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电信行业工人皮肤恶性黑色素瘤:1976 - 1983年死亡率研究

Malignant melanoma of the skin among workers in a telecommunications industry: mortality study 1976-83.

作者信息

DeGuire L, Cyr D, Thériault G, Provencher S, Iturra H, Case B W

机构信息

Department of Community Health, Sacre-Coeur Hospital, Montreal, Quebec, Canada.

出版信息

Br J Ind Med. 1992 Oct;49(10):728-31. doi: 10.1136/oem.49.10.728.

DOI:10.1136/oem.49.10.728
PMID:1419862
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC1012149/
Abstract

An incidence study of malignant melanoma of the skin (MMS), conducted previously among the workers of four plants of a large telecommunications industry located in Montreal, Canada, showed a standardised incidence ratio of 2.7 (95% confidence interval (95% CI) 1.3-5.02) for the years 1976 to 1983. To describe more precisely the magnitude of the problem a mortality study was started among the same population (n = 9590) for the same period (1976-83). At the end of 1983, 9180 workers were alive, 261 were dead, and 149 (1.5%) were not traced. Standardised mortality ratios (SMRs) for all causes of death were surprisingly low for men (SMR = 0.57; 95% CI 0.50-0.64) and women (SMR = 0.56; 95% CI 0.37-0.82). The SMRs for major causes of death were also less than expected. These results may be explained by a pronounced selection bias (healthy worker effect) and by the short duration of follow up (eight years). For MMS, two deaths occurred among men (SMR = 2.00; 95% CI 0.24-7.22) and one among women (SMR = 4.81; 95% CI 0.12-26.78). A third man who died of MMS was miscoded as having a primary pulmonary melanoma. Including this case increased the SMR for MMS to 3.00 (95% CI 0.62-8.77; p = 0.08). Polyvinyl chloride and polychlorinated biphenyls were used in the plants and some of the workers did soldering. A planned case-control study will investigate other possible exposures at work.

摘要

此前在加拿大蒙特利尔市一家大型电信行业的四家工厂的工人中进行的一项皮肤恶性黑色素瘤(MMS)发病率研究显示,1976年至1983年期间的标准化发病率为2.7(95%置信区间(95%CI)1.3 - 5.02)。为了更精确地描述该问题的严重程度,在同一人群(n = 9590)中针对同一时期(1976 - 1983年)开展了一项死亡率研究。到1983年底,9180名工人存活,261人死亡,149人(1.5%)失访。所有死因的标准化死亡率(SMR)在男性(SMR = 0.57;95%CI 0.50 - 0.64)和女性(SMR = 0.56;95%CI 0.37 - 0.82)中出奇地低。主要死因的SMR也低于预期。这些结果可能由明显的选择偏倚(健康工人效应)以及较短的随访时间(八年)来解释。对于MMS,男性中有两例死亡(SMR = 2.00;95%CI 0.24 - 7.22),女性中有一例死亡(SMR = 4.81;95%CI 0.12 - 26.78)。第三名死于MMS的男性被错误编码为原发性肺黑色素瘤。将该病例纳入后,MMS的SMR增至3.00(95%CI 0.62 - 8.77;p = 0.08)。这些工厂使用了聚氯乙烯和多氯联苯,一些工人从事焊接工作。一项计划中的病例对照研究将调查工作中的其他可能暴露因素。

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本文引用的文献

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Malignant melanoma: social status and outdoor work.恶性黑色素瘤:社会地位与户外工作
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