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接触环氧乙烷工人的死亡率:英国队列的长期随访

Mortality of workers exposed to ethylene oxide: extended follow up of a British cohort.

作者信息

Coggon D, Harris E C, Poole J, Palmer K T

机构信息

MRC Environmental Epidemiology Unit, University of Southampton, UK.

出版信息

Occup Environ Med. 2004 Apr;61(4):358-62. doi: 10.1136/oem.2003.008268.

Abstract

AIMS

To obtain further information about the risks of cancer associated with occupational exposure to ethylene oxide

METHODS

Follow up was extended by 13 years for a cohort of 2876 men and women with definite or potential exposure to ethylene oxide in the chemical industry or in hospital sterilising units. Subjects were traced through National Health Service and social security records, and their mortality was compared with that expected from rates in the national population by the person-years method.

RESULTS

Analysis was based on 565 deaths, of which 339 had occurred during the additional period of follow up. Mortality was close to or below expectation for all causes (565 deaths v 607.6 expected), all cancers (188 v 184.2), and for all specific categories of malignancy including stomach cancer (10 v 11.6), breast cancer (11 v 13.2), non-Hodgkin's lymphoma (7 v 4.8), and leukaemia (5 v 4.6). All five deaths from leukaemia occurred in the subset of subjects with greatest potential for exposure to ethylene oxide, but even in this group the excess of deaths was small (2.6 expected).

CONCLUSIONS

The balance of evidence from this and other epidemiological investigations indicates that any risk of human cancer from ethylene oxide is low, particularly at the levels of occupational exposure that have occurred in Britain over recent decades. This may reflect the capacity of human cells to repair DNA damage caused by the chemical, which is a potent genotoxin and animal carcinogen.

摘要

目的

获取与职业性接触环氧乙烷相关的癌症风险的更多信息。

方法

对化学工业或医院消毒部门中2876名明确或可能接触环氧乙烷的男性和女性队列进行了13年的随访。通过国民健康服务和社会保障记录追踪受试者,并采用人年法将他们的死亡率与全国人口的预期死亡率进行比较。

结果

分析基于565例死亡病例,其中339例发生在额外的随访期间。所有原因(565例死亡对607.6例预期)、所有癌症(188例对184.2例)以及所有特定类型的恶性肿瘤,包括胃癌(10例对11.6例)、乳腺癌(11例对13.2例)、非霍奇金淋巴瘤(7例对4.8例)和白血病(5例对4.6例)的死亡率均接近或低于预期。所有5例白血病死亡均发生在环氧乙烷暴露可能性最大的受试者亚组中,但即使在该组中,死亡超额数也很小(预期为2.6例)。

结论

这项研究和其他流行病学调查的证据表明,环氧乙烷导致人类患癌的任何风险都很低,尤其是在英国近几十年来发生的职业暴露水平下。这可能反映了人类细胞修复由这种化学物质引起的DNA损伤的能力,环氧乙烷是一种强效的基因毒素和动物致癌物。

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