肺癌与粉尘暴露：对3260名工人进行50年随访的前瞻性队列研究结果
Lung cancer and dust exposure: results of a prospective cohort study following 3260 workers for 50 years.
作者信息
Moshammer H, Neuberger M
机构信息
Dept of Preventive Medicine, Institute of Environmental Health, University of Vienna, Austria.
出版信息
Occup Environ Med. 2004 Feb;61(2):157-62. doi: 10.1136/oem.2002.001255.
AIMS
To study the lasting health impact of occupational dust exposure on life expectancy and specific causes of death.
METHODS
Male Viennese workers, selected at age > or =40 (mean 54) years during preventive check-ups between 1950 and 1960, were followed prospectively until death. Half of them (1630) were exposed at work to (non-fibrous) particulates, while the non-exposed workers were matched for year, age, and smoking status at the start of observation.
RESULTS
Average life expectancy of those exposed was 1.6 years less than that of those non-exposed. Only a small part of this decrease in life expectancy (hazards ratios in brackets) was related to acknowledged occupational diseases such as silicosis and silicotuberculosis (67.12). Chronic obstructive lung disease (1.82) and cancer of the lung (1.42) and stomach (1.77) were found more frequently among those exposed.
CONCLUSIONS
Results support the hypothesis that high exposure to insoluble particulates such as silica in the metal, glass, ceramics, and stone industries promotes bronchial cancer and chronic obstructive pulmonary disease. The finding of an increased incidence of stomach cancer might be related to particles swallowed after clearance from the airways.
目的
研究职业性粉尘暴露对预期寿命和特定死因的长期健康影响。
方法
选取1950年至1960年间预防性体检时年龄≥40岁（平均54岁）的维也纳男性工人，进行前瞻性随访直至死亡。其中一半（1630人）在工作中接触（非纤维性）颗粒物，未接触的工人在观察开始时按年份、年龄和吸烟状况进行匹配。
结果
接触者的平均预期寿命比未接触者短1.6年。预期寿命下降的一小部分（括号内为风险比）与公认的职业病如矽肺和硅肺结核（67.12）有关。在接触者中，慢性阻塞性肺疾病（1.82）、肺癌（1.42）和胃癌（1.77）的发病率更高。
结论
结果支持以下假设，即在金属、玻璃、陶瓷和石材行业中，高暴露于不溶性颗粒物（如二氧化硅）会引发支气管癌和慢性阻塞性肺疾病。胃癌发病率增加的发现可能与气道清除后吞咽的颗粒有关。
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