Richardson David B, Wing Steve, Wolf Susanne
Department of Epidemiology, School of Public Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina 27599, USA.
Am J Ind Med. 2007 Dec;50(12):881-91. doi: 10.1002/ajim.20511.
Workers employed at the Savannah River Site (SRS) were potentially exposed to a range of chemical and physical hazards, many of which are poorly characterized. We therefore compared the observed deaths among workers to expectations based upon death rates for referent populations.
The cohort included 18,883 SRS workers hired between 1950 and 1986. Vital status and cause of death information were ascertained through 2002. Sex-specific standardized mortality ratios (SMR) were computed using U.S. and South Carolina mortality rates. SMRs were tabulated separately for monthly-, weekly-, and hourly-paid men.
Males had fewer deaths from all causes [SMR=0.80, 90% confidence interval (CI): 0.78, 0.82], all cancers (SMR=0.85, 90% CI: 0.81, 0.89), and lung cancer (SMR=0.88, 90% CI: 0.82, 0.95) than expected based upon US mortality rates. The SMR for cancer of the pleura was 4.25 (90% CI: 1.99, 7.97) for men. The SMR for leukemia was greater than unity for monthly-paid (SMR=1.33, 90% CI: 0.88, 1.93) and hourly-paid (SMR=1.36, 90% CI: 1.02, 1.78) men. Female workers had fewer deaths from all causes (SMR=0.75, 90% CI: 0.69, 0.82) than expected, but more deaths than expected from cancer of the kidney (SMR=2.58, 90% CI: 1.21, 4.84) and skin (SMR=3.90, 90% CI: 2.11, 6.61).
While the observed numbers of deaths in most categories of cause of death were less than expected, there are greater than expected numbers of deaths due to cancer of the pleura and leukemia, particularly among hourly-paid male workers. It is plausible that occupational hazards, including asbestos and ionizing radiation, contribute to these excesses.
在萨凡纳河工厂(SRS)工作的工人可能接触到一系列化学和物理危害,其中许多危害的特征尚不明确。因此,我们将工人中的观察到的死亡人数与基于参考人群死亡率的预期人数进行了比较。
该队列包括1950年至1986年间雇佣的18,883名SRS工人。通过2002年确定了生命状态和死亡原因信息。使用美国和南卡罗来纳州的死亡率计算了按性别划分的标准化死亡率(SMR)。分别列出了月薪、周薪和时薪男性的SMR。
与基于美国死亡率的预期相比,男性因所有原因导致的死亡人数较少[SMR = 0.80,90%置信区间(CI):0.78,0.82],所有癌症(SMR = 0.85,90% CI:0.81,0.89)和肺癌(SMR = 0.88,90% CI:0.82,0.95)。男性胸膜癌的SMR为4.25(90% CI:1.99,7.97)。月薪男性(SMR = 1.33,90% CI:0.88,1.93)和时薪男性(SMR = 1.36,90% CI:1.02,1.78)的白血病SMR大于1。女性工人因所有原因导致的死亡人数比预期少(SMR = 0.75,90% CI:0.69,0.82),但因肾癌(SMR = 2.58,90% CI:1.21,4.84)和皮肤癌(SMR = 3.90,90% CI:2.11,6.61)导致的死亡人数比预期多。
虽然大多数死因类别中的观察到的死亡人数少于预期,但因胸膜癌和白血病导致的死亡人数高于预期,特别是在时薪男性工人中。包括石棉和电离辐射在内的职业危害导致这些超额死亡是合理的。