Case 2: Unionized Labourer, Steel Industry 

• A former labourer for the steel industry was diagnosed with Non-Hodgkin’s Lymphoma (NHL) at the age of 67 years. He has since passed away.

• His family believes that the development of his NHL resulted from his exposures from working in the steel industry.

 Exposure History

• 36 years working as a labourer in various areas of a steel plant.

• During his working career and based on common exposures in the steel industry, the worker was likely exposed to the following:

·         Dusts and fumes, including iron oxide, calcium oxide, magnesium oxide, manganese dioxide

·         Heavy metals (lead, chromium, zinc, nickel and manganese)

·         Carbon monoxide

·         Sulphur dioxide

·         Coal tar pitch volatiles and coke oven emissions (containing polycyclic aromatic hydrocarbons)

·         Acid mists

·         Sulphur compounds

·         Oil mists

·         Silica

·         Asbestos

• By-products from the coke making process also include tar, benzene, toluene, xylene, naphthylamine and ammonia^i,ii.

• The worker also performed various cleaning tasks. He would have used a variety of cleaners and detergents where he would have most notably been exposed to numerous solvents. The worker may have also been exposed to trichloroethylene, while performing his cleaning and degreasing work.

Barriers

• Case was denied by WSIB, as they indicated that there is no evidence to suggest that NHL is related to asbestos.

• No exposure monitoring specific to this worker. Occupational Hygienist from the company provided a list of contaminants to which the worker could have possibly been exposed.

Risk factors for Non-Hodgkin’s Lymphoma

• The incidence of non-Hodgkin’s lymphoma (NHL) doubled from 10 per 100,000 in 1973 to 20 per 100,000 in 1997ⁱⁱⁱ.

• Non-occupational risk factors for NHL include, age (>60 years), gender (being male) and immunosuppression.

• Occupational risk factors have included the following: exposure to organic solvents, including benzene, trichloroethylene, tetrachloroethylene, and styrene; conflicting evidence for agricultural and forestry workers exposed to pesticides, carbon disulfide, phosphine, methyl bromide, and ethylene dibromideⁱⁱⁱ.

Opinion and Conclusion

• The subsequent opinion and conclusion was made following an extensive literature review and discussions with an Occupational Physician:

“[The worker] was likely exposed to several carcinogenic agents during his work at [company] including benzene, benzo (A) pyrene, coke oven emissions, silica and asbestos while working as a labourer. He also reported being exposed to pesticides. [The worker] may have also been exposed to trichloroethylene, while performing his cleaning and degreasing work, which as indicated has been associated with an increased risk of NHL. From the recent publication of the Clapp reportⁱⁱⁱ, there is evidence to support the relationship between exposure to organic solvents, including benzene and the development of non-Hodgkin’s lymphoma. Although we cannot quantify his exposures, we also cannot deny them. Therefore, we also cannot deny the association between his working history and the development of his non-Hodgkin’s lymphoma.”

(This case summary was written by Cassidy DeDiana, MHSc. OEH, Occupational Health Coordinator, OHCOW Sudbury) 

i Masaitas J. 1998. Iron & Steel Industry. In: Encyclopedia of Occupational Health & Safety, 4th Edition, Volume 3. International Labour Organization. Pp. 73.2 – 73.17.

 ii Burgess W. 1981. Iron and Steel. In: Recognition of Health Hazards in Industry. A

Review of Materials and Processes. John Wiley & Sons. New York. Pgs. 194 to 196.

 iii Clapp R, Howe Genevieve and Lefevre MJ. 2005. Environmental and Occupational Causes of Cancer: A review of recent scientific literature. University of Massachusetts, Lowell.