Gun R T, Pratt N, Ryan P, Roder D
Department of Public Health, University of Adelaide, SA, Australia.
Occup Environ Med. 2006 Jul;63(7):476-81. doi: 10.1136/oem.2005.023796. Epub 2006 May 12.
To update the analysis of the cohort mortality and cancer incidence study of employees in the Australian petroleum industry.
Employees of Australian Institute of Petroleum member companies were enrolled in the cohort in four industry-wide surveys between 1981 and 1999. Mortality of 16,547 males and 1356 females was determined up to 31 December 2001 and cancer incidence to 31 December 2000. Cause specific mortality and cancer incidence were compared with those of the Australian population by means of standardised mortality ratios (SMRs) and standardised incidence ratios (SIRs). Associations between increased incidence of specific cancers and employment in the petroleum industry were tested by trends according to period of first employment, duration of employment, latency, and hydrocarbon exposure, adjusting for personal smoking history where appropriate.
There was a significant elevation of the incidence of mesothelioma (SIR 1.77, 95% CI 1.05 to 2.79), melanoma (SIR 1.37, 95% CI 1.19 to 1.58), and prostate cancer (SIR 1.18, 95% CI 1.04 to 1.34). The SIRs of all leukaemias and of acute non-lymphocytic leukaemia (ANLL) were not significantly different from unity, but all 11 ANLL cases were clustered in the middle to high hydrocarbon exposure categories. Tanker drivers had a significantly elevated incidence of kidney cancer (12 cases v 5.84 expected, SIR 2.05, 95% CI 1.06 to 3.59). Lung cancer incidence was significantly reduced (SIR 0.69, 95% CI 0.57 to 0.83)
Most cases of mesothelioma are probably related to past exposure to asbestos in refineries. No occupational cause has been identified for the excess of melanoma, or prostatic or bladder cancer. The possibility of a causal relationship between cancer of the kidney and hydrocarbon exposure warrants further study. It is uncertain whether benzene exposures, particularly past levels of exposure, have been high enough to cause ANLL.
更新对澳大利亚石油行业员工队列死亡率和癌症发病率的研究分析。
澳大利亚石油学会成员公司的员工在1981年至1999年期间的四次全行业调查中被纳入该队列。截至2001年12月31日确定了16547名男性和1356名女性的死亡率,截至2000年12月31日确定了癌症发病率。通过标准化死亡率(SMR)和标准化发病率(SIR)将特定病因死亡率和癌症发病率与澳大利亚人群进行比较。根据首次就业时间、就业时长、潜伏期和碳氢化合物暴露情况,通过趋势检验特定癌症发病率增加与石油行业就业之间的关联,并在适当情况下对个人吸烟史进行调整。
间皮瘤发病率显著升高(SIR 1.77,95%可信区间1.05至2.79)、黑色素瘤(SIR 1.37,95%可信区间1.19至1.58)和前列腺癌(SIR 1.18,95%可信区间1.04至1.34)。所有白血病和急性非淋巴细胞白血病(ANLL)的SIR与1无显著差异,但所有11例ANLL病例都集中在碳氢化合物暴露中至高类别。油轮司机患肾癌的发病率显著升高(12例,预期5.84例,SIR 2.05,95%可信区间1.06至3.59)。肺癌发病率显著降低(SIR 0.69,95%可信区间0.57至0.83)。
大多数间皮瘤病例可能与过去炼油厂接触石棉有关。尚未确定黑色素瘤、前列腺癌或膀胱癌过多的职业病因。肾癌与碳氢化合物暴露之间存在因果关系的可能性值得进一步研究。苯暴露,尤其是过去的暴露水平是否高到足以导致ANLL尚不确定。