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The health of UK petroleum industry workers has been monitored for many years.To identify any long-term adverse health outcomes from occupational exposures in this industry.The mortality (1951–2003) and cancer morbidity (1971–2003) experienced by cohorts of 28 555 oil refinery workers and 16 477 petroleum distribution workers has been investigated. Study subjects were all those males first employed in the period 1946–74 at one of eight UK oil refineries or 476 UK petroleum distribution centres; all subjects had a minimum of 12 months employment with some employment after 1 January 1951. Observed numbers of cause-specific deaths and site-specific cancer registrations were compared with expectations based on national mortality and cancer incidence rates.Standardized mortality ratios (SMRs) were significantly <100 for all causes both in oil refinery workers (Obs 11 156, SMR 89) and in petroleum distribution workers (Obs 7320, SMR 96). Significantly elevated SMRs were shown in oil refinery workers for cancer of the pleura (mesothelioma) (Obs 64, SMR 261) and melanoma (Obs 48, SMR 168). Significantly elevated SMRs were not found in petroleum distribution workers for any site of cancer. Significantly elevated standardized registration ratios (SRRs) were only shown in oil refinery workers and for cancer of the pleura (mesothelioma) (Obs 115, SMR 274), melanoma (Obs 85, SMR 129) and other skin cancer (Obs 983, SRR 117).The only findings that showed clear evidence of an occupational cancer hazard were those for mesothelioma in oil refinery workers.