Gun R T, Pratt N L, Griffith E C, Adams G G, Bisby J A, Robinson K L
Department of Public Health, University of Adelaide, Australia.
Occup Environ Med. 2004 Feb;61(2):150-6. doi: 10.1136/oem.2002.005199.
To update the analysis of the cohort mortality and cancer incidence study of employees in the Australian petroleum industry.
Employees from 1981 to 1996 were traced through the Australian National Death Index and the National Cancer Statistics Clearing House. Cause specific mortality and cancer incidence were compared with those of the Australian population by means of standardised mortality ratios (SMRs) and standardised incidence ratios (SIRs). Associations between increased incidence of specific cancers and employment in the petroleum industry were tested by trends according to period of first employment, duration of employment, latency, and hydrocarbon exposure, adjusting for personal smoking history where appropriate. Total follow up time was 176 598 person-years for males and 10 253 person-years for females.
A total of 692 of the 15 957 male subjects, and 16 of the 1206 female subjects had died by the cut off date, 31 December 1996. In males, the all-cause SMR and the SMRs for all major disease categories were significantly below unity. There was a non-significant increase of the all-cancer SIR (1.04, 95% CI 0.97 to 1.11). There was a significant increase of the incidence of melanoma (SIR 1.54, 95% CI 1.30 to 1.81), bladder cancer (SIR 1.37, 95% CI 1.00 to 1.83), and prostate cancer (SIR 1.19, 95% CI 1.00 to 1.40), and a marginally significant excess of pleural mesothelioma (SIR 1.80, 95% CI 0.90 to 3.22), leukaemia (SIR 1.39, 95%CI 0.91 to 2.02), and multiple myeloma (SIR 1.72, 95% CI 0.96 to 2.84).
Most cases of mesothelioma are probably related to past exposure to asbestos in refineries. The melanoma excess may be the result of early diagnosis. The excess bladder cancer has not been observed previously in this industry and is not readily explained. The divergence between cancer incidence and cancer mortality suggests that the "healthy worker effect" may be related to early reporting of curable cancers, leading to increased likelihood of cure and prolonged mean survival time.
更新对澳大利亚石油行业员工队列死亡率和癌症发病率的研究分析。
通过澳大利亚国家死亡指数和国家癌症统计信息中心对1981年至1996年期间的员工进行追踪。采用标准化死亡率（SMR）和标准化发病率（SIR）将特定病因死亡率和癌症发病率与澳大利亚人群进行比较。根据首次就业时间、就业时长、潜伏期和碳氢化合物暴露情况，对特定癌症发病率增加与石油行业就业之间的关联进行趋势检验，并在适当情况下对个人吸烟史进行调整。男性的总随访时间为176598人年，女性为10253人年。
截至1996年12月31日的截止日期，15957名男性受试者中有692人死亡，1206名女性受试者中有16人死亡。在男性中，全因SMR和所有主要疾病类别的SMR均显著低于1。所有癌症的SIR有不显著的增加（1.04，95%可信区间0.97至1.11）。黑色素瘤（SIR 1.54，95%可信区间1.30至1.81）、膀胱癌（SIR 1.37，95%可信区间1.00至1.83）和前列腺癌（SIR 1.19，95%可信区间1.
