Health studies on pulp and paper pollution

Some of the following are specific to pulp production; others are more general studies of health effects related to emissions found at pulp mills. Executive summaries have been included where they are particularly illustrative:

OBJECTIVES: A study was conducted to investigate cancer risks in a cohort of pulp and paper workers.

METHODS: All male workers with > or =1 years of employment in 14 pulp and paper mills in 1950-1992 were studied. Standardized incidence ratios (SIR) were used to compare the cancer incidence of the cohort with that of the Canadian male population. Record linkage with the National Cancer Registry was performed using the generalized iterative record linkage method. RESULTS: Altogether 1756 cancer cases were observed in the entire cohort. For > or =15 years of work, the entire cohort had significantly increased SIR values for pleural and prostate cancer and skin melanoma; there was also a significantly increased risk for skin melanoma among workers in the kraft process only, rectal cancer among workers in the sulfite process only, and stomach and prostate cancer and all leukemias combined among workers in both the kraft and sulfite processes. A separate analysis comparing workers in pulping and papermaking with those in the pulping process only did not reveal any difference in cancer risk and hence did not modify the results. The SIR values for skin melanoma were not significantly increased in a comparison using the British Columbia male population. Nine of 10 pleural cancers were mesotheliomas, which likely reflect past asbestos exposure.

CONCLUSIONS: The results suggest that long term work in the pulp and paper industry is associated with excess risks of prostate and stomach cancers and all leukemias for work in both kraft and sulfite processes and of rectal cancer for work in the sulfite process only.

Haahtela, Tari, et al.
The South Karelia Air Pollution Study: Acute Health Effects of Malodorous Sulfur Air Pollutants Released by a Pulp Mill
American Journal of Public Health, April 1992 Pages: 603-605 Vol: 82, #4

Hirsch, Alan R.
"Negative Health Effects of Environmental Odor Pollution"
Proceedings: Second Colloquium on Particulate Air Pollution and Human Health
Smell & Taste Treatment and Research Found., Chicago, May 1-3, 1996 Pages: 207-214. See also "Testimony of Dr. Alan Hirsch on Physical and Psychological Impacts of Air Pollution from Pulp Mills," during Powell River air permit appeal: Dr. Hirsch said that at least two of the six appellants of the Powell River pulp mill permit extension were suffering olfactory and immune impairment, and that such problems were common near mills and other sites.

Muir, T., Zegarac, M., 2001.
"Economics of health costs due to environmental disease."
Presented at Dioxin 2001, Kyoung ju, Korea, Sept. 9-14, 2001

Muir and Zegarac (2001) estimated the total cumulative costs associated with certain health effects -- Parkinson's Disease, hypothyroidism (and its sequelae), and effects on the Intelligence Quotient or IQ -- to be US$513.963 billion - US$710.897 billion per year in Canada and the US. Assuming that at least 10% of these effects and their associated costs are due to environmental causes, they estimated a minimum attributable cost of US$51 to US$71 billion per year. Considering the likelihood that some of these diseases have a greater than average environmental causation (e.g., Parkinson's Disease, Childhood Developmental Disorders and IQ decrements, and possibly diabetes), they also apportioned 50% of the associated costs to environmental causation. This resulted in an attributable cost of between US$257 billion and US$356 billion per year.

Ritchlin, Jay and Johnston, Paul.
"Zero Discharge: technological progress towards eliminating kraft pulp mill liquid effluent, minimising remaining waste streams and advancing worker safety"
Reach for Unbleached! Foundation, 1998.

The Zero Discharge report has a section on worker and community health and safety. There is also extensive technical information regarding the best environmental options for the kraft pulp industry. A pdf version is available for download.

Southern Tongass [AK] Voice, Volume 1 Issue 1, 20 Feb 1996. Contact rtkp@ptialaska.net for a copy.

Teschke, Kay and Denners, Paul (Chapter Editors)
"Paper and Pulp Industry: Industries Based on Biological Resources"
Encyclopedia of Occupational Health and Safety, Pages: 72.2-72.17

Van Eenwyk, J. Washington State Dept.of Health, Epidemiology, "Washington State Leading Causes of Death in Selected Zip codes ", 10/l/99.
Ibid, Letter from Dept. of Health to the organization Protect the Peninsula’s Future 9/24/99. "Mortality by Subgroup 1990_1997, Task # 5, 9/24/99.

Looking at age-adjusted mortality in zip codes for other Washington communities with chlorine bleach paper mills from 1990-97 reveals that Port Angeles is not alone in excess mortality.

Death rate/100,000 population
Camas (98607) 880.04
Longview (98632) 929.2*
Cosmopolis (98537) 1,339.5*
Everett (98203) 887.7*
Bellingham (98225) 917.0*
Port Angeles, (east subgroup) 972.4*
Washington State 851.1

*Statistically significant elevation compared to state mortality

Acting State Epidemiologist, Juliet van Eenwyk notes: "The rates of heart disease are elevated in Longview, Cosmopolis, and Everett; rates of stroke are elevated in Longview and Bellingham; chronic obstructive pulmonary disease (COPD) is high in Everett; pneumonia and influenza are high in Camas and Bellingham. The impact of emissions from industry remains one of many causes that would need to be considered..."

Vedal, Sverre. University of BC and BC Lung Assn. "Health Effects of Inhalable Particles: Implications for British Columbia"

Vedal, S., Blair,J. et al.
"Adverse Respiratory Health Effects of Ambient Inhalable Particle Exposure"
American Journal of Respiratory and Critical Care Medicine, April 1995, Pages: 1-15 Vol: 151

Won Jin Lee et al. 'Mortality from Lung Cancer In Workers Exposed to Sulfur Dioxide in the P&P Industry'
Environmental Health Perspectives: 110:10:991-5 (Oct. '02).
http://ehpnet1.niehs.nih.gov/docs/2002/110p991-996lee/abstract.html

A multinational team of government agency & academic authors (one industry, from Stora Enso) conducted this research. Obviously confounding is a major issue given the other chemicals that workers are intimately exposed to, but they did find a significant association, helped by analyzing a huge set of workers.

Selected Health References