Krstev S, Stewart P, Rusiecki J, Blair A
Occupational and Environmental Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, Department of Health and Human Services, Bethesda, Maryland 20892, USA.
Occup Environ Med. 2007 Oct;64(10):651-8. doi: 10.1136/oem.2006.029652.
BACKGROUND: The mortality experience of 4702 (4413 men and 289 women) civilian workers in a US Coast Guard shipyard was evaluated. METHODS: All workers employed at the shipyard between 1 January 1950 and 31 December 1964 were included in the study and were followed through 31 December 2001 for vital status. Detailed shipyard and lifetime work histories found in the shipyard personnel records and job descriptions were evaluated. Workers were classified as likely exposed to any potential hazardous substances. In addition, 20 job groups were created on likely similar exposures. Standardised mortality ratios (SMRs) were calculated based on the general population of the state and adjusted for age, calendar period, sex and race. RESULTS: The follow-up was successful for 93.3% of the workers. Among all men employed in the shipyard, there was an excess of mortality from all causes of death (SMR 1.08; 95% CI 1.04 to 1.12), respiratory cancers (SMR 1.29; 95% CI 1.15 to 1.43), lung cancer (SMR 1.26; 95% CI 1.12 to 1.41), mesothelioma (SMR 5.07; 95% CI 1.85 to 11.03) and emphysema (SMR 1.44; 95% CI 1.01 to 1.99) and a decrease for cardiovascular diseases (OR 0.95; 95% CI 0.90 to 1.00), vascular lesions of the central nervous system (SMR 0.80; 95% CI 0.67 to 0.96), cirrhosis of the liver (SMR 0.38; 95% CI 0.25 to 0.57) and external causes of death (SMR 0.55; 95% CI 0.44 to 0.68). A similar pattern was observed for the men classified as exposed. No increasing trend of mortality was found with duration of employment in the shipyard, with the exception of mesothelioma (SMRs of 4.23 and 6.27 for <10 years and > or =10 years, respectively). In occupations with at least three cases and with an SMR of > or =1.3, the authors observed a significantly elevated mortality for lung cancer among machinists (SMR 1.60; 95% CI 1.08 to 2.29) and shipfitters, welders and cutters (SMR 1.34; 95% CI 1.07 to 1.65) and for oral and nasopharyngeal cancers among wood workers (SMR 6.20; 95% CI 2.27 to 13.50). CONCLUSION: Employment in this Coast Guard shipyard revealed a small but significant excess mortality from all causes, lung cancer and mesothelioma, most of which is probably related to asbestos exposure.
背景：对美国海岸警卫队造船厂的4702名（4413名男性和289名女性）文职工人的死亡情况进行了评估。 方法：本研究纳入了1950年1月1日至1964年12月31日期间在该造船厂工作的所有工人，并对其进行随访直至2001年12月31日以了解其生命状态。对造船厂人员记录和工作描述中详细的造船厂工作经历和终生工作经历进行了评估。将工人分类为可能接触任何潜在有害物质的人群。此外，根据可能相似的接触情况创建了20个工作群组。基于该州的总体人群计算标准化死亡比（SMR），并对年龄、日历时间、性别和种族进行了调整。 结果：93.3%的工人随访成功。在该造船厂工作过的所有男性中，所有死因的死亡率均有升高（标准化死亡比为1.08；95%置信区间为1.04至1.12），呼吸道癌症（标准化死亡比为1.29；95%置信区间为1.15至1.43）、肺癌（标准化死亡比为1.26；95%置信区间为1.12至1.41）、间皮瘤（标准化死亡比为5.07；95%置信区间为1.85至11.03）和肺气肿（标准化死亡比为1.44；95%置信区间为1.01至1.99），而心血管疾病（比值比为0.95；95%置信区间为0.90至1.00）、中枢神经系统血管病变（标准化死亡比为0.80；95%置信区间为0.67至0.96）、肝硬化（标准化死亡比为0.38；95%置信区间为0.25至0.57）和外部死因（标准化死亡比为0.55；95%置信区间为0.44至0.68）的死亡率有所下降。在被分类为接触者的男性中也观察到了类似的模式。除间皮瘤外（工作<10年和≥10年的标准化死亡比分别为4.23和6.27），未发现死亡率随在造船厂工作时间的延长而呈上升趋势。在至少有3例病例且标准化死亡比≥1.3的职业中，作者观察到机械师（标准化死亡比为1.60；95%置信区间为1.08至2.29）以及船体装配工、焊工和切割工（标准化死亡比为1.34；95%置信区间为1.07至1.65）的肺癌死亡率显著升高，而木工的口腔和鼻咽癌死亡率显著升高（标准化死亡比为6.20；95%置信区间为2.27至13.50）。 结论：在这家海岸警卫队造船厂工作显示，所有死因、肺癌和间皮瘤的死亡率虽略有升高但具有显著意义，其中大部分可能与石棉接触有关。
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