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接触氯苯氧基除草剂和氯酚的工人的癌症死亡率。

Cancer mortality in workers exposed to chlorophenoxy herbicides and chlorophenols.

作者信息

Saracci R, Kogevinas M, Bertazzi P A, Bueno de Mesquita B H, Coggon D, Green L M, Kauppinen T, L'Abbé K A, Littorin M, Lynge E

机构信息

Unit of Analytical Epidemiology, International Agency for Research on Cancer, Lyon, France.

出版信息

Lancet. 1991 Oct 26;338(8774):1027-32. doi: 10.1016/0140-6736(91)91898-5.

Abstract

Epidemiological studies have revealed an increased risk of cancer, notably soft-tissue sarcomas and non-Hodgkin's lymphomas, in people occupationally exposed to chlorophenoxy herbicides, including those contaminated by 2, 3, 7, 8-tetrachlorodibenzo-p-dioxin (TCDD). We report here a historical cohort study of mortality in an international register of 18,910 production workers or sprayers from ten countries. Exposure was reconstructed through questionnaires, factory or spraying records, and job histories. Cause-specific national death rates were used as reference. No excess was observed in all-cause mortality, for all neoplasms, for the most common epithelial cancers, or for lymphomas. A statistically non-significant two-fold excess risk, based on 4 observed deaths, was noted for soft-tissue sarcoma with a standardised mortality ratio (SMR) of 196 and 95% confidence interval (Cl) 53-502; this was concentrated as a six-fold statistically significant excess, occurring 10-19 years from first exposure in the cohort as a whole (SMR = 606 [165-1552]) and, for the same time period, as a nine-fold excess among sprayers (SMR = 882 [182-2579]). Risks appeared to be increased for cancers of the testicle, thyroid, other endocrine glands, and nose and nasal cavity, based on small numbers of deaths. The excess of soft-tissue sarcomas among sprayers is compatible with a causal role of chlorophenoxy herbicides but the excess does not seem to be specifically associated with those herbicides probably contaminated by TCDD.

摘要

流行病学研究表明,职业接触氯苯氧基除草剂(包括被2,3,7,8 - 四氯二苯并 - p - 二恶英(TCDD)污染的除草剂)的人群患癌症的风险增加,尤其是软组织肉瘤和非霍奇金淋巴瘤。我们在此报告一项针对来自十个国家的18910名生产工人或喷雾器的国际登记册中人员死亡率的历史性队列研究。通过问卷调查、工厂或喷雾记录以及工作经历来重建暴露情况。以特定病因的国家死亡率作为参考。在全因死亡率、所有肿瘤、最常见的上皮癌或淋巴瘤方面均未观察到超额情况。基于4例观察到的死亡病例,软组织肉瘤的标准化死亡比(SMR)为196,95%置信区间(Cl)为53 - 502,观察到统计学上无显著意义的两倍超额风险;这一超额风险集中表现为在整个队列中首次暴露后10 - 19年出现的六倍统计学显著超额风险(SMR = 606 [165 - 1552]),并且在同一时间段内,喷雾器中的超额风险为九倍(SMR = 882 [182 - 2579])。基于少量死亡病例,睾丸、甲状腺、其他内分泌腺以及鼻和鼻腔的癌症风险似乎有所增加。喷雾器中软组织肉瘤的超额风险与氯苯氧基除草剂的因果作用相符,但这种超额风险似乎并非特别与可能被TCDD污染的那些除草剂相关。

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