evaluation of the carcinogenic risk of chemical to humans.
Polynuclear aromatic compounds, Part 3: industrial exposures in aluminium production, coal gasification, coke production andiron and steel founding.
IARC, (1984),
[34.]
E.S. Gibson, D.R. McCalla, C. Kaiser-Farrell, A.A. Kerr, J.N. Lockington, C. Hertzman, J.M. Rosenfeld.
Lung cancer in a steel foundry: A search for causation.
J Occup Med, 25 (1983), pp. 573-578
[35.]
D. Coggon, D.J. Barker, R.B. Cole.
Stomach cancerand work in dusty industries.
Br J Ind Med, 47 (1990), pp. 298-301
[36.]
C.A. Gonzalez, M. Sanz, G. Marcos, S. Pita, E. Brullet, F. Vida, et al.
Occupation and gastric cancer in Spain.
Scand J Work Environ Health, 17 (1991), pp. 240-247
[37.]
L. Tomatis, A. Aitio, N.E. Day, E. Heseltine, J. Kaldor, A.B. Miller, D.M. Parkin, E. Riboli.
Cancer: causes, occurrence and control.
IARC, (1990),
[38.]
T. Kauppinen, R. Riala, J. Seitsamo, S. Hernberg.
Primary liver cancerand occupational exposure.
Scand J Work Environ Health, 18 (1992), pp. 18-25
[39.]
V. Vargas.
Cáncer primitivo hepático. Etiología y epidemio-logía.
Jano, 34 (1988), pp. 12-18
[40.]
M. McCredie, J.H. Stewart.
Risk factors for kidney cancer in New South Wales. IV. Occupation.
Br J Ind Med, 50 (1993), pp. 349-354
[41.]
j. Siemiatycki, R. Dewar, L. Nadon, et al.
Associations between several sites of cancer and twelve petroleum-derived liquids: results from a case-referent study in Montreal.
Scand J Work Environ Health, 13 (1987), pp. 493-504
[42.]
T. Partanen, P. Heikkilä, S. Hernberg, ¿ Kauppinen, G. Moneta, A. Ojajärvi.
Renal cell cancer and occupational exposure to chemicals agents.
Scand J Work Environ Health, 17 (1991), pp. 231-239
[43.]
O.M. Jensen, J.B. Knudsen, J.K. McLaughlin, B.L. Sørensen.
The Copenhagen case-control study of renal pelvis and ureter cancer: role of smoking and ocupaticnal exposures.
Int J Cancer, 41 (1988), pp. 557-561
[44.]
C. González, G. López-Abente, M. Errezola, et al.
Occupation and bladder cancer in Spain: a multi-centre case-control study.
Int J Epidemiol, 18 (1989), pp. 569-577
[45.]
G. López-Abente.
Cáncer en agricultores. Mortalidadpro-porcional y estudios caso-control con certificados de defunción.
Fondo de Investigacion Sanitaria, (1991),
[46.]
M. Delgado, M. Sillero, R. Gálvez.
Estudios de mortalidad proporcional: Criterios de eleccion de los grupos participates.
Gac Sanit, 8 (1994), pp. 85-93
[47.]
B.C.K. Choi.
Definition, sources, magnitude, effect modifiers, and strategies of the healthy worker effect.
J Occup Med, 34 (1992), pp. 979-988
[48.]
R.R. Monson.
Observation on the healthy worker effect.
J Occup Med, 6 (1986), pp. 425-433
[49.]
H. Checkoway, N. Pearce, D.J. Crawford-Brown.
Research methods in occupational epidemiology.
Oxford University Press, (1989),

Este trabajo contó con una ayuda económica dentro del programa de investigación de la CECA (CEE).

Copyright © 1995. Sociedad Española de Salud Pública y Administración Sanitaria
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