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医生们和码头工人。

The doctors and the dockers.

作者信息

Greenberg Morris

出版信息

Am J Ind Med. 2004 Jun;45(6):573-81. doi: 10.1002/ajim.20011.

Abstract

BACKGROUND

London Dockers unloading a dusty asbestos cargo in 1965, consulted an eminent Occupational Health physician, Dr. Donald Hunter who informed them that they had been at serious risk. A second, opinion provided jointly by a Consultant Chest Physician, the Port Medical Officer, and the Medical Advisor to the Trades Union Congress, declared that they knew of no disease affecting dockers, and stated that intermittent exposure to asbestos constituted an inconsiderable risk that with certain precautions would be eradicated.

METHODS

Archival material have been obtained to supplement limited published material and eyewitness accounts of the event, to provide a clearer picture of the issues.

RESULTS

Reassured by the Chest Physician, the Port Medical Officer, and the Medical Advisor to the Trades Union Congress that they had little to fear, London dockers resumed unloading asbestos. From time to time dockers at other ports were to express concern and interrupt work, only to be similarly reassured.

CONCLUSIONS

Had the medical troika in 1965 considered the available health statistics, they would have had reason to take a less sanguine attitude to the cancer mortality of dockers. An analysis of data for 16 selected occupations for the years 1900-1902, showed dockers to have an unhealthy job, with deaths from 'All Cancers' of 1.09 per 1,000 years of life (the fourth highest). The Registrar General's occupational mortality report for 1951, noted excess tumors of the lung and stomach for dockers. Elevated Standardized Mortality Ratios for lung cancer had consistently been calculated by the Registrar General for the 20-64 age group of dockers; in 1931 (183), 1951 (149), and 1961 (169): by 1971 it would be 182. A total of 266 dockers were to be registered in the UK by 1999 as having died of malignant mesotheliomas, proving that Donald Hunter's concern for dockers had not been excessive.

摘要

背景

1965年,伦敦码头工人卸载一批满是灰尘的石棉货物,他们咨询了著名的职业健康医生唐纳德·亨特博士,博士告知他们处于严重风险之中。一位胸科顾问医师、港口医务官以及工会大会医学顾问联合给出的第二种意见宣称,他们不知道有影响码头工人的疾病,还表示间歇性接触石棉构成的风险微不足道,采取某些预防措施后该风险便可消除。

方法

已获取档案资料以补充有限的已发表资料及该事件的目击者描述,从而更清楚地了解相关问题。

结果

胸科医师、港口医务官以及工会大会医学顾问让伦敦码头工人放心,称他们没什么可担心的,于是码头工人恢复了石棉卸载工作。其他港口的码头工人不时表示担忧并中断工作,但得到的也是类似的安抚。

结论

1965年那三位医学专家若考虑一下现有的健康统计数据,就会有理由对码头工人的癌症死亡率持不那么乐观的态度。对1900 - 1902年期间16个选定职业的数据进行分析后发现,码头工人的工作不健康,“所有癌症”导致的死亡率为每1000人年1.09例(排名第四高)。1951年的总登记官职业死亡率报告指出,码头工人的肺部和胃部肿瘤过多。总登记官一直计算得出,20 - 64岁年龄段的码头工人肺癌标准化死亡率升高;1931年为183,1951年为149,1961年为169;到1971年将达到182。到1999年,英国共有266名码头工人登记死于恶性间皮瘤,这证明唐纳德·亨特对码头工人的担忧并非过度。

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