Date of filling in this questionnaire or last update: 22/10/2020
Cohort name
  Danish styrene cohort

  • Denmark

  Henrik Kolstad
  Aarhus University Hospital
Name of committee
  No ethical approval need for this register linkage based cohort
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Contact Principal Investigator (name)
  Henrik Kolstad
Data access policy (briefly describe)
  Data is established at Statistics Denmark and access to data at Statistics Denmark is possible through PI
Participation in pooled analyses

  • The cohort is potentially interested in participating in pooled analyses of (European) occupational cohort studies (note pooled analyses also includes remote decentralized analyses that would not require any transfer of primary data as well as meta-analyses).

Main aim of cohort, please briefly describe the main objectives of the cohort
  Assess exposure response associations for styrene and malignant and non-malignant health outcomes
Study design (please select as many as appropriate)

  • Retrospective cohort
  • Nested case-control / Case-cohort

Source population (please select as many as appropriate)

  • Industry / occupation-based

Comparators (please select as many as appropriate)

  • Internal study population
  • External comparison of workers with other exposure

Inclusion criteria
  Any employment in a reinforced plastics company in Denmark 1965-2007 and alive in 1968
Exclusion criteria
Age range at entry (main cohort)

Minimum Maximum Mean
<30 (12.8%) >80 (0.8%) 69.3% <50 years of age (these values are for all person years)

Men at enrollment
  60 478
Women at enrollment
  11 774
Children (<18 years) at enrollment
Men at last follow-up
  60 478
Women at last follow-up
  11 774
Participation rate at enrollment (if known)
  Dynamic cohort with day-by-day inclusion and follow up of vital status, incidence and mortality outcome data.
Type of data for outcome follow-up (please select as many as appropriate)

  • Death certificate
  • Disease incidence records
  • Use of registers (specify)

Death certificate (specify)

  • National mortality register (ICD-8, ICD-10)

Disease incidence records (specify)

  • National patient register of alle out- and inpatient registrations

Specify: Use of registers

  • A diagnosis (ICD-8, ICD-10) is specified for each registration

First follow-up period (provide year)
Last follow-up period (provide year)
Number of follow-ups after baseline (provide number)
Participation at last follow-up (if known)
  Almost complete follow-up
Source of exposure data collected (please select as many as appropriate)

  • Questionnaire, Personal (Occupational/industry modules)
  • Industry-based questionnaire
  • Job-employment records
  • Registry-based
  • Environmental samples

Occupational history/time frame
  Follow-up period
Occupational coding performed
Occupation (specify coding system used)

  • ISCO-68 and ISCO-88

Types of exposure measurements

  • Personal external sampling

Methods for exposure assessment (please select as many as appropriate)

  • Data modelling

Main categories

  • Solvents

Solvents | Aliphatic and alicyclic hydrocarbon solvents

  • Other (specify)

Solvents | Aromatic hydrocarbon solvents

  • Styrene and styrene oxide

Baseline - type of outcome data collected (select more than one if applicable)

  • Death certificates
  • Registry-based


  • Cancer incidence
  • Employment status
  • Hospital discharge
  • Medication usage
  • Mortality register
  • Migration

Follow-up - type of outcome data collected (select more than one if applicable)

  • Death certificates
  • Registry-based


  • Cancer incidence
  • Employment status
  • Hospital discharge
  • Medication usage
  • Mortality register
  • Migration

Diagnostic groups based on ICD10

  • A Bacterial infectious disease, type of microorganisms*
  • B Viral infections, type of microorganisms*
  • B99 Other and unspecified infectious diseases, type of microorganisms*
  • C + D Neoplasms
  • D Diseases of blood and blood-forming organs excl. leukemia
  • E Endocrinological disease
  • E Malnutrition and obesity
  • E Metabolism disease
  • F Mental disorders
  • G Disease in the nervous system
  • H Disorders of the eye
  • H Disorders of the ear
  • I Heart disease
  • I Cerebrovascular diseases
  • J Respiratory disease
  • K Diseases of oral cavity, salivary glands and jaws
  • K Diseases of oesophagus, stomach, duodenum and appendix
  • K Hernia, colon and intestine disease
  • K Diseases of peritoneum, liver
  • L Skin, nail and hair disorders
  • M Arthritis, arthrosis, systemic connective disorders, spine disorders
  • M Disorders of muscles, bones, synovialis, bursa, cartilage
  • N Kidney, renal pelvis disease
  • N Male and female related disorders
  • O+P Pregnancy and labour
  • S Injuries

A Bacterial infectious disease, type of microorganisms*

  • Anasakis
  • Bartonella
  • Bordetella pertussis
  • Borrelia
  • Brucella
  • Campylobacter
  • Coxiella
  • Clostridium tetani
  • Clostridium difficile
  • Francisella tularensis
  • Helicobacter pylori
  • Legionella
  • Leishmania
  • Leptospira
  • Mycobacterium bovis
  • Mycobacterium tuberculosis
  • Neisseria gonorrhoeae
  • Neisseria meningitides
  • Pseudomonas aeruginosa
  • Rickettsia
  • Salmonella
  • Shigella
  • Staphylococcus
  • Streptococcus
  • Toxocara
  • Toxoplasma gondii
  • Trachomatis
  • Treponema pallidum
  • Trichomonas vaginalis

B Viral infections, type of microorganisms

  • Cytomegalovirus
  • Hantavirus
  • Hepatitis (A,B,C,E)
  • HIV virus
  • Human herpes virus
  • Human papilloma virus
  • Human T-lymphotrophic virus
  • Influenza virus
  • Measles virus
  • Monkey pox virus
  • Mumps virus
  • Parvovirus
  • Rhinovirus
  • Rubella virus
  • Tick-borne encephalitis virus
  • Varicella zoster virus
  • West Nile virus
  • SARS coronavirus

B99 Other and unspecified infectious diseases, type of microorganisms

  • Giardia lamblia
  • Chlamydia

C + D Neoplasms

  • Benign neoplasm
  • Carcinoma in situ
  • Leukemia
  • Malignant neoplasms gastro intes. system including liver, gall bladder, pancreas
  • Malignant neoplasm lung
  • Mesothelioma
  • Other malignant neoplasm of respiratory and intrathoracic organs, heart, pleura
  • Malignant neoplasm of bone and articular cartilage
  • Melanoma and other malignant neoplasms of skin
  • Neoplasms connective and soft tissue including nerves
  • Malignant neoplasm of breast
  • Malignant neoplasms, females gynecological
  • Malignant neoplasms of male genital organs
  • Malignant neoplasm of urinary tract and kidney
  • Malignant neoplasms of eye, brain and other parts of central nervous system
  • Malignant neoplasms of thyroid and other endocrine glands
  • Malignant neoplasms of ill-defined, secondary and unspecified sites
  • Malignant neoplasm without specification of site including excl. leukemia

D Diseases of blood and blood-forming organs excl. leukemia

  • Diseases of spleen
  • Polycythaemia vera
  • Myelodysplastic syndromes
  • Essential (haemorrhagic) thrombocythaemia
  • Other neoplasms of uncertain or unknown behaviour of lymphoid, haematopoietic and related tissue
  • Iron deficiency
  • Vitamin deficiency
  • Aplastic and other anemias
  • Acquired haemolytic anaemia
  • Enzyme disorders including Thalassaemia and Sickle-cell disorders
  • Other anaemias
  • Anaemia, unspecified
  • Coagulation defects
  • Purpura and other haemorrhagic conditions
  • Other diseases of blood and blood-forming organs
  • Immunodeficiency
  • Sarcoidosis

E Endocrinological disease

  • Thyroidea
  • Parathyroidea
  • Diabetes mellitus
  • Pituitary
  • Other endocrinological disease
  • Adrenogenital disorders
  • Testicular dysfunction

E Malnutrition and obesity

  • Vitamin A deficiency
  • Thiamine deficiency
  • Deficiency of other B group vitamins
  • Vitamin D deficiency
  • Deficiency of vitamin E
  • Deficiency of vitamin K
  • Vitamin deficiency, unspecified
  • Calcium deficiency
  • Deficiency of other nutrient elements

E Metabolism disease

  • Disorder of amino-acid metabolism, unspecified
  • Lactose intolerance
  • Disorders of sphingolipid metabolism and other lipid storage disorders
  • Disorders of glycosaminoglycan and glucoprotein metabolism metabolism
  • Disorders of lipoprotein metabolism and other lipidaemias
  • Hypercholesterolemia
  • Disorders of purine and pyrimidine metabolism
  • Disorders of porphyrin and bilirubin metabolism
  • Disorders of mineral metabolism
  • Cystic fibrosis

F Mental disorders

  • Dementia
  • Personality and behavioural disorders
  • Schizophrenia
  • Mood [affective] disorders
  • Depression
  • Eating disorders
  • Mental retardation
  • Disorders of psychological development including autism and Aspergers syndrome
  • Other mental disorder, not otherwise specified

G Disease in the nervous system

  • Infectious diseases of the central nervous system
  • Non-infectious encephalitis, myelitis and encephalomyelitis
  • Intracranial and intraspinal abscess and granuloma
  • Systemic atrophies primarily affecting the central nervous system including
  • Huntington's disease and Hereditary ataxia
  • Spinal muscular atrophy and related syndromes
  • Parkinson's disease
  • Dystonia
  • Alzheimer's disease
  • Other degenerative disorders of nervous system in diseases classified elsewhere
  • Multiple sclerosis
  • Epilepsy
  • Migraine
  • Sleep disorders
  • Facial nerve disorders
  • Disorders of other cranial nerves
  • Nerve root and plexus disorders
  • Carpal tunnel syndrome
  • Lesion of ulnar nerve
  • Lesion of radial nerve
  • Other mononeuropathies
  • Polyneuropathies and other disorders of the peripheral nervous system
  • Myasthenia gravis and other myoneural disorders
  • Muscular dystrophy
  • Muscular myopathy
  • Cerebral palsy and other paralytic syndromes
  • Toxic encephalopathy
  • Hydrocephalus

H Disorders of the eye

  • Disorders of eyelid
  • Xanthelasma of eyelid
  • Disorders of lachrymal system
  • Disorders of orbit
  • Conjunctivitis
  • Disorders of sclera
  • Disorders of cornea
  • Iridocyclitis
  • Senile cataract
  • Other cataract
  • Other disorders of lens
  • Retinal disorders
  • Glaucoma
  • Other disorders of vitreous body and globe in diseases classified elsewhere
  • Disorders of optic nerve and visual pathways
  • Disorders of ocular muscles, binocular movement, accommodation and refraction
  • Visual disturbances and blindness

H Disorders of the ear

  • Diseases of middle ear and mastoid
  • Diseases of inner ear

I Heart disease

  • Rheumatic heart disease, unspecified
  • Hypertensive diseases
  • Angina pectoris
  • Acute myocardial infarction
  • Atrial septal defect
  • Chronic ischaemic heart disease
  • Pulmonary embolism
  • Other pulmonary heart diseases
  • Nonrheumatic mitral valve disorders
  • Pulmonary valve disorders
  • Endocarditis
  • Myocarditis
  • Cardiomyopathy
  • Atrioventricular arrhythmia
  • Heart failure

I Cerebrovascular diseases

  • Subarachnoid haemorrhage
  • Intracerebral haemorrhage
  • Cerebral infarction
  • Stroke, not specified as haemorrhage or infarction
  • Atherosclerosis
  • Aneurysm and dissection
  • Raynaud's syndrome
  • Thromboangiitis obliterans [Buerger]
  • Arterial embolism and thrombosis
  • Phlebitis and thrombophlebitis
  • Haemorrhoids
  • Oesophageal varices
  • Varicose veins of other sites
  • Lymphadenitis
  • Hypotension

J Respiratory disease

  • Acute upper respiratory infections of multiple and unspecified sites
  • Influenza
  • Viral pneumonia
  • Bacterial pneumonia
  • Pneumonia due to other infectious organisms, not elsewhere classified
  • Abscess of lung and mediastinum
  • Pyothorax
  • Acute bronchitis
  • Acute bronchiolitis
  • Vasomotor and allergic rhinitis
  • Chronic rhinitis, nasopharyngitis and pharyngitis
  • Chronic sinusitis
  • Nasal polyp
  • Chronic diseases of tonsils and adenoids
  • Diseases of vocal cords and larynx, not elsewhere classified
  • Chronic Bronchitis
  • Emphysema
  • Chronic obstructive pulmonary disease (COPD)
  • Asthma
  • Byssinosis
  • Bronchiectasis
  • Pneumoconiosis
  • Hypersensitivity pneumonitis due to organic dust
  • Other interstitial lung disease
  • Adult respiratory distress syndrome
  • Pulmonary edema
  • Pneumothorax
  • Respiratory failure, not elsewhere classified

K Diseases of oral cavity, salivary glands and jaws

  • Dental caries
  • Gingivitis and periodontal diseases
  • Dentofacial anomalies [including malocclusion]
  • Stomatitis and related lesions
  • Diseases of tongue

K Diseases of oesophagus, stomach, duodenum and appendix

  • Oesophagitis
  • Other diseases of oesophagus
  • Gastric ulcer
  • Duodenal ulcer
  • Peptic ulcer, site unspecified
  • Gastrojejunal ulcer
  • Gastritis and duodenitis
  • Dyspepsia

K Hernia, colon and intestine disease

  • Hernia
  • Crohn's disease
  • Ulcerative colitis
  • Other non-infective gastro-enteritis and colitis
  • Vascular disorders of intestine
  • Paralytic ileus and intestinal obstruction without hernia
  • Diverticular disease of intestine
  • Irritable bowel syndrome
  • Fissure and fistula of anal and rectal regions
  • Abscess of anal and rectal regions
  • Intestinal malabsorption

K Diseases of peritoneum, liver

  • Peritonitis
  • Alcoholic liver disease
  • Toxic liver disease
  • Chronic hepatitis
  • Fibrosis and cirrhosis of liver
  • Cholelithiasis/Cholecystitis
  • Acute pancreatitis

L Skin, nail and hair disorders

  • Infections of the skin and subcutaneous tissue
  • Bullous disorders
  • Atopic dermatitis
  • Allergic contact dermatitis
  • Irritant contact dermatitis
  • Dermatitis due to substances taken internally
  • Pruritus
  • Psoriasis/Parapsoriasis
  • Urticaria
  • Erythema nodosum
  • Sunburn
  • Nail disorders
  • Alopecia areata
  • Hypertrichosis
  • Acne
  • Vitiligo

M Arthritis, arthrosis, systemic connective disorders, spine disorders

  • Bacterial arthritis
  • Reactive arthritis
  • Rheumatoid arthritis
  • Juvenile arthritis
  • Gout
  • Other arthritis
  • Polyarthrosis
  • Coxarthrosis
  • Gonarthrosis [arthrosis of knee]
  • Arthrosis of first carpometacarpal joint
  • Other arthrosis
  • Deformities of fingers and toes
  • Deformities of limbs
  • Deformities of spine including scoliosis
  • Disorders of patella
  • Internal derangement of knee
  • Pathological dislocation and subluxation of joint
  • Systemic lupus erythematosus
  • Systemic sclerosis
  • Polymyalgia rheumatic
  • Other systemic involvement of connective tissue
  • Spine disk disorders
  • Lumbago with sciatica
  • Low back pain

M Disorders of muscles, bones, synovialis, bursa, cartilage

  • Myositis
  • Calcification and ossification of muscle
  • Contracture of muscle
  • Chronic crepitant synovitis of hand and wrist
  • Bursitis of hand
  • Olecranon bursitis
  • Prepatellar bursitis
  • Other bursitis
  • Rotator cuff syndrome
  • Bicipital tendinitis
  • Calcific tendinitis of shoulder
  • Impingement syndrome of shoulder
  • Medial epicondylitis
  • Lateral epicondylitis
  • Other Synovitis and tenosynovitis
  • Osteoporosis
  • Osteomalacia
  • Skeletal fluorosis
  • Osteomyelitis - Osteonecrosis
  • Chondropathies

N Kidney, renal pelvis disease

  • Glomerular diseases
  • Renal tubulo-interstitial diseases
  • Obstructive and reflux uropathy
  • Nephropathy
  • Renal failure
  • Urolithiasis
  • Cystitis
  • Urethral stricture

N Male and female related disorders

  • Hyperplasia of prostate
  • Other disorders of prostate
  • Torsion of testis
  • Orchitis and epididymitis
  • Male infertility
  • Disorders of penis
  • Other disorders of male genital organs
  • Benign mammary dysplasia
  • Salpingitis and oophoritis
  • Inflammatory disease of uterus
  • Inflammatory disease of cervix uteri
  • Female pelvic inflammatory disease, unspecified
  • Inflammation of vagina and vulva
  • Endometriosis
  • Other disorders of female genital and reproductive organs
  • Abnormal menstrual cycle
  • Female infertility
  • In vitro fertilisation
  • Spontaneous abortion
  • Molar pregnancy
  • Elective abortion

O+P Pregnancy and labour

  • Oedema, proteinuria and hypertensive disorders in pregnancy, childbirth and the puerperium
  • Eclampsia in pregnancy, labour or puerperium
  • Excessive vomiting in pregnancy
  • Venous complications in pregnancy
  • Infections of genito-urinary tract in pregnancy
  • Diabetes mellitus in pregnancy
  • Malnutrition in pregnancy
  • Other specified pregnancy-related conditions
  • Complications of labour and delivery
  • Preterm delivery
  • Extremely low birth weight
  • Other low birth weight
  • Exceptionally large baby
  • Birth trauma
  • Congenital viral diseases
  • Foetal death of unspecified cause

S Injuries

  • Injuries to the head
  • Injuries to the thorax
  • Injuries to the abdomen, lower back, lumbar spine and pelvis
  • Injuries to the shoulder, arm and fingers
  • Injuries to the hip and thigh
  • Injuries to the knee and lower leg, ankle and foot

6. Other Information

  • Education
  • Medical history
  • Residential history
  • Socioeconomic status

Possibility for linkage to data registries/data enrichment via data linkage

  • Birth register
  • Cancer incidence
  • Disease specific clinical database
  • Employment status
  • Hospital discharge
  • Medication usage
  • Migration
  • Mortality register
  • Other (specify)

Specify: Other
  Pathology and other registers using the national personal ID number ("CPR-number")
Please describe plans that are funded or most likely to be funded
  Pooling with other styrene exposed cohorts from the reinforced plastics industry