Sorahan T, Kinlen L J, Doll R
Institute of Occupational and Environmental Medicine, University of Birmingham, Edgbaston, Birmingham B15 2TT, UK.
Occup Environ Med. 2005 Apr;62(4):231-6. doi: 10.1136/oem.2004.015628.
To examine mortality from different causes and cancer incidence among a cohort of benzene workers in England and Wales.
A cohort of 5514 workers who had been occupationally exposed to benzene in 1966/67 or earlier was assembled by the former Factory Inspectorate and the Medical Research Council from details provided by 233 employers in England and Wales. The cohort was followed up for mortality (1968-2002) and cancer registrations (1971-2001). National mortality rates and cancer registration (incidence) rates were used to calculate standardised mortality ratios and standardised registration ratios.
Mortality was close to expectation for all causes and significantly increased for cancer of the lip, cancer of the lung and bronchus, secondary and unspecified cancers, acute non-lymphocytic leukaemia (ANLL), and all neoplasms. Significant deficits were shown for three non-malignant categories (mental disorders, diseases of the digestive system, accidents). SMRs for other leukaemia, lymphomas, and multiple myeloma were close to or below expectation. There was some evidence of under-ascertainment of cancer registrations, although significantly increased SRRs were shown for lung cancer and cancer of the pleura (mesothelioma).
Many study subjects would have been exposed to carcinogens other than benzene (for example, asbestos, rubber industry fumes, foundry fumes, polycyclic aromatic hydrocarbons), and the excesses of lung cancer and mesothelioma are likely to reflect exposures to these other carcinogens. The carcinogenic effects of benzene exposure on the lymphohaematopoietic system were limited to ANLL.
研究英格兰和威尔士一组苯作业工人的不同病因死亡率及癌症发病率。
前工厂监察局和医学研究理事会根据英格兰和威尔士233家雇主提供的详细信息,组建了一组在1966/67年或更早时期职业性接触苯的5514名工人。对该队列进行了死亡率随访(1968 - 2002年)和癌症登记(1971 - 2001年)。使用全国死亡率和癌症登记(发病率)率来计算标准化死亡率比和标准化登记率。
所有病因的死亡率接近预期,但唇癌、肺癌和支气管癌、继发性和未明确的癌症、急性非淋巴细胞白血病(ANLL)以及所有肿瘤的死亡率显著增加。三个非恶性类别(精神障碍、消化系统疾病、事故)显示出显著的死亡率不足。其他白血病、淋巴瘤和多发性骨髓瘤的标准化死亡率比接近或低于预期。有证据表明癌症登记存在漏报情况,尽管肺癌和胸膜癌(间皮瘤)的标准化登记率显著增加。
许多研究对象可能接触了苯以外的致癌物(如石棉、橡胶工业烟雾、铸造烟雾、多环芳烃),肺癌和间皮瘤的超额发病率可能反映了对这些其他致癌物的接触。苯接触对淋巴造血系统的致癌作用仅限于急性非淋巴细胞白血病。