Gennaro V, Finkelstein M M, Ceppi M, Fontana V, Montanaro F, Perrotta A, Puntoni R, Silvano S
Environmental Epidemiology and Biostatistics, National Cancer Institute, Genoa, Italy.
Am J Ind Med. 2000 Mar;37(3):275-82. doi: 10.1002/(sici)1097-0274(200003)37:3<275::aid-ajim5>3.0.co;2-i.
Asbestos exposure has been definitively found to be associated with both mesothelioma and lung cancer. Nevertheless, in the overall population of oil refinery workers potentially exposed to asbestos, many studies clearly show a definitely increased risk of mesothelioma, but no proven excess of lung cancer after comparison to the general population. Through the presentation of new data and the re-appraisal of two recent and independent epidemiological studies conducted in Liguria, Italy, and Ontario, Canada, we attempt to shed light on this apparently paradoxical finding.
Lung cancer mortality was studied among maintenance workers exposed to asbestos, and among two other subgroups of refinery employees: blue collar and white collar workers. The comparison with blue collar workers was performed in order to take into account the role of healthy worker effect, smoking habit, and the socioeconomic level. The comparison with white collar workers was performed to control for other occupational lung carcinogens.
Results reveal a consistency between the two studies and show that 96-100% of the mesotheliomas and 42-49% of the lung tumors arising among maintenance workers were attributable to asbestos exposure. Our new analysis, estimating two cases of asbestos-related lung cancer for each case of mesothelioma, confirms published findings on the magnitude of asbestos-related tumors in oil refineries.
现已明确发现,接触石棉与间皮瘤和肺癌均有关联。然而,在可能接触石棉的炼油厂工人总体中,许多研究清楚地表明,间皮瘤风险确实增加,但与普通人群相比,肺癌并无经证实的超额患病情况。通过展示新数据并重新评估在意大利利古里亚和加拿大安大略进行的两项近期独立流行病学研究,我们试图阐明这一明显矛盾的发现。
对接触石棉的维修工人以及炼油厂员工的另外两个亚组(蓝领和白领工人)的肺癌死亡率进行了研究。与蓝领工人进行比较是为了考虑健康工人效应、吸烟习惯和社会经济水平的作用。与白领工人进行比较是为了控制其他职业性肺癌致癌物。
结果显示两项研究结果一致,表明维修工人中96% - 100%的间皮瘤和42% - 49%的肺部肿瘤可归因于石棉接触。我们的新分析估计,每例间皮瘤有两例与石棉相关的肺癌,这证实了已发表的关于炼油厂中与石棉相关肿瘤规模的研究结果。