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某大学实验室淋巴造血系统癌症的发病率:一项聚集性调查。

Incidence of lymphohaematopoietic cancer at a university laboratory: a cluster investigation.

作者信息

Kristensen Petter, Hilt Bjørn, Svendsen Kristin, Grimsrud Tom K

机构信息

National Institute of Occupational Health, Gydas vei 8, Oslo, Norway.

出版信息

Eur J Epidemiol. 2008;23(1):11-5. doi: 10.1007/s10654-007-9203-5. Epub 2007 Nov 6.

Abstract

We investigated a suspected cluster of lymphohaematopoietic cancer in departments of biology and chemistry at a Norwegian university. A historical cohort of students and employees (n = 7,189) were followed for cancer for 96,936 person-years in the Cancer Registry of Norway. Overall, 12 cases of lymphohaematopoietic cancer were identified, which was close to the expected number (standardised incidence ratio 1.1, 95% confidence interval (CI) 0.6-1.9). The SIR for leukaemia was 1.8 (95% CI 0.6-4.2) whereas incidences for non-Hodgkin lymphoma and Hodgkin's disease incidence were close to the expected. Distinct rate differences were observed in subgroups, and the strongest adjusted associations were found for Ph.D. students (rate ratio (RR) = 4.8, 95% CI 1.1-20.3) and students who participated in basic organic chemistry laboratory course (RR = 4.4, 95% CI 1.2-18.8). The latter category was identified a priori because it was the only student activity with known use of benzene according to the university administration. This is an observational study with some limitations, and hence, caution is warranted when drawing inferences on the causal relationship between university activities and cancers under study. The study provides an example that cluster investigations can answer questions of public importance despite a more limited value regarding causal inference.

摘要

我们对挪威一所大学的生物与化学系中疑似淋巴造血系统癌症聚集情况展开了调查。在挪威癌症登记处,对一个由学生和员工组成的历史队列(n = 7189)进行了为期96936人年的癌症随访。总体而言,共确诊了12例淋巴造血系统癌症病例,这与预期数量相近(标准化发病比为1.1,95%置信区间(CI)为0.6 - 1.9)。白血病的标准化发病比为1.8(95%CI为0.6 - 4.2),而非霍奇金淋巴瘤和霍奇金病的发病率则接近预期。在亚组中观察到了明显的发病率差异,调整后关联最强的是博士生(发病率比(RR)= 4.8,95%CI为1.1 - 20.3)以及参加基础有机化学实验课程的学生(RR = 4.4,95%CI为1.2 - 18.8)。后一类学生是预先确定的,因为据大学管理部门称,这是唯一已知使用苯的学生活动。这是一项存在一些局限性的观察性研究,因此,在推断大学活动与所研究癌症之间的因果关系时需谨慎。该研究提供了一个例子,即尽管在因果推断方面价值较为有限,但聚集性调查仍可回答具有公共重要性的问题。

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