Pirastu R, Bruno C, De Santis M, Comba P
Dipartimento di Biologia Animale e dell'Uomo, Università La Sapienza, Roma.
Epidemiol Prev. 1998 Oct-Dec;22(4):226-36.
The aim of the present study is to investigate cause-specific mortality among male workers employed in vinyl chloride manufacture and polymerization in three Italian plants located in Ferrara, Rosignano and Ravenna. The cohorts include all workers hired between start of operation and, respectively 1985, 1978 and 1985, amounting to 418, 206 and 635 subjects followed up for mortality until 1996 (Ferrara and Rosignano) and 1997 (Ravenna). Cause specific SMRs (Standardized mortality ratios) were computed. Expected figures were obtained from mortality rates for the population resident in the region where the plant was located, for each SMR value a 90% confidence interval (CI) was calculated on the assumption of a Poisson distribution. The study detected an increased mortality for primary liver cancer in all three plants; SMR values were 444 in Ferrara (4 Obs. 90% CI 160-1069), 200 in Rosignano (1 Obs. 90% CI 10-869) and 375 in Ravenna (3 Obs. 90% CI 110-1038). In the pooled cohort liver cancer SMR was equal to 364 (8 Obs. 90% CI 108-390). In one plant, Ferrara, observed mortality was above the expected for lung cancer, SMR = 146 (14 Obs. 90% CI 89-229) and for larynx cancer, SMR = 500 (4 Obs. 90% CI 174-1167). One death from pleural cancer was observed in Rosignano (SMR = 1000 90% CI 47-4331). A non significant increase was detected for liver cirrhosis, in Ferrara (SMR 108, 6 Obs. 90% CI 73-332) and Rosignano (SMR 129, 3 Obs. 90% CI 35-332). The study results are confirming the carcinogenic action of vinyl chloride on the liver, they are pointing to its possible role in lung cancer development, as already shown for workers employed in Porto Marghera; an increased risk for larynx cancer is also shown.
本研究的目的是调查在位于费拉拉、罗西尼亚诺和拉文纳的三家意大利工厂中从事氯乙烯制造和聚合工作的男性工人的特定病因死亡率。队列包括所有在工厂运营开始至1985年（费拉拉）、1978年（罗西尼亚诺）和1985年（拉文纳）期间雇佣的工人，分别有418名、206名和635名受试者，对其死亡率进行随访直至1996年（费拉拉和罗西尼亚诺）和1997年（拉文纳）。计算了特定病因的标准化死亡比（SMR）。预期数据来自工厂所在地区居民的死亡率，对于每个SMR值，在泊松分布的假设下计算90%置信区间（CI）。该研究发现所有三家工厂的原发性肝癌死亡率均有所增加；费拉拉的SMR值为444（观察到4例，90%CI 160 - 1069），罗西尼亚诺为200（观察到1例，90%CI 10 - 869），拉文纳为375（观察到3例，90%CI 110 - 1038）。在合并队列中，肝癌SMR等于364（观察到8例，90%CI 108 - 390）。在一家工厂，即费拉拉，观察到的肺癌死亡率高于预期，SMR = 146（观察到14例，90%CI 89 - 229），喉癌的SMR = 500（观察到4例，90%CI 174 - 1167）。在罗西尼亚诺观察到1例胸膜癌死亡（SMR = 1000，90%CI 47 - 4331）。在费拉拉（SMR 108，观察到6例，90%CI 73 - 332）和罗西尼亚诺（SMR 129，观察到3例，90%CI 35 - 332）检测到肝硬化死亡率有不显著增加。研究结果证实了氯乙烯对肝脏的致癌作用，指出了其在肺癌发生中的可能作用，正如已经在马尔盖拉港工作的工人中所显示的那样；还显示出喉癌风险增加。
