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波兰一家石棉加工厂工人的恶性肿瘤死亡率:长期观察结果

Mortality from malignant neoplasms among workers of an asbestos processing plant in Poland: results of prolonged observation.

作者信息

Wilczyńska Urszula, Szymczak Wiesław, Szeszenia-Dabrowska Neonila

机构信息

Department of Environmental Epidemiology, Nofer Institute of Occupational Medicine, Lódź, Poland.

出版信息

Int J Occup Med Environ Health. 2005;18(4):313-26.

Abstract

OBJECTIVES

The study on mortality from cancer among workers of an asbestos plant manufacturing asbestos yarn, cloth, cords, packings, stuffing, brake linings and asbestos-rubber sheets was launched in the 1980s. The present paper discusses the results of further tracing of asbestos workers of the same plant.

MATERIALS AND METHODS

The study cohort covered 4497 workers employed at the asbestos plant in 1945-1980. The follow-up of the cohort continued until 31 December 1999. Deaths by causes were analyzed using standardized mortality ratio (SMR) calculated by the person-years method. The mortality pattern of the general population of Poland was used as reference.

RESULTS

The availability of the cohort was 93.1% (2805 men and 1382 women were traced). Mortality from malignant neoplasms in total (281 deaths among men, SMR = 118, 95%CI: 105-133 and 135 deaths among women, SMR = 159, 95%CI: 133-188) as well as that from lung cancer (102 deaths among men, SMR = 126, 95%CI: 103-153 and 18 deaths among women, SMR = 259, 95%CI: 153-409) were significantly higher than in the general population. Unlike earlier stages of analysis, the present study revealed an increased risk of pleural mesothelioma (2 deaths among men, SMR = 510, 95%CI: 62-1842 and 3 deaths among women, SMR = 2033, 95%CI: 419-5941). Mortality analysis among workers with asbestosis and in those without diagnosed asbestosis, did not reveal direct association between the risk of asbestos-induced lung cancer and previously diagnosed asbestosis.

CONCLUSIONS

The prolonged cohort tracing showed an increased risk of asbestos-related cancers. It concerned mainly workers hired by the plant between 1945-1955, when the working condition were most strenuous.

摘要

目的

20世纪80年代开展了一项针对一家生产石棉纱、布、绳索、填料、填充物、刹车片和石棉橡胶板的石棉厂工人癌症死亡率的研究。本文讨论了对同一家工厂石棉工人进一步追踪的结果。

材料与方法

研究队列涵盖了1945年至1980年期间受雇于该石棉厂的4497名工人。对该队列的随访持续到1999年12月31日。采用人年法计算标准化死亡比(SMR),分析按病因分类的死亡情况。以波兰普通人群的死亡率模式作为对照。

结果

该队列的可获得率为93.1%(追踪到2805名男性和1382名女性)。总体恶性肿瘤死亡率(男性281例死亡,SMR = 118,95%CI:105 - 133;女性135例死亡,SMR = 159,95%CI:133 - 188)以及肺癌死亡率(男性102例死亡,SMR = 126,95%CI:103 - 153;女性18例死亡,SMR = 259,95%CI:153 - 409)均显著高于普通人群。与早期分析阶段不同,本研究显示胸膜间皮瘤风险增加(男性2例死亡,SMR = 510,95%CI:62 - 1842;女性3例死亡,SMR = 2033,95%CI:419 - 5941)。对患有石棉肺的工人和未被诊断为石棉肺的工人进行死亡率分析,未发现石棉所致肺癌风险与先前诊断的石棉肺之间存在直接关联。

结论

延长队列追踪显示与石棉相关癌症的风险增加。主要涉及1945年至1955年期间该厂雇佣的工人,当时工作条件最为艰苦。

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