Chen J, McLaughlin J K, Zhang J Y, Stone B J, Luo J, Chen R A, Dosemeci M, Rexing S H, Wu Z, Hearl F J
Tongji Medical University, School of Public Health, Department of Labor Health and Occupational Diseases, Wuhan, People's Republic of China.
J Occup Med. 1992 Mar;34(3):311-6. doi: 10.1097/00043764-199203000-00017.
A cohort study of approximately 68,000 persons employed during 1972 to 1974 at metal mines and pottery factories in south central China was conducted to evaluate mortality from cancer and other diseases among workers exposed to different levels of silica and other dusts. A follow-up of subjects through December 31, 1989 revealed 6,192 deaths, a number close to that expected based on Chinese national mortality rates. There was, however, a nearly 6-fold increase in deaths from pulmonary heart disease (standard mortality ratio, 581; 95% confidence interval 538 to 626), and a 48% excess of mortality from nonmalignant respiratory diseases (standard mortality ratio, 148; 95% confidence interval, 139 to 158), primarily because of a more than 30-fold excess of pneumoconiosis. Pulmonary heart disease and noncancerous respiratory disease rates rose in proportion to dust exposure. Cancer mortality overall was not increased among the miners or pottery workers. There was no increased risk of lung cancer, except among tin miners, and trends in risk of this cancer with increasing level of dust exposure were not significant. Risks of lung cancer were 22% higher among workers with than without silicosis. The findings indicate that respiratory disease continues to be an occupational hazard among Chinese miners and pottery workers, but that cancer risks are not as yet strongly associated with work in these dusty trades.
对1972年至1974年期间在中国中南部金属矿和陶瓷厂工作的约68000人进行了一项队列研究，以评估接触不同水平二氧化硅和其他粉尘的工人中癌症和其他疾病的死亡率。对研究对象随访至1989年12月31日，共发现6192例死亡，这一数字与根据中国全国死亡率预期的数字接近。然而，肺心病死亡人数增加了近6倍（标准化死亡比为581；95%置信区间为538至626），非恶性呼吸道疾病死亡率高出48%（标准化死亡比为148；95%置信区间为139至158），主要原因是尘肺病死亡人数高出30多倍。肺心病和非癌性呼吸道疾病发病率与粉尘接触量成正比上升。矿工和陶瓷工人总体癌症死亡率并未增加。除锡矿工人外，肺癌风险没有增加，且这种癌症风险随粉尘接触水平增加的趋势并不显著。患矽肺病的工人患肺癌的风险比未患矽肺病的工人高22%。研究结果表明，呼吸道疾病仍是中国矿工和陶瓷工人的职业危害，但癌症风险与这些多尘行业的工作尚未有强烈关联。
