Logo of oenvmedOccupational and Environmental MedicineVisit this articleSubmit a manuscriptReceive email alertsContact usBMJ
Occup Environ Med. Oct 1996; 53(10): 708–713.
PMCID: PMC1128579

Exposure to nickel compounds and smoking in relation to incidence of lung and nasal cancer among nickel refinery workers.


OBJECTIVES: To investigate the relation between occupational hazards among nickel refinery workers and their exposure to different forms of nickel over time and the interaction between smoking and total exposure to nickel. METHODS: The cohort consisted of 379 workers with first employment 1916-40 and at least three years of employment and 4385 workers with at least one year of employment 1946-83. Data on smoking (ever or never) were available for almost 95% of the cohort. Two analyses were used, indirect standardisation from observed and expected numbers and Poisson regression. RESULTS: During the follow up 1953-93, 203 new cases of lung cancer were observed v 68 expected (standardised incidence ratio (SIR) 3.0, 95% confidence interval (95% CI) 2.6-3.4) and 32 cases of nasal cancer were observed v 1.8 expected (SIR 18.0, 95% CI 12-25). The Poisson regression analysis showed an excess risk of lung cancer in association with exposure to soluble forms of nickel, with a threefold increase in relative risk (RR) (P < 0.001) and a multiplicative effect of smoking and exposure to nickel. The RRs were 1.1 (95% CI 0.2-5.1) for exposed workers who had never smoked and 5.1 (95% CI 1.3-20.5) for exposed workers who smoked. CONCLUSION: It is not possible to state with certainty which specific nickel compounds are carcinogenic, but a significant excess risk was found for workers exposed to soluble nickel alone or in combination with other forms of nickel. The present study suggests a multiplicative effect of smoking and nickel exposure.

Full text

Full text is available as a scanned copy of the original print version. Get a printable copy (PDF file) of the complete article (1.2M), or click on a page image below to browse page by page. Links to PubMed are also available for Selected References.

Selected References

These references are in PubMed. This may not be the complete list of references from this article.
  • DOLL R. Cancer of the lung and nose in nickel workers. Br J Ind Med. 1958 Oct;15(4):217–223. [PMC free article] [PubMed]
  • Mastromatteo E. Nickel: a review of its occupational health aspects. J Occup Med. 1967 Mar;9(3):127–136. [PubMed]
  • LØKEN AC. Lungecarcinom hos nikkelarbeidere. Tidsskr Nor Laegeforen. 1950 Jun 1;70(11):376–passim. [PubMed]
  • Pedersen E, Hogetveit AC, Andersen A. Cancer of respiratory organs among workers at a nickel refinery in Norway. Int J Cancer. 1973 Jul 15;12(1):32–41. [PubMed]
  • Magnus K, Andersen A, Høgetveit AC. Cancer of respiratory organs among workers at a nickel refinery in Norway. Int J Cancer. 1982 Dec 15;30(6):681–685. [PubMed]
  • Sunderman FW, Jr, Aitio A, Morgan LG, Norseth T. Biological monitoring of nickel. Toxicol Ind Health. 1986 Jul;2(1):17–78. [PubMed]
  • DiPaolo JA, Casto BC. Quantitative studies of in vitro morphological transformation of Syrian hamster cells by inorganic metal salts. Cancer Res. 1979 Mar;39(3):1008–1013. [PubMed]
  • Sunderman FW, Jr, Hopfer SM, Knight JA, McCully KS, Cecutti AG, Thornhill PG, Conway K, Miller C, Patierno SR, Costa M. Physicochemical characteristics and biological effects of nickel oxides. Carcinogenesis. 1987 Feb;8(2):305–313. [PubMed]
  • Dunnick JK, Elwell MR, Radovsky AE, Benson JM, Hahn FF, Nikula KJ, Barr EB, Hobbs CH. Comparative carcinogenic effects of nickel subsulfide, nickel oxide, or nickel sulfate hexahydrate chronic exposures in the lung. Cancer Res. 1995 Nov 15;55(22):5251–5256. [PubMed]
  • Costa M, Salnikow K, Cosentino S, Klein CB, Huang X, Zhuang Z. Molecular mechanisms of nickel carcinogenesis. Environ Health Perspect. 1994 Sep;102 (Suppl 3):127–130. [PMC free article] [PubMed]
  • Rønneberg A, Lund KE, Hafstad A. Lifetime smoking habits among Norwegian men and women born between 1890 and 1974. Int J Epidemiol. 1994 Apr;23(2):267–276. [PubMed]
  • Lund E, Zeiner-Henriksen T. Røking som risikofaktor for ulike kreftformer blant 26,000 norske menn og kvinner. En kobling av et røkermateriale med Kreftregisteret over en 12 års periode. Tidsskr Nor Laegeforen. 1981 Dec 10;101(34-36):1937–1940. [PubMed]
  • Karjalainen S, Kerttula R, Pukkala E. Cancer risk among workers at a copper/nickel smelter and nickel refinery in Finland. Int Arch Occup Environ Health. 1992;63(8):547–551. [PubMed]
  • Shannon HS, Walsh C, Jadon N, Julian JA, Weglo JK, Thornhill PG, Cecutti AG. Mortality of 11,500 nickel workers--extended follow up and relationship to environmental conditions. Toxicol Ind Health. 1991 Jul;7(4):277–294. [PubMed]
  • Lessard R, Reed D, Maheux B, Lambert J. Lung cancer in New Caledonia, a nickel smelting island. J Occup Med. 1978 Dec;20(12):815–817. [PubMed]

Articles from Occupational and Environmental Medicine are provided here courtesy of BMJ Group


Related citations in PubMed

See reviews...See all...

Cited by other articles in PMC

See all...


  • Compound
    PubChem Compound links
  • MedGen
    Related information in MedGen
  • PubMed
    PubMed citations for these articles
  • Substance
    PubChem Substance links

Recent Activity

Your browsing activity is empty.

Activity recording is turned off.

Turn recording back on

See more...