Burdorf Alex, Dahhan Mohssine, Swuste Paul
Erasmus MC, University Medical Center Rotterdam, Department of Public Health, The Netherlands.
Ann Occup Hyg. 2003 Aug;47(6):485-92. doi: 10.1093/annhyg/meg062.
To describe the occupational background of cases with an asbestos-related disease and to present overall mesothelioma risks across industries with historical exposure to asbestos.
For the period 1990-2000, cases were collected from records held by two law firms. Information on jobs held, previous employers, activities performed and specific products used were obtained from patients themselves or next of kin. Branches of industry and occupations were coded and the likelihood of asbestos exposure was assessed. For each branch of industry, the overall risk of mesothelioma was calculated from the ratio of the observed number of mesothelioma cases and the cumulative population-at-risk in the period 1947-1960. In order to compare mesothelioma risks across different industries, risk ratios were calculated for the primary asbestos industry and asbestos user industries relative to all other branches of industry.
In total, 710 mesotheliomas and 86 asbestosis cases were available. The average latency period was approximately 40 yr and the average duration of exposure was 22 yr. Ship building and maintenance contributed the largest number of cases (27%), followed by the construction industry (14%), the insulation industry (12%), and the navy and army, primarily related to ship building and maintenance (5%). In the insulation industry, the overall risk of mesothelioma was 5 out of 100 workers, and in the ship building industry, 1 out of 100 workers. The construction industry had an overall risk comparable with many other asbestos-using industries (7 per 10,000 workers), but due to its size claimed many mesothelioma cases.
The majority of cases with asbestos-related diseases had experienced their first asbestos exposure prior to 1960. For cases with first asbestos exposure after 1960, a shift was observed from the primary asbestos industry towards asbestos-using industries, such as construction, petroleum refining, and train building and maintenance. Due to the long latency period, asbestos exposure from 1960 to 1980 will cause a considerable number of mesothelioma cases in the next two decades.
描述石棉相关疾病病例的职业背景，并呈现各行业历史上接触石棉后的间皮瘤总体风险。
在1990 - 2000年期间，从两家律师事务所保存的记录中收集病例。关于所从事工作、以前的雇主、进行的活动以及使用的特定产品的信息，是从患者本人或其近亲处获得的。对行业分支和职业进行编码，并评估接触石棉的可能性。对于每个行业分支，间皮瘤的总体风险是根据1947 - 1960年期间观察到的间皮瘤病例数与累积风险人群的比例计算得出的。为了比较不同行业的间皮瘤风险，计算了主要石棉行业和石棉使用行业相对于所有其他行业分支的风险比。
总共获得了710例间皮瘤和86例石棉沉着病病例。平均潜伏期约为40年，平均接触时长为22年。造船及船舶维修行业的病例数最多（27%），其次是建筑业（14%）、绝缘材料行业（12%）以及主要与造船及船舶维修相关的海军和陆军（5%）。在绝缘材料行业，间皮瘤的总体风险为每100名工人中有5例，在造船行业为每100名工人中有1例。建筑业的总体风险与许多其他使用石棉的行业相当（每10000名工人中有7例），但由于其规模庞大，间皮瘤病例数量较多。
大多数石棉相关疾病病例在1960年之前首次接触石棉。对于1960年之后首次接触石棉的病例，观察到从主要石棉行业向石棉使用行业的转变，如建筑、石油精炼以及火车制造和维修行业。由于潜伏期较长，1960年至1980年期间的石棉接触将在未来二十年导致相当数量的间皮瘤病例。
