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电磁场与健康影响——癌症、中枢神经系统疾病及心律失常相关心脏病的流行病学研究

Electromagnetic fields and health effects--epidemiologic studies of cancer, diseases of the central nervous system and arrhythmia-related heart disease.

作者信息

Johansen Christoffer

机构信息

Department of Psychosocial Cancer Research, Institute of Cancer Epidemiology, The Danish Cancer Society, Copenhagen, Denmark.

出版信息

Scand J Work Environ Health. 2004;30 Suppl 1:1-30.

Abstract

This epidemiologic investigation comprised separate studies of the risk of cancer, cause-specific mortality rates, risks for neurodegenerative diseases, and the risk of arrhythmia-related heart disease among employees exposed to extremely low-frequency (50-Hz) electromagnetic fields (EMF) in the Danish utility industry. All the employees in this industry were followed-up in several registers. The risk of disease was analyzed in relation to occupational exposure to EMF, latency, and duration of employment. A specific job-exposure matrix was developed and validated by comparison with direct measurements of EMF during a workday. Linkage with the Danish Cancer Register did not identify increased risks for the cancers suggested a priori to be associated with exposure to EMF, including leukemia, brain tumors, and breast cancer. Significantly increased risks for lung cancer and mesothelioma were identified for workers highly exposed to asbestos. Linkage with the National Mortality Register revealed a significantly increased overall mortality rate from amyotrophic lateral sclerosis (ALS), with an increasing trend with duration of employment and EMF exposure. In addition, a significantly increased mortality rate from electric accidents was observed. It was hypothesized that the observation of increased mortality from ALS was associated with exposure to EMF or electric shocks. No increased mortality rate from cardiovascular or cerebrovascular disease was observed. Linkage with the National Hospital Register also revealed an increased risk of ALS and, thereby confirmed the finding of an increased mortality rate for this disease in the previous study. Linkage of the cohort with the Multiple Sclerosis Register revealed an increased risk of multiple sclerosis, which was not, however, significant. Linkage with the Pacemaker Register showed no increased risk of severe arrhythmia-related heart disease. The second part of the study included the establishment of a large, nationwide cohort of mobile phone subscribers comprising some 420 000 persons. No increased risk was observed for the cancers considered a priori to be possibly associated with the radiofrequency fields emitted by mobile phones, which were brain tumors, including acoustic neuroma, salivary gland tumors, and leukemia. The data were analyzed by duration of phone use, latency, system used (NMT, GSM or both) and age at first subscription. A study of the incidence of ocular malignant melanoma in comparison with the annual increase among the mobile phone subscribers showed a highly stable incidence rate for this rare cancer in Denmark over close to 50 years of registration. On the basis of these studies and the scientific literature, it is concluded that occupational exposure to 50-Hz EMF is not associated with an increased risk of cancer, but that these fields, electric shocks, or some other unknown factor related to alternating current electricity may be associated with the risk of ALS. There is no clear evidence that 50-Hz EMF is associated with other neurodegenerative or cardiovascular diseases. At present, there is little, if any, evidence that the use of mobile phones is associated with cancer in adults, including brain tumors, acoustic neuroma, cancer of the salivary glands, leukemia, or malignant melanoma of the eye.

摘要

这项流行病学调查包括对丹麦公用事业行业中暴露于极低频(50赫兹)电磁场(EMF)的员工进行的癌症风险、特定病因死亡率、神经退行性疾病风险以及心律失常相关心脏病风险的单独研究。该行业的所有员工都在多个登记册中接受随访。分析了疾病风险与职业性EMF暴露、潜伏期和就业时长的关系。通过与工作日期间EMF的直接测量结果进行比较,开发并验证了一个特定的工作暴露矩阵。与丹麦癌症登记处的关联并未发现先前认为与EMF暴露相关的癌症风险增加,这些癌症包括白血病、脑肿瘤和乳腺癌。对于高度暴露于石棉的工人,肺癌和间皮瘤的风险显著增加。与国家死亡率登记处的关联显示,肌萎缩侧索硬化症(ALS)的总体死亡率显著增加,且随着就业时长和EMF暴露增加呈上升趋势。此外,观察到触电事故导致的死亡率显著增加。据推测,ALS死亡率增加的观察结果与EMF暴露或电击有关。未观察到心血管或脑血管疾病导致的死亡率增加。与国家医院登记处的关联还显示ALS风险增加,从而证实了先前研究中该疾病死亡率增加的发现。该队列与多发性硬化症登记处的关联显示多发性硬化症风险增加,但不显著。与起搏器登记处的关联显示严重心律失常相关心脏病风险未增加。研究的第二部分包括建立一个约42万人的全国性大型手机用户队列。对于先前认为可能与手机发射的射频场相关的癌症,未观察到风险增加,这些癌症包括脑肿瘤,如听神经瘤、唾液腺肿瘤和白血病。根据手机使用时长、潜伏期、使用的系统(NMT、GSM或两者皆用)以及首次订阅时的年龄对数据进行了分析。一项关于眼部恶性黑色素瘤发病率与手机用户年度增长情况的比较研究表明,在丹麦近50年的登记中,这种罕见癌症的发病率高度稳定。基于这些研究和科学文献,得出结论:职业性暴露于50赫兹EMF与癌症风险增加无关,但这些电磁场、电击或与交流电相关的其他一些未知因素可能与ALS风险有关。没有明确证据表明50赫兹EMF与其他神经退行性或心血管疾病有关。目前,几乎没有证据表明使用手机与成年人患癌症有关,包括脑肿瘤、听神经瘤、唾液腺癌、白血病或眼部恶性黑色素瘤。

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