Hein Misty J, Stayner Leslie T, Lehman Everett, Dement John M
Industrywide Studies Branch, Division of Surveillance, Hazard Evaluations and Field Studies, National Institute for Occupational Safety and Health, Cincinnati, Ohio 45226, USA.
Occup Environ Med. 2007 Sep;64(9):616-25. doi: 10.1136/oem.2006.031005. Epub 2007 Apr 20.
This report provides an update of the mortality experience of a cohort of South Carolina asbestos textile workers.
A cohort of 3072 workers exposed to chrysotile in a South Carolina asbestos textile plant (1916-77) was followed up for mortality through 2001. Standardised mortality ratios (SMRs) were computed using US and South Carolina mortality rates. A job exposure matrix provided calendar time dependent estimates of chrysotile exposure concentrations. Poisson regression models were fitted for lung cancer and asbestosis. Covariates considered included sex, race, age, calendar time, birth cohort and time since first exposure. Cumulative exposure lags of 5 and 10 years were considered by disregarding exposure in the most recent 5 and 10 years, respectively.
A majority of the cohort was deceased (64%) and 702 of the 1961 deaths occurred since the previous update. Mortality was elevated based on US referent rates for a priori causes of interest including all causes combined (SMR 1.33, 95% CI 1.28 to 1.39); all cancers (SMR 1.27, 95% CI 1.16 to 1.39); oesophageal cancer (SMR 1.87, 95% CI 1.09 to 2.99); lung cancer (SMR 1.95, 95% CI 1.68 to 2.24); ischaemic heart disease (SMR 1.20, 95% CI 1.10 to 1.32); and pneumoconiosis and other respiratory diseases (SMR 4.81, 95% CI 3.84 to 5.94). Mortality remained elevated for these causes when South Carolina referent rates were used. Three cases of mesothelioma were observed among cohort members. Exposure-response modelling for lung cancer, using a linear relative risk model, produced a slope coefficient of 0.0198 (fibre-years/ml) (standard error 0.00496), when cumulative exposure was lagged 10 years. Poisson regression modelling confirmed significant positive relations between estimated chrysotile exposure and lung cancer and asbestosis mortality observed in previous updates of this cohort.
This study confirms the findings from previous investigations of excess mortality from lung cancer and asbestosis and a strong exposure-response relation between estimated exposure to chrysotile and mortality from lung cancer and asbestosis.
本报告提供了南卡罗来纳州石棉纺织工人队列死亡率情况的最新信息。
对南卡罗来纳州一家石棉纺织厂（1916 - 1977年）接触温石棉的3072名工人队列进行随访，直至2001年的死亡率情况。使用美国和南卡罗来纳州的死亡率计算标准化死亡率（SMR）。工作接触矩阵提供了随日历时间变化的温石棉接触浓度估计值。对肺癌和石棉沉着病拟合泊松回归模型。考虑的协变量包括性别、种族、年龄、日历时间、出生队列以及首次接触后的时间。分别通过忽略最近5年和10年的接触情况，考虑了5年和10年的累积接触滞后。
该队列中的大多数人已死亡（64%），自上次更新以来，1961例死亡中有702例发生。基于美国参考率，对于预先设定的感兴趣病因，死亡率有所升高，包括所有病因综合（标准化死亡率1.33，95%置信区间1.28至1.39）；所有癌症（标准化死亡率1.27，95%置信区间1.16至1.39）；食管癌（标准化死亡率1.87，95%置信区间1.09至2.99）；肺癌（标准化死亡率1.95，95%置信区间1.68至2.24）；缺血性心脏病（标准化死亡率1.20，95%置信区间1.10至1.32）；以及尘肺病和其他呼吸系统疾病（标准化死亡率为4.81，95%置信区间3.84至5.94）。使用南卡罗来纳州参考率时，这些病因的死亡率仍然升高。在队列成员中观察到3例间皮瘤病例。对于肺癌的暴露 - 反应建模，使用线性相对风险模型，当累积接触滞后10年时，斜率系数为0.0198（纤维 - 年/毫升）（标准误差0.00496）。泊松回归建模证实了在该队列先前更新中观察到的估计温石棉接触与肺癌和石棉沉着病死亡率之间存在显著的正相关关系。
本研究证实了先前关于肺癌和石棉沉着病超额死亡率调查的结果，以及估计的温石棉接触与肺癌和石棉沉着病死亡率之间存在强烈的暴露 - 反应关系。
