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新西兰非霍奇金淋巴瘤的高风险职业:病例对照研究。

High risk occupations for non-Hodgkin's lymphoma in New Zealand: case-control study.

作者信息

't Mannetje A, Dryson E, Walls C, McLean D, McKenzie F, Maule M, Cheng S, Cunningham C, Kromhout H, Boffetta P, Blair A, Pearce N

机构信息

Centre for Public Health Research, Massey University Wellington Campus, Private Box 756, Wellington, New Zealand.

出版信息

Occup Environ Med. 2008 May;65(5):354-63. doi: 10.1136/oem.2007.035014. Epub 2007 Nov 21.

Abstract

OBJECTIVES

Previous studies into occupational risk factors for non-Hodgkin's lymphoma (NHL) in New Zealand have indicated that farmers and meat workers are at increased risk for these neoplasms. A new nationwide case-control study was conducted to assess whether previously observed associations persist and to identify other occupations that may contribute to the risk of NHL in the New Zealand population.

METHODS

A total of 291 incident cases of NHL (age 25-70 years) notified to the New Zealand Cancer Registry during 2003 and 2004, and 471 population controls, were interviewed face-to-face. The questionnaire collected demographic information and a full occupational history. The relative risk for NHL associated with ever being employed in particular occupations and industries was calculated by unconditional logistic regression adjusting for age, sex, smoking, ethnicity and socioeconomic status. Estimates were subsequently semi-Bayes adjusted to account for the large number of occupations and industries being considered.

RESULTS

An elevated NHL risk was observed for field crop and vegetable growers (OR 2.74, 95% CI 1.04 to 7.25) and horticulture and fruit growing (OR 2.28, 95% CI 1.37 to 3.79), particularly for women (OR 3.44, 95% CI 0.62 to 18.9; OR 3.15, 95% CI 1.50 to 6.61). Sheep and dairy farming was not associated with an increased risk of NHL. Meat processors had an elevated risk (OR 1.97, 95% CI 0.97 to 3.97), as did heavy truck drivers (OR 1.98, 95% CI 0.92 to 4.24), workers employed in metal product manufacturing (OR 1.92, 95% CI 1.12 to 3.28) and cleaners (OR 2.11, 95% CI 1.21 to 3.65). After semi-Bayes adjustment the elevated risks for horticulture and fruit growing, metal product manufacturing and cleaners remained statistically significant, representing the most robust findings of this study.

CONCLUSIONS

This study has confirmed that crop farmers and meat workers remain high risk occupations for NHL in New Zealand, and has identified several other occupations and industries of high NHL risk that merit further study.

摘要

目的

此前针对新西兰非霍奇金淋巴瘤(NHL)职业风险因素的研究表明,农民和肉类加工工人患这些肿瘤的风险增加。开展了一项新的全国性病例对照研究,以评估此前观察到的关联是否仍然存在,并确定可能导致新西兰人群患NHL风险的其他职业。

方法

对2003年和2004年通知新西兰癌症登记处的总共291例NHL新发病例(年龄25 - 70岁)以及471名人群对照进行了面对面访谈。问卷收集了人口统计学信息和完整的职业史。通过对年龄、性别、吸烟、种族和社会经济地位进行调整的无条件逻辑回归,计算曾从事特定职业和行业与患NHL的相对风险。随后对估计值进行半贝叶斯调整,以考虑所研究的大量职业和行业。

结果

大田作物和蔬菜种植者(比值比2.74,95%置信区间1.04至7.25)以及园艺和水果种植者(比值比2.28,95%置信区间1.37至3.79)患NHL的风险升高,尤其是女性(比值比3.44,95%置信区间0.62至18.9;比值比3.15,95%置信区间1.50至6.61)。养羊和奶牛养殖与NHL风险增加无关。肉类加工人员风险升高(比值比1.97,95%置信区间0.97至3.97),重型卡车司机也是如此(比值比1.98,95%置信区间0.92至4.24),金属制品制造业工人(比值比1.92,95%置信区间1.12至3.28)和清洁工(比值比2.11,95%置信区间1.21至3.65)。经过半贝叶斯调整后园艺和水果种植、金属制品制造业和清洁工的风险升高在统计学上仍具有显著性差异,这是本研究最有力的发现。

结论

本研究证实,作物种植者和肉类加工工人在新西兰仍然是患NHL的高风险职业,并确定了其他几个患NHL高风险的职业和行业,值得进一步研究。

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