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epidemiological data
Type of information:
experimental study
Adequacy of study:
supporting study
Study period:
not reported
1 (reliable without restriction)
Rationale for reliability incl. deficiencies:
other: see 'Remark'
Meets generally accepted scientific standards, well documented and acceptable for assessment. Relevant exposure to submission substance, adequate information on study cohort and exposure, relevant endpoint (A detailed description of the scoring criteria can be found in the .pdf document attached to the 'Epidemiological Data Scoring Rationale Document' record at the beginning of Section 7.10.2).
Cross-referenceopen allclose all
Reason / purpose for cross-reference:
reference to same study
Reason / purpose for cross-reference:
reference to other study

Data source

Reference Type:
Exposure to different forms of nickel and risk of lung cancer.
Grimsrud TK, Berge SR, Haldorsen T, Andersen A.
Bibliographic source:
Am. J. Epidemiol., 156, 1123-1132.

Materials and methods

Study type:
case control study (retrospective)
Endpoint addressed:
Test guideline
no guideline followed
Principles of method if other than guideline:
No standard guideline reported. Study details provided in the following sections
GLP compliance:
not specified

Test material


Type of population:
Ethical approval:
not applicable
Details on study design:
HYPOTHESIS TESTED: The aim of the present study was to explore the dose-related association between cumulative exposure to nickel and lung
cancer, with optimal adjustment for smoking, according to the four forms of nickel conventionally addressed: water-soluble,
sulfidic, oxidic, and metallic. Another aim was to evaluate the effect of joint exposure to nickel and tobacco smoking.

- Type: Record review / Work history
- Details: information obtained from company records, questionnaires, and The Cancer Registry of Norway

STUDY PERIOD: employment during the period of 1910 - 1994 and under observation for cancer between 1952-1995.

SETTING: evaluated men who had been employed in the nickel refinery in Kristiansand, Norway

- Total population (Total no. of persons in cohort from which the subjects were drawn): 5389
- Selection criteria: employment for a minimum of 12 months
- Total number of subjects participating in study: 213
- Sex/age/race: men
- Smoker/nonsmoker: smoking history was examined
- Total number of subjects at end of study: 213
- Matching criteria: none reported
- Other: none

- Type: Control or reference group
- Details: n= 525, controls were free of lung cancer and had been born within 24 months from the case’s date of birth.

- Disease(s): lung cancer
- ICD No.: not reported
- Year of ICD revision: not reported
- Diagnostic procedure: not reported
- Other health effects: not reported

Exposure assessment:
Details on exposure:
TYPE OF EXPOSURE: inhalation of nickel refinery dusts and aerosols

TYPE OF EXPOSURE MEASUREMENT: Personal sampling, nickel speciation performed with sequential extractions (Zatka et al. 1992)

EXPOSURE LEVELS: See table below

EXPOSURE PERIOD: minimum of 12 months

POSTEXPOSURE PERIOD: 10 to 20 year lag

DESCRIPTION / DELINEATION OF EXPOSURE GROUPS / CATEGORIES: evaluated by nickel species: water soluble, oxidic, sulfidic, or metallic Ni
Statistical methods:
Relative risks were estimated as odds ratios and 95 percent confidence intervals derived from conditional logistic regression models.

Results and discussion

EXPOSURE: mean cumulative exposure (mg/m3) x years of refinery workers for cases
Water soluble Ni: 2.45
Sulfidic Ni: 0.63
Oxidic Ni: 4.34
Metallic Ni: 0.92
Other exposures included: As, asbestos, mists containing sulfuric acid. Some workers were exposed to carcinogens outside the refinery. . [Exposure matrix reported in Grimsrud et al., 2000]

FINDINGS: A clear dose-related effect was seen for water-soluble nickel (odds ratio = 1.7) and lung cancer

- Number of cases for lung cancer: 213 workers, 525 controls

- OR (Odds ratio): smoking adjusted by Ni species, high exposure
Water soluble Ni (4.93 mg/m3 x years) = 3.8
Sulfidic Ni (1.43 mg/m3 x years) = 2.8
Oxidic Ni (12.6 mg/m3 x years) = 2.2
Metallic Ni (2.32 mg/m3 x years) = 2.4
- OR (Odds ratio): for water-soluble Ni, smoking adjusted, 10-year lag = 1.7 (95% CI = 1.2-2.3)

OTHER OBSERVATIONS: The exposures to various forms of nickel were all correlated. Exposures to water-soluble nickel and metallic nickel and exposures to oxifdic and sulfidic nickel were highly correlated (r = 0.71 and 0.87, respectively). It was not possible to distinguish between the effect from metallic nickel and other forms of insoluble nickel. The exposure levels of the Cases were similar to the Controls for sulfidc and oxidic nickel but were 50% and 30% higher than Controls for soluble and metallic nickel, respectively.
Confounding factors:
effects of smoking were addressed
Strengths and weaknesses:
Strengths: Examined Ni species.
Weaknesses: There was low to moderate confounding from smoking.

Applicant's summary and conclusion

A clear dose-related effect was seen for water-soluble nickel (odds ratio = 1.7) and lung cancer.
Executive summary:


(A detailed description of the scoring criteria can be found in the .pdf document attached to the 'Epidemiological Data Scoring Rationale Document' record at the beginning of Section 7.10.2).