MacLennan Paul A, Delzell Elizabeth, Sathiakumar Nalini, Myers Susan L, Cheng Hong, Grizzle William, Chen Vivien W, Wu Xiao Cheng
Department of Epidemiology and International Health, School of Public Health, University of Alabama at Birmingham, Birmingham, Alabama.
J Occup Environ Med. 2002 Nov;44(11):1048-58. doi: 10.1097/00043764-200211000-00011.
This study evaluated cancer incidence and prostate specific antigen (PSA) testing among workers at a plant in Louisiana (LA) that made atrazine and other triazine herbicides. The study covered the time period 1985 through 1997 and included 2045 subjects, of whom 757 worked for the company that owned the plant and 1288 were contract employees. Linkage with a population-based cancer registry and review of death certificates and plant medical records identified cancer cases. Standardized incidence ratios (SIRs) with 95% confidence intervals (CIs) compared subjects' cancer incidence rates with those of a regional general population. Plant medical records provided data on the proportion receiving PSA tests among male company employees. Subjects had 46 observed and 40 expected cases of all cancers combined (SIR = 114, CI = 83-152) and had 11/6.3 prostate cancers (SIR = 175, CI = 87-312). The prostate cancer excess was greater in actively working company employees (5/1.3, SIR = 394, CI = 128-920) than in contract employees or inactive company employees (6/5.0, SIR = 119, CI = 44-260) and was limited to men under 60 years of age. Of the 11 prostate cancer cases, nine were diagnosed at an early clinical stage. From 1993 to 1999, the proportion of male company employees who had at least one PSA test was 86% for those who reached 40 years of age while actively working and was 98% for those who reached 45 years of age. The observed prostate cancer increase may have been due to the frequent PSA testing of actively working company employees. There is no epidemiologic or other information that clearly supports a causal relation between atrazine and prostate cancer.
本研究评估了路易斯安那州（LA）一家生产莠去津及其他三嗪类除草剂工厂的工人的癌症发病率及前列腺特异性抗原（PSA）检测情况。该研究涵盖了1985年至1997年的时间段，包括2045名受试者，其中757人受雇于拥有该工厂的公司，1288人为合同工。通过与基于人群的癌症登记处建立联系，并查阅死亡证明和工厂医疗记录来确定癌症病例。采用标准化发病比（SIRs）及95%置信区间（CIs）将受试者的癌症发病率与地区普通人群的发病率进行比较。工厂医疗记录提供了男性公司员工中接受PSA检测比例的数据。受试者共观察到46例所有癌症合并病例，预期为40例（SIR = 114，CI = 83 - 152），前列腺癌观察到11例，预期为6.3例（SIR = 175，CI = 87 - 312）。在职公司员工的前列腺癌超额发病率（5/1.3，SIR = 394，CI = 128 - 920）高于合同工或非在职公司员工（6/5.0，SIR = 119，CI = 44 - 260），且仅限于60岁以下男性。在11例前列腺癌病例中，9例在临床早期被诊断出来。1993年至1999年期间，在职时年满40岁的男性公司员工中至少进行过一次PSA检测的比例为86%，年满45岁的男性公司员工这一比例为98%。观察到的前列腺癌发病率增加可能是由于在职公司员工频繁进行PSA检测所致。目前没有流行病学或其他信息能明确支持莠去津与前列腺癌之间存在因果关系。
