Laakkonen A, Kyyrönen P, Kauppinen T, Pukkala E I
Finnish Institute of Occupational Health, Department of Epidemiology and Biostatistics, Helsinki, Finland.
Occup Environ Med. 2006 Nov;63(11):726-33. doi: 10.1136/oem.2005.025825. Epub 2006 Apr 6.
BACKGROUND: There is inconclusive evidence concerning cancer risks of organic dusts. AIM: The carcinogenic exposures are mainly inhalatory and the authors therefore studied associations between occupational exposure to eight different organic dusts and respiratory cancers in Finland. METHODS: The authors followed up a cohort of all economically active Finns born between 1906 and 1945 for 30 million person-years during 1971-95. Incident cases of nasal, laryngeal, and lung cancer and mesotheliomas were identified through a record linkage with the Finnish Cancer Registry. Occupations from the population census in 1970 were converted to exposures to eight organic dusts with a job-exposure matrix (FINJEM). Cumulative exposure (CE) was calculated as a product of prevalence, level, and estimated duration of exposure. Standardised incidence ratios (SIR) and 95% confidence intervals (CI) adjusted for age, period, and social class were calculated for each organic dust using the economically active population as the reference. RESULTS: A total of 20 426 incident cases of respiratory cancer were observed. Slightly increased risk was observed among men exposed to wood dust for nasal cancer (SIR 1.42, 95% CI 0.79 to 2.44). For laryngeal cancer, men exposed to plant dust (mainly grain millers) had a raised SIR in the high exposure class (SIR 3.55, 95% CI 1.30 to 7.72). Men exposed to wood dust had a raised SIR for lung cancer, but only in the low exposure class (SIR 1.11, 95% CI 1.04 to 1.18). Women exposed to wood dust showed an increased SIR for mesotheliomas in the low exposure class (SIR 4.57, 95% CI 1.25 to 11.7) and some excess in the medium exposure category. CONCLUSIONS: Exposure to organic dusts is unlikely to be a major risk factor of respiratory cancer. Even exposure to wood dust which is a major exposure in Finland seems to have minor effect for nasal cancer. The authors found suggestive evidence that exposure to grain dust may increase the risk of laryngeal cancer, and some support to the hypothesis that exposure to textile dust, and to plant and animal dust (agricultural dusts) may decrease the risk of lung cancer.
背景：关于有机粉尘致癌风险的证据尚无定论。 目的：致癌暴露主要通过吸入途径，因此作者研究了芬兰职业接触八种不同有机粉尘与呼吸道癌症之间的关联。 方法：作者对1906年至1945年间出生的所有有经济活动的芬兰人组成的队列进行了随访，随访时间为1971年至1995年，共3000万人年。通过与芬兰癌症登记处的记录链接，确定了鼻癌、喉癌、肺癌和间皮瘤的发病病例。利用工作暴露矩阵（FINJEM）将1970年人口普查中的职业转换为对八种有机粉尘的暴露。累积暴露量（CE）通过暴露患病率、暴露水平和估计暴露持续时间的乘积计算得出。以有经济活动的人群为参照，计算每种有机粉尘经年龄、时期和社会阶层调整后的标准化发病比（SIR）和95%置信区间（CI）。 结果：共观察到20426例呼吸道癌症发病病例。暴露于木尘的男性患鼻癌的风险略有增加（SIR 1.42，95%CI 0.79至2.44）。对于喉癌，暴露于植物粉尘（主要是谷物磨坊工人）的男性在高暴露组中的SIR升高（SIR 3.55，95%CI 1.30至7.72）。暴露于木尘的男性患肺癌的SIR升高，但仅在低暴露组（SIR 1.11，95%CI 1.04至1.18）。暴露于木尘的女性在低暴露组中间皮瘤的SIR增加（SIR 4.57，95%CI 1.25至11.7），在中等暴露组中有一些超额风险。 结论：接触有机粉尘不太可能是呼吸道癌症的主要危险因素。即使在芬兰，木尘是主要暴露源，其对鼻癌的影响似乎也较小。作者发现有提示性证据表明，接触谷物粉尘可能增加患喉癌的风险，并且有一些证据支持这样的假设，即接触纺织粉尘、植物和动物粉尘（农业粉尘）可能降低患肺癌的风险。
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