Consonni D, Bernucci I, Bertazzi P A
Istituti Clinici di Perfezionamento di Milano, Clinica del Lavoro L. Devoto.
Med Lav. 1999 Jan-Feb;90(1):67-83.
Man-made vitreous fibres (MMVF) showed carcinogenic potential in experimental animals. Epidemiological data suggested an increased mortality from lung cancer among production workers, but the interpretation is still a matter of controversy. A European study encompassing 13 plants in 7 countries pointed towards a moderate excess of lung cancer among workers employed longer than 1 year in the production of rock/slag wool (SMR = 1.34, 95% CI = 1.08-1.63) and glass wool (SMR = 1.27, 95% CI = 1.07-1.50); the latter increase was not confirmed after applying local rates to calculate expected deaths. The elevated risk among rock/slag wool producers was present even in comparison with local rates, and was associated with increasing time from first exposure, and duration of exposure. Glass wool results exhibited a less definite pattern. Smoking was excluded, although indirectly, as a sufficient alternative explanation of the increased lung cancer risk. In a few plants, exposure to asbestos had occurred in limited periods for some workers, and might have contributed to the findings. Case-control studies are under way to thoroughly investigate the relative and possibly combined role of the different exposures, either occupational or not. Cohort studies in the USA produced results closely consistent with those of the European study.
人造玻璃纤维(MMVF)在实验动物中显示出致癌潜力。流行病学数据表明,生产工人的肺癌死亡率有所上升,但对此的解释仍存在争议。一项涵盖7个国家13家工厂的欧洲研究指出,在从事岩棉/矿渣棉生产(标准化死亡比=1.34,95%置信区间=1.08 - 1.63)和玻璃棉生产(标准化死亡比=1.27,95%置信区间=1.07 - 1.50)超过1年的工人中,肺癌发生率略有偏高;在应用当地发病率计算预期死亡人数后,后者的增加未得到证实。即使与当地发病率相比,岩棉/矿渣棉生产者的风险升高依然存在,且与首次接触后的时间增加以及接触持续时间有关。玻璃棉的结果呈现出不太明确的模式。吸烟虽未直接作为肺癌风险增加的充分替代解释而被排除。在一些工厂,部分工人在有限时间段内接触过石棉,这可能对研究结果有所影响。病例对照研究正在进行,以全面调查不同暴露因素(无论是否为职业性暴露)的相对作用以及可能的联合作用。美国的队列研究结果与欧洲研究结果高度一致。