Carel Rafael, Boffetta Paolo, Kauppinen Timo, Teschke Kay, Andersen Aage, Jäppinen Paavo, Pearce Neil, Rix Bo Andreassen, Bergeret Alain, Coggon David, Persson Bodil, Szadkowska-Stanczyk Irena, Kielkowski Danuta, Henneberger Paul, Kishi Reiko, Facchini Luiz Augusto, Sala Maria, Colin Didier, Kogevinas Manolis
International Agency for Research on Cancer, 150 Cours Albert-Thomas, 69008 Lyon, France.
J Occup Environ Med. 2002 Jun;44(6):579-84. doi: 10.1097/00043764-200206000-00022.
We studied the mortality from lung and pleural cancers in a cohort of 62,937 male workers employed for at least 1 year in the pulp and paper industry in 13 countries during 1945 to 1996. Mill departments were classified according to probability and level of exposure to asbestos on the basis of available dust measurements and mill-specific information on exposure circumstances. Thirty-six percent of workers were classified as ever exposed to asbestos. Standardized mortality ratios of lung cancer were 0.99 (95% confidence interval [CI], 0.90 to 1.08) among unexposed and 1.00 (95% CI, 0.90 to 1.11) among ever exposed workers. The number of pleural cancer deaths among unexposed workers was 10; that among exposed workers was 14, most of which occurred among maintenance workers. In internal analyses, a trend in mortality from either neoplasm was suggested for estimated cumulative exposure to asbestos, weighted for the individual probability of exposure within the department and for duration of exposure (relative risk for lung cancer for 0.78+ f/cc-years, as compared with < or = 0.01 f/cc-years: 1.44; 95% CI, 0.85 to 2.45; corresponding relative risk for pleural cancer: 2.43; 95% CI, 0.43 to 13.63). Despite a possible nondifferential misclassification of exposure and outcome, this study suggests that the carcinogenic effect of asbestos can be detected among workers employed in industries such as the pulp and paper industry, in which it is not considered to be a major hazard.
我们研究了1945年至1996年期间在13个国家的纸浆和造纸行业至少工作1年的62937名男性工人的肺癌和胸膜癌死亡率。根据现有的粉尘测量结果以及工厂特定的接触情况信息，将工厂部门按照接触石棉的可能性和程度进行分类。36%的工人被归类为曾接触过石棉。未接触者的肺癌标准化死亡率为0.99（95%置信区间[CI]，0.90至1.08），曾接触者的肺癌标准化死亡率为1.00（95%CI，0.90至1.11）。未接触者中胸膜癌死亡人数为10人；曾接触者中胸膜癌死亡人数为14人，其中大多数发生在维修工人中。在内部分析中，对于估计的石棉累积接触量（根据部门内个体接触可能性和接触持续时间加权），两种肿瘤的死亡率都显示出一种趋势（与≤0.01f/cc - 年相比，0.78 + f/cc - 年的肺癌相对风险：1.44；95%CI，0.85至2.45；胸膜癌的相应相对风险：2.43；95%CI，0.43至13.63）。尽管接触和结果可能存在非差异性错误分类，但本研究表明，在纸浆和造纸等行业的工人中可以检测到石棉的致癌作用，而在这些行业中石棉不被视为主要危害因素。
