Ajani U A, Seddon J M, Hsieh C C, Egan K M, Albert D M, Gragoudas E S
Epidemiology Unit, Massachusetts Eye and Ear Infirmary, Boston 02114.
Cancer. 1992 Dec 15;70(12):2891-900. doi: 10.1002/1097-0142(19921215)70:12<2891::aid-cncr2820701228>3.0.co;2-1.
Little is known about the cause of uveal melanoma, the most common primary intraocular malignant lesion in adults. This population-based case-control study evaluated occupational exposures.
One hundred ninety-seven newly diagnosed cases of uveal melanoma participated. Approximately two control subjects matched for age, sex, and telephone exchange area were selected for each case by random-digit dialing. Data were collected by a structured telephone interview. Two systems of occupational coding were used: an occupation-exposure linkage system and the Bureau of Census data. Conditional logistic regression for matched studies was used to examine various occupational exposures while controlling for previously reported potential confounders and for family income. The occupation-exposure matrix was used to define clusters of cases exposed to a particular chemical group from various occupations.
Odds ratios were elevated for agriculture and farming work for both industry and occupation; this was consistent across both classification systems. Elevated odds ratios also were found for occupations involving machine operations, fabrication, assembling, equipment cleaning, and exposure to metal industries. Exposure to alkylating agents and phenols was associated with a lower risk compared with all other exposures. Several self-reported exposures also were studied. Exposures associated with elevated odds ratios were inks, insecticides, gases, radioactive substances, polybromated biphenyls, and chemical solvents.
This exploratory study suggests various occupational associations for uveal melanoma and areas for future research.
葡萄膜黑色素瘤是成人中最常见的原发性眼内恶性病变，但其病因鲜为人知。这项基于人群的病例对照研究评估了职业暴露情况。
197例新诊断的葡萄膜黑色素瘤患者参与研究。通过随机数字拨号为每个病例选择约两名年龄、性别和电话交换区匹配的对照对象。通过结构化电话访谈收集数据。使用了两种职业编码系统：职业-暴露关联系统和人口普查局数据。在控制先前报告的潜在混杂因素和家庭收入的同时，采用匹配研究的条件逻辑回归分析各种职业暴露情况。职业-暴露矩阵用于定义来自不同职业且接触特定化学物质组的病例集群。
农业和农事工作在行业和职业方面的优势比均升高；在两种分类系统中均一致。涉及机器操作、制造、装配、设备清洁以及接触金属行业的职业优势比也升高。与所有其他暴露相比，接触烷基化剂和酚类的风险较低。还研究了一些自我报告的暴露情况。与优势比升高相关的暴露包括油墨、杀虫剂、气体、放射性物质、多溴联苯和化学溶剂。
这项探索性研究表明了葡萄膜黑色素瘤与各种职业的关联以及未来研究的方向。
