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Mortality Among Hardmetal Production Workers: A Retrospective Cohort Study in the Austrian Hardmetal Industry

Wallner, Peter MD; Kundi, Michael PhD; Moshammer, Hanns MD; Zimmerman, Sarah D. MS; Buchanich, Jeanine M. PhD; Marsh, Gary M. PhD

Journal of Occupational and Environmental Medicine: December 2017 - Volume 59 - Issue 12 - p e282–e287
doi: 10.1097/JOM.0000000000001046
Original Articles

Objective: This study retrospectively investigates causes of death among workers of a hardmetal plant in Austria.

Methods: A retrospective cohort was formed of 1965 workers still employed in or after 1970. Follow-up was until end of 2014 based on national databases. Cobalt exposure was assessed through industrial hygiene data and urine analyses. Cox proportional hazards models were calculated for selected causes of death.

Results: During 45,598 years of observation in total 177 deaths were observed. Forty-nine workers died from any cancer, 10 from lung cancer, and three from chronic obstructive pulmonary disease. Only the latter showed a significant association with cumulative exposure.

Conclusions: Although this is a young study population with little power to detect subtle effects, at least it does not indicate a pronounced cancer risk among tungsten carbide workers due to cobalt.

Institute of Environmental Health, Center for Public Health, Medical University of Vienna, Vienna, Austria (Dr Wallner, Dr Kundi, Dr Moshammer); and Center for Occupational Biostatistics and Epidemiology, Department of Biostatistics, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, Pennsylvania (Ms Zimmerman, Dr Buchanich, Dr Marsh).

Address correspondence to: Hanns Moshammer, MD, Medical University Vienna, Vienna, Austria (

Funding: Austrian workers’ compensation board (AUVA).

Conflicts of Interest: None declared.

Copyright © 2017 by the American College of Occupational and Environmental Medicine