Sorahan T, Williams S P
Institute of Occupational and Environmental Medicine, University of Birmingham, Edgbaston, Birmingham B15 2TT, UK.
Occup Environ Med. 2005 Feb;62(2):80-5. doi: 10.1136/oem.2004.014985.
Excess risks of respiratory cancer have been shown in some groups of nickel exposed workers. It is clear, however, that not all forms of nickel exposure are implicated in these excess risks.
To determine whether occupational exposures received in a modern nickel carbonyl refinery lead to increased risks of cancer, in particular nasal cancer and lung cancer.
The mortality experienced by a cohort of 812 workers employed at a nickel refinery was investigated. Study subjects were all male workforce employees first employed in the period 1953-92 who had at least five years' employment with the company. Observed numbers of cause specific deaths were compared with expectations based on national mortality rates; SMRs were also calculated by period from commencing employment, year of commencing employment, and type of work.
Overall, standardised mortality ratios (SMRs) were close to 100 for all causes (Obs 191, SMR 96, 95% CI 83 to 111), all neoplasms (Obs 63, SMR 104, 95% CI 80 to 133), non-malignant diseases of the respiratory system (Obs 18, SMR 97, 95% CI 57 to 153), and diseases of the circulatory system (Obs 85, SMR 94, 95% CI 75 to 116). There were no significantly increased SMRs for any site of cancer. There was a non-significant excess for lung cancer (Obs 28, Exp 20.17, SMR 139, 95% CI 92 to 201), and in subgroup analyses a significantly increased SMR of 231 (Obs 9) was found for those 142 workers with at least five years' employment in the feed handling and nickel extraction departments. In the total cohort there was a single death from nasal cancer (Exp 0.10).
The non-significant excess of lung cancer deaths may well be a chance finding, but in light of previous studies some role for nickel exposures cannot be excluded.
在一些接触镍的工人群体中已显示出呼吸道癌症的额外风险。然而,很明显并非所有形式的镍接触都与这些额外风险有关。
确定在现代羰基镍精炼厂中的职业接触是否会导致癌症风险增加,尤其是鼻癌和肺癌。
对一家镍精炼厂的812名工人组成的队列的死亡率进行了调查。研究对象均为1953年至1992年期间首次受雇且在该公司至少工作五年的男性员工。将特定病因的死亡观察数与基于全国死亡率的预期数进行比较;还按开始工作的时间段、开始工作年份和工作类型计算标准化死亡比(SMR)。
总体而言,所有病因的标准化死亡比(SMR)接近100(观察值191,SMR 96,95%置信区间83至111),所有肿瘤(观察值63,SMR 104,95%置信区间80至133),呼吸系统非恶性疾病(观察值18,SMR 97,95%置信区间57至153),以及循环系统疾病(观察值85,SMR 94,95%置信区间75至116)。任何癌症部位的SMR均未显著增加。肺癌有非显著的超额情况(观察值28,预期值20.17,SMR 139,95%置信区间92至201),在亚组分析中,发现142名在进料处理和镍提取部门至少工作五年的工人的SMR显著增加至231(观察值9)。在整个队列中,有1例鼻癌死亡(预期值0.10)。
肺癌死亡的非显著超额很可能是偶然发现,但鉴于先前的研究,不能排除镍接触的某种作用。