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Cancer and Noncancer Mortality among Aluminum Smelting Workers in Badin, North Carolina – Carolina Center for Population Aging and Health

Cancer and Noncancer Mortality among Aluminum Smelting Workers in Badin, North Carolina


McClure, Elizabeth S.; Vasudevan, Pavithra; DeBono, Nathan L.; Robinson, Whitney R.; Marshall, Stephen W.; & Richardson, David B. (2020). Cancer and Noncancer Mortality among Aluminum Smelting Workers in Badin, North Carolina. American Journal of Industrial Medicine, 63(9), 755-765. PMCID: PMC7890681


BACKGROUND: Badin, North Carolina, hosted an aluminum smelting plant from 1917 to 2007. The Concerned Citizens of West Badin reported suspected excess cancer mortality among former employees. This study aimed to investigate these concerns.
METHODS: The study cohort was enumerated from United Steel Workers' records of workers employed from 1980 to 2007. Cause-specific mortality rates in the cohort were compared with North Carolina population mortality rates using standardized mortality ratios (SMRs), standardized by age, sex, race, and calendar period. We estimated cause-specific adjusted standardized mortality ratios (aSMRs) using negative controls to mitigate healthy worker survivor bias (HWSB). Standardized rate ratios (SRRs) were calculated to compare mortality rates between workers ever employed vs never employed in the pot room.
RESULTS: All-cause mortality among Badin workers was lower than in the general population (SMR: 0.81, 95% confidence interval [CI]: 0.71-0.92). After adjusting for HWSB, excesses for all cancers (aSMR: 1.55, 95% CI: 1.10-2.21), bladder cancer (3.47, 95% CI: 1.25-9.62), mesothelioma (17.33, 95% CI: 5.40-55.59), and respiratory cancer (1.24, 95% CI: 0.77-1.99) were observed. Black males worked the highest proportion of their employed years in the pot room. Potroom workers experienced higher respiratory cancer (SRR: 2.99, 95% CI: 1.23-7.26), bladder cancer (SRR: 1.58, 95% CI: 0.15-15.28), and mesothelioma (SRR: 3.36, 95% CI: 0.21-53.78) mortality rates than never workers in the pot room.
CONCLUSIONS: This study responds to concerns of a group of former aluminum workers. The results, while imprecise, suggest excess respiratory and bladder cancers among pot room workers in a contemporary cohort of union employees at a US smelter.


Reference Type

Journal Article

Year Published


Journal Title

American Journal of Industrial Medicine


McClure, Elizabeth S.
Vasudevan, Pavithra
DeBono, Nathan L.
Robinson, Whitney R.
Marshall, Stephen W.
Richardson, David B.

Article Type




Data Set/Study

United Steel Workers' Records of Workers


United States of America


North Carolina


Robinson, W - 0000-0003-4009-0488