PARAFFIN NOT PRODUCTIVE OF CANCER
HAROLD B. WOOD
(Epidemiologist, Pennsylvania Department of Health, Harrisburg)
Paraffin has unjustly been accused of .producing cancer.
Some writers declare paraffin workers develop cancer of the
bladder, while others declare that cancer of the scrotum may
be the result of this employment. British writers sometimes
use the word paraffin to designate what is more correctly
termed paraffin oil, which may be carcinogenic. The name
paraffin should be used only for a definite chemical entity,
C2,Hb6,and when investigations are made of unrefined, contaminated, oily or acidulated paraffinoid substances definite
declarations should be made of such facts, as it may be the oily,
soiled clothing and entire lack of personal cleanliness which lead
to skin affections.
In experimental work Leitch and Kennaway (1) found that
many kinds of petroleum will not produce cancer. They
heated the California non-carcinogenic petroleum to 880" C.
and produced many aromatic compounds which were not in
the original oil and which were actively carcinogenic. The
California petroleum has an asphaltic base, the Appalachian
oils a paraffin base. Kennaway (2) in his production of experimental tar cancer among mice found that high temperature
coal tar which gives the greatest proportion of cancers is very
poor in paraffins and the tars containing the most paraffins
produce no experimental cancers. Leitch (3) produced tumor
formations in 30 out of 74 mice which survived the treatment of
frequent applications of crude shale oils containing paraffins.
Mook and Wander (4) stated however that single injections of
paraffin into the subcutaneous tissues of man lead to the production of tumors. Burrows and Jorstad ( 5 ) wrote that
paraffin, liquid petrolatum, coal tar, and vegetable and animal
oils when introduced into the tissues become encapsulated (as
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HAROLD B. WOOD
will any foreign body) and form sarcoidal masses. They believe
that these lipoidal solvents induce the development of cancers
in which the chief factor is undernourishment. This statement,
however, has never been confirmed. Weidman (6) declared
the tumors from oil, liquid petrolatum or paraffin injections
were not neoplasms but disfiguring foreign body granulomas.
Blegvad warns against using paraffin injections for cosmetic
purposes, but Dr. George M. Dorrance writes me he has used
it for many years with no malignancy resulting. Ehrlich (7)
observed five cases of cancer of the scrotum in five years among
the employees of a petroleum refining plant in Czechoslovakia,
four being in pressmen of the paraffin works, each of whom had
worked between 13 to 16 years. Scott (8) in his routine
examinations of all workmen in the paraffin departments of
the Scottish shale oil industry during four years found various
akin lesions in half of the men. The lesions developed a few
weeks after beginning work, persisted throughout and ceased at
the termination of employment. The lesions varied between
erythema, comedones, papules and pustules. He declared that
epitheliomas may develop from warts after the man has been
working more than twenty years in paraffin. He lists the
epithelioma cases going to the Royal Infirmary, 1900 to 1921,
finding the distribution of the cases of the paraffin workers as:
arms and hands 63 per cent, face 16, scrotum 16 and groin 5
per cent. White (9) stated that Bridge found no evidence of
skin affections in paraffin candlemakers. White saw that
women and girls working, year after year, bedaubed with refined
paraffin wax free from impurities, experienced no detrimental
effect whatever from the wax.
Most of the reports of paraffin cancer are British, on whose
island paraffin is obtained from shale oil which yields olefines
with paraffin, whereas in coal shales hydrocarbons of the
aromatic benzene group are largely represented, instead of the
olefines. Since, in the experimental production of cancer in
mice by using coal tar, it seems probable that the high temperature distillate of the aromatic benzenes may be carcinogenic,
the apparent contradictory analogy of the Scottish paraffins
PARAFFIN NOT PRODUCTIVE O F CANCER
99
perhaps producing cancer and the American being inert is
explained by the fact that paraffin contains no benzene compounds.
The carcinogenic powers of the olefines and also of individual
aromatic benzenes need further experimental investigation,
though Kennaway has shown that many of them will not
produce tumors.
Paraffin is melted and used for coating objects, as glassware
in preparation for etching by hydrofluoric acid, for making
various kinds of corks and stoppers airtight, to render objects
non-conductors of electricity and for other purposes. The hot
paraffin bath, which is the melted paraffin, gives off a distinct
characteristic odor of vaporized paraffin and I have not read
that anybody has suggested that the persons working in it
develop pulmonary carcinoma. I have examined a considerable
number of men who work over paraffin baths and have been
unable to determine any damaging effect from this exposure.
Davis (10) found wax-boils among the pressmen in a Chicago
refinery and said prolonged occupation may produce true
epithelioma, but that wax-boils and the subsequent lesions were
unknown among the workers in the finished paraffin and among
the men who handled the crude oil. He believed paraffinoma
was a chronic granuloma due not to paraffin but a long continued
action of a low grade chemical irritant. Schamberg wrote that
it was not the finished product paraffin which produces cancer
but the blackish oily mass from which, during cooling, paraffin
separates.
Among a total of 8,673 deaths from carcinoma in Pennsylvania in 1927 there were 292 deaths from cancer of the bladder,
one of which occurred in a man who had worked in paraffin in
Philadelphia. There were recorded 2,719 deaths from carcinoma in men for whom the certificates described definite
occupations. Only 8 of these men were oil operators, one an
oil refiner and one paraffin worker. This prevalence of cancer
means one death among approximately 1,000men of the general
population, the same ratio for oil refiners and one death among
4,000 oil field operatives, using the census figures for these
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HAROLD B. WOOD
occupations. These figures do not even suggest any cancer
hazard in working in crude oil or its products.
Field investigations were undertaken to determine the existence of any carcinomatous conditions among the living paraffin
handlers. Trips were made to 15 oil refineries in the 8 principal
locations of the Pennsylvania oil field. Ten of these refineries
manufacture paraffin wax and employ 76 men who are handling
the wax. The labor tqrnover among the wax handlers is very
small. Nearly every man had worked at his particular job
over five years, many ten, some twenty and others up to fortyone years. Every man was entirely healthy as far as cancer or
precancerous symptoms were concerned. In some plants these
men strip the sheet of wax off the revolving drum at the final
stage of its production and pack it into barrels, their hands
and forearms coming into constant contact with the paraffin;
in other refineries the paraffin is pressed out in sheets in canvas
bags and from them is removed by the men. This second is an
exceedingly greasy process and yields the greater amount of
the " wax-boils." Local physicians and numerous plant executives all declared they had never known a wax handler to
develop cancer.
The death records of these same localities showed a total of
124 men who had died of cancer within the past six years.
These men were employed in sixty different occupations.
Where the death certificate gave no occupation, or said the
man had retired or was a laborer definite information as to his
previous occupations was obtained from his family or acquaintances. The occupational data were obtained for all but three
men. Twenty-five men were outdoor laborers and did not
work for oil companies. Only 12 of the 124 men were connected with the oil business: executives of refining companies 3,
oil pumpers 5, and oil driller, oil distributor, oil tester and stillman each one. Not a single man was a paraffin wax handler.
The oil refineries visited employed over 1,500 men, and of all
the men of these communities dying of cancer within the past
six years only the three executives, the oil tester and the stillman worked a t the oil refineries. The oil pumpers were among
PARAFFIN NOT PRODUCTIVE O F CANCER
101
the hundreds of such men throughout the oil fields who attend
the pumps at the oil wells and come into little contact with
the crude oil.
Cancer of the bladder, which some persons allege follows the
handling of paraffin, caused five deaths of the 124 men who
died of cancer. These five men were in different occupations;
to wit, civil engineer, farmer, painter, railroad engineer and
wagon builder. None had anything to do with oil or paraffin.
There were no scrota1 cancers in this series and only five skin
cancers, on the ear, nose and neck, none of which occurred in a
man working in any oil occupation.
Paraffin and oil workmen occasionally develop local reactions upon the skin, what are popularly called " wax-boils."
These are furuncles of varying size and number and are very
troublesome for some persons, but they produce no adenitis or
permanent effect, according to the physicians. The " waxboils" were much more prevalent in the olden days when less
attention was given to personal cleanliness. Some authorities
stated the furuncles were more prevalent among the new hands,
or among those who did the piping or pumping at the oil wells
or among the uncleanly workmen. There were no present
cases of this condition at the plants visited.
A pustular rash was found on the forearms of a paraffin
handler at an oil refinery in Philadelphia, but the pustular
rashes come principally in the men coming in contact with the
oils, and principally the heavier oils. The paraffin doubtless is
effective only by its oleaginous nature, and the saturation by
oil of the atmosphere of the workrooms is an added factor.
The rash is most apt to appear where the dirty and oily shirt
sleeve rubs against the skin. The men who had had it stated
it occurred only on the forearms, except one man who had
had it upon the front of the thighs. Only a few oil handlers
get this eruption. I believe it is due to the oil dissolving the
sebum of the skin and opening up opportunities for the introduction of infection being rubbed in by a dirty shirt cuff or
by the fingers. The rash was more prevalent in former years.
Pure paraffin, C2,Hb6,is without doubt inert and in no way
deleterious to the health of persons using it.
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HAROLD B. WOOD
mFERENCES
1. KENNAWAY,
E. L.: The Anatomical Distribution of the Occupational Cancers.
Jour. Industrial Hygiene, 1926,No. 7,p. 69.
E.L.: Brit. Med. Jour., 1924,I, 664.
2. KENNAWAY,
3. L~ITCH,
ARCHIBALD:
Brit. Med. Jour., 1922,II,1104.
4. MOOK,W.H., AND WANDER,
W. C.: Camphor Tar Tumors. Archiv. Dermat.
& Syph., 1920,I, 304.
6. BURROWS,
M. T., AND JORSTAD,
L. H.: Cause of Growth of Sarcoida or Oil
Tumors. J. A. M. A., 1927,lxxxviii, 1460.
0. WEIDMAN,
F. D.: J. A. M. A,, 1923,Ixxx, 1761.
7. EHRLICH,H.: Arch. f. klin. Chir., 1918,cx, 327.
8. SCOTT,
ALIDXAND~R:
Eighth Sci. Report Imperial Cancer Research Fund, 1923,
p. 85.
9. WHITE,PROSSER:
Occupational Affections of the Skin, p. 143.
10. DAVIS,B. F.: Paraffinoma and Wax Cancer. J. A. M. A,, 1920,lxxv, 1709.