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Chemical Agents and Related Occupations Volume 100 F a Review of Human Carcinogens

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Chemical Agents and Related Occupations Volume 100 F a Review of Human Carcinogens CHEMICAL AGENTS AND RELATED OCCUPATIONS volume 100 F A review oF humAn cArcinogens This publication represents the views and expert opinions of an IARC Working Group on the Evaluation of Carcinogenic Risks to Humans, which met in Lyon, 20-27 October 2009 LYON, FRANCE - 2012 iArc monogrAphs on the evAluAtion oF cArcinogenic risks to humAns SOOT, AS FOUND IN OCCUPATIONAL EXPOSURE OF CHIMNEY SWEEPS Soot was considered by previous IARC Working Groups in 1972, 1984, and 1987 (IARC, 1973, 1985, 1987). Chimney sweeping and other exposures to soot were evaluated in 2005 (IARC, 2010). Since that time new data have become available, which have been incorporated in this Monograph, and taken into consideration in the present evaluation. 1. Exposure Data compounds, water, and other adsorbed liquids and gases (IARC, 1985; Watson & Valberg, 2001). For hundreds of years, chimneys have been Table 1.1 summarizes several recent studies swept with long steel brushes inserted manu­ that investigated exposure of chimney sweeps to ally into the chimney from the top and from the PAHs. Knecht et al. (1989) assessed exposures in bottom. Chimney sweeps are exposed to soot, the breathing zone of chimney sweeps during with concurrent exposure to sulfur dioxide and so-called ‘dirty’ or ‘black work’ on 11 working arsenic (Bagchi & Zimmerman, 1980). days. Samples were taken per ‘job category’, Soot is black particulate matter that is formed based on the type of fuel fired: oil fuel, oil/solid as a by-product of combustion or pyrolysis of or solid fuels. Twenty PAHs were quantified in a organic (carbon-containing) materials, such as total of 115 samples. Higher concentrations were coal, wood, fuel oil, waste oil, paper, plastics and seen in soots that originated from burning of household refuse. The chemical composition solid fuels. A bio-monitoring study carried out and properties of soots are highly variable and in Germany (n = 93) and Poland (n = 7) in 1995 depend on the type of starting material and the reported 1-hydroxypyrene concentrations in the conditions of combustion. Soots vary consid­ urine ranging from below the detection limit erably with respect to their relative content of (0.1 μg/L) up to 12.8 μg/L (Letzel et al., 1999). carbon, their particle type, size and shape, and Urinary concentrations in the samples from the types of organic and inorganic compounds Poland were on average five times higher, most adsorbed onto the particles. In general, soots probably due to the fact that coal and wood are have a total carbon content of up to 60%, a high used more often as fuels in Poland. The concentra­ content of inorganic material, and a soluble tions in urine samples from workers in Germany organic fraction. The latter is extractable with were relatively low. The use of personal protective organic solvents and consists largely of PAHs devices among this group of 100 chimney sweeps and their derivatives. Inorganic constituents may was not mentioned. In an Italian study, Pavanello include oxides, salts, metals, sulfur and nitrogen et al. (2000) analysed the urine of 27 chimney 209 210 IARC MONOGRAPHS – 100F MONOGRAPHSIARC 100F – Table 1.1 Concentrations of PAHs in the ambient air and in urine of chimney sweeps Reference Job/task No. of No. of No. of PAH Air levels (μg/m3) Urinary levels (μmol/mol Country subjects samples smokers creatinine) Year of study Mean Range Median Range Knecht et al. Chimney sweeps NR (1989) Oil fuel 37 Benzo[a]pyrene 0.36 Germany Oil/solid fuel 34 0.83 NR Solid fuel 44 0.82 Göen et al. Chimney sweeps 27 0.36 0.05–1.40 (1995) Germany Letzel et al. Chimney sweeps 100 100 42 1-Hydroxypyrene [0.25]* [0.04–4.5]* (1999) Apprentices, 79 79 NR [0.28]* Germany, journeymen Poland District master 21 21 NR [0.11]* 1995 From Germany 93 93 38 [0.14–0.32]* From Poland 7 7 4 [1.23]* Smokers 42 42 42 [0.39]* Non-smokers, ex­ 58 58 0 [0.19]* smokers Pavanello et al. Chimney sweeps 27 27 0 Mean (2000) 1-Hydroxypyrene 0.56 0.04–2.34 Italy NR * Originally reported in µg/L. Conversion factor: 1 μmol/mol creat. = 1.93 μg/g creat. = 0.013 μmol/L = 2.84 μg/L NR, not reported Chimney soot sweeps: the 1-hydroxypyrene concentrations analyses indicated that confounding from tobacco were in the same wide range as those reported smoking did not explain the findings regarding for the chimney sweeps in Germany and Poland lung cancer. In two Danish cohort studies an (Letzel et al., 1999). excess of total cancer was found, but the studies Increased concentrations of polychlorinated were too small to evaluate individual cancer sites dibenzo-p-dioxins and polychlorinated dibenzo­ (Hansen et al., 1982; Hansen, 1983; see Table 2.1, furans were found in blood lipids of 227 chimney available at http://monographs.iarc.fr/ENG/ sweeps from Bavaria (Wrbitzky et al., 2001). Monographs/vol100F/100F-16-Table2.1.pdf). Pukkala et al. (2009) reported on a record- linkage study from the Nordic countries encom­ 2. Cancer in Humans passing 15 million people aged 30–64 identified from the censuses in 1960, 1970, 1980/81, and In IARC Monograph Volume 92 (IARC, 2010), 1990, and followed for cancer in the national epidemiological studies of cancer in humans cancer registries until 2005. A total of 5498 were considered to provide sufficient evidence for male chimney sweeps from Denmark, Finland, the carcinogenicity of occupational exposure as a Norway and Sweden were identified in the cohort. chimney sweep. The evidence partly came from Statistically significant excesses of cancers of a large series of reports on cases of scrotal skin the lung, oesophagus, pharynx, bladder, and cancer in this occupational group. Soot was first colon were found. There was no excess of non- noted as a cause of scrotal cancer in humans by melanoma skin cancer. There was not a large Pott (1775). Many case reports of scrotal and other heterogeneity in risk between countries, and no skin cancers among chimney sweeps appeared adjustment for smoking was made. subsequently in several different countries (e.g. The above-mentioned study by Pukkala et Earle, 1808; Butlin, 1892; Henry & Irvine, 1936; al. (2009) – which included information from Henry, 1937, 1946, 1947). A total of 1487 cases the earlier study (Pukkala, 1995) – adds to the of scrotal cancer were reported to the Registrar previous evidence of an excess of cancer of the General for England and Wales from 1911–1935 lung, bladder and oesophagus among chimney (Henry, 1937). Of these, 6.9% had occurred in sweeps. Despite the classical risk for scrotal chimney sweeps; the estimated proportion of cancer in chimney sweeps, studies of this occu­ chimney sweeps in England and Wales in 1921 pational group under modern working condi­ and 1931 was about 0.06% of all adult males, tions show no such excesses. indicating a large excess of scrotal cancer among Overall, considering a consistently observed workers in this profession. increased lung-cancer risk in several studies, Evanoff et al. (1993) conducted large cohort and on the basis of a large cohort study that study of Swedish chimney sweeps and found an demonstrated an internal dose–response after excess of cancer of the lung, bladder, oesophagus group-level adjustment for smoking, there is and haematolymphatic organs; a study from evidence from human epidemiological studies Finland corroborated these findings Pukkala,( that lung cancer is causally associated with occu­ 1995). These studies did not include individual pational exposure during work as a chimney adjustments for tobacco smoking, but in the sweep. No internal dose–response was observed Swedish study an adjustment was made for for bladder cancer in the large Swedish study, smoking at the group level, whereas in the Finnish and the evidence for an excess bladder cancer study adjustment was for social class. Both among chimney sweeps must be considered as 211 IARC MONOGRAPHS – 100F limited. The incidence of oesophageal cancer 4. Other Relevant Data is highly correlated with smoking and alcohol consumption, and in the absence of control for 4.1 Mechanistic evidence relevant these two factors, the evidence of an association to the carcinogenic hazards with occupational exposure as a chimney sweep is inadequate. From historical case reports there from occupational exposure as a is sufficient evidence of an increased risk for chimney sweep (scrotal) skin cancer among chimney sweeps. 4.1.1 Experimental systems Experimental studies on soots have been 3. Cancer in Experimental Animals evaluated in IARC Monograph Volume 35 and in Supplement 7 (IARC, 1985, 1987). In one study, extracts of soot samples from domestic Coal soot was tested in two experiments in sources were mutagenic in Salmonella typhi­ mice by whole-body exposure, but these studies murium, both in the presence and absence of were inadequate for evaluation. Coal-soot an exogenous metabolic system. Extracts of an extracts applied to the skin of mice produced experimentally-derived soot were mutagenic in skin tumours in two studies (IARC, 1985). forward-mutation assays in S. typhimurium and In limited studies, subcutaneous implants of in cultured human lymphoblasts in the presence wood soot in female rats produced a few local of metabolic activation (IARC, 1985). Extracts sarcomas. Similar implants in the scrotal sac of particulate emissions from wood-combustion of rats did not produce tumours. One study of induced sister chromatid exchange in Chinese wood-soot extract applied to the skin of mice was hamster ovary cells, transformation of Syrian uninformative (IARC, 1985). hamster embryo cells, and mutation in S. typhi­ One study of an extract of fuel-oil soot applied murium.
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