Hauptmann Michael, Lubin Jay H, Stewart Patricia A, Hayes Richard B, Blair Aaron
Division of Cancer Epidemiology and Genetics, National Cancer Institute, Department of Health and Human Services, Bethesda, MD 20892, USA.
Am J Epidemiol. 2004 Jun 15;159(12):1117-30. doi: 10.1093/aje/kwh174.
In industrial workers, formaldehyde exposure has been associated with cancer of the nasal cavities, nasopharynx, prostate, lung, and pancreas; however, these associations are inconsistent and remain controversial. Animals exposed to formaldehyde show excesses of nasal cancer. In an extended follow-up of a large cohort of formaldehyde-exposed workers, the authors evaluated mortality from solid cancers (1,921 deaths) among 25,619 workers (865,708 person-years) employed in 10 US formaldehyde-producing or -using facilities through 1994. Exposure assessment included quantitative estimates of formaldehyde exposure. Standardized mortality ratios and relative risks were calculated. Compared with that for the US population, mortality from solid cancers was significantly lower than expected among subjects exposed and nonexposed to formaldehyde (standardized mortality ratios = 0.91 and 0.78, respectively). Relative risks for nasopharyngeal cancer (nine deaths) increased with average exposure intensity, cumulative exposure, highest peak exposure, and duration of exposure to formaldehyde (p-trend = 0.066, 0.025, <0.001, and 0.147, respectively). Formaldehyde exposure did not appear to be associated with lung (744 deaths), pancreas (93 deaths), or brain (62 deaths) cancer. Although relative risks for prostate cancer (145 deaths) were elevated for some measures of formaldehyde exposure, the trend was inconsistent. In this cohort of formaldehyde-industry workers, some evidence was found of an exposure-response relation with mortality from nasopharyngeal cancer (based on small numbers) but not for cancers of the pancreas, brain, lung, or prostate.
在产业工人中,接触甲醛与鼻腔癌、鼻咽癌、前列腺癌、肺癌和胰腺癌有关;然而,这些关联并不一致,仍存在争议。接触甲醛的动物会出现鼻腔癌增多的情况。在对一大群接触甲醛的工人进行的长期随访中,作者评估了1994年之前受雇于美国10家甲醛生产或使用工厂的25,619名工人(865,708人年)中实体癌的死亡率(1,921例死亡)。接触评估包括对甲醛接触的定量估计。计算了标准化死亡率和相对风险。与美国人群相比,接触和未接触甲醛的受试者中实体癌死亡率均显著低于预期(标准化死亡率分别为0.91和0.78)。鼻咽癌(9例死亡)的相对风险随甲醛平均接触强度、累积接触量、最高峰值接触量和接触持续时间的增加而增加(p趋势分别为0.066、0.025、<0.001和0.147)。甲醛接触似乎与肺癌(744例死亡)、胰腺癌(93例死亡)或脑癌(62例死亡)无关。尽管对于某些甲醛接触指标,前列腺癌(145例死亡)的相对风险有所升高,但趋势并不一致。在这组甲醛行业工人中,发现了一些证据表明存在与鼻咽癌死亡率的接触-反应关系(基于少量病例),但未发现与胰腺癌、脑癌、肺癌或前列腺癌有关。