Attfield Michael D, Costello Joseph
Division of Respiratory Disease Studies, NIOSH, Morgantown, West Virginia 26505, USA.
Am J Ind Med. 2004 Feb;45(2):129-38. doi: 10.1002/ajim.10348.
Excess lung cancer mortality among the exposed Vermont granite workers has been reported. These studies were based on job and tenure surrogates, with the potential for misclassification and inability to evaluate quantitative exposure-response.
Industrial hygiene data collected from 1924 to 1977 was analyzed in conjunction with mortality data to examine quantitative exposure-response for silica, lung cancer, and other lung diseases. A person-years analysis was undertaken by cumulative exposure group, including lagged and unlagged tabulations. Poisson models were fitted to untransformed and log transformed exposure.
The results indicated a clear relationship of lung cancer, tuberculosis, pneumoconiosis, non-malignant lung disease, and kidney cancer with cumulative exposure. An exposure to 0.05 mg/m(3) from age 20 to 64 was associated with a lifetime excess risk of lung cancer for white males of 27/1,000.
The results of this study of workers exposed almost exclusively to silica and no other major occupational confounding exposures indicate a clear exposure-response for lung cancer.
已有报道称,接触石棉的佛蒙特州花岗岩工人肺癌死亡率过高。这些研究基于工作和工龄替代指标,存在错误分类的可能性,且无法评估定量暴露-反应关系。
分析了1924年至1977年收集的工业卫生数据,并结合死亡率数据,以研究二氧化硅、肺癌和其他肺部疾病的定量暴露-反应关系。按累积暴露组进行人年分析,包括滞后和未滞后的列表。对未转换和对数转换的暴露数据拟合泊松模型。
结果表明,肺癌、肺结核、尘肺病、非恶性肺部疾病和肾癌与累积暴露之间存在明显关系。20岁至64岁期间接触0.05毫克/立方米与白人男性肺癌终生超额风险27/1000相关。
这项几乎仅接触二氧化硅且无其他主要职业混杂暴露的工人研究结果表明,肺癌存在明确的暴露-反应关系。