Spirtas R, Stewart P A, Lee J S, Marano D E, Forbes C D, Grauman D J, Pettigrew H M, Blair A, Hoover R N, Cohen J L
US National Cancer Institute, NIH.
Br J Ind Med. 1991 Aug;48(8):515-30. doi: 10.1136/oem.48.8.515.
A retrospective cohort study of 14,457 workers at an aircraft maintenance facility was undertaken to evaluate mortality associated with exposures in their workplace. The purpose was to determine whether working with solvents, particularly trichloroethylene, posed any excess risk of mortality. The study group consisted of all civilian employees who worked for at least one year at Hill Air Force Base, Utah, between 1 January 1952 and 31 December 1956. Work histories were obtained from records at the National Personnel Records Centre, St. Louis, Missouri, and the cohort was followed up for ascertainment of vital state until 31 December 1982. Observed deaths among white people were compared with the expected number of deaths, based on the Utah white population, and adjusted for age, sex, and calendar period. Significant deficits occurred for mortality from all causes (SMR 92, 95% confidence interval (95% CI) 90-95), all malignant neoplasms (SMR 90, 95% CI 83-97), ischaemic heart disease (SMR 93, 95% CI 88-98), non-malignant respiratory disease (SMR 87, 95% CI 76-98), and accidents (SMR 61, 95% CI 52-70). Mortality was raised for multiple myeloma (MM) in white women (SMR 236, 95% CI 87-514), non-Hodgkin's lymphoma (NHL) in white women (SMR 212, 95% CI 102-390), and cancer of the biliary passages and liver in white men dying after 1980 (SMR 358, 95% CI 116-836). Detailed analysis of the 6929 employees occupationally exposed to trichloroethylene, the most widely used solvent at the base during the 1950s and 1960s, did not show any significant or persuasive association between several measures of exposure to trichloroethylene and any excess of cancer. Women employed in departments in which fabric cleaning and parachute repair operations were performed had more deaths than expected from MM and NHL. The inconsistent mortality patterns by sex, multiple and overlapping exposures, and small numbers made it difficult to ascribe these excesses to any particular substance. Hypothesis generating results are presented by a variety of exposures for causes of death not showing excesses in the overall cohort.
对一家飞机维修厂的14457名工人进行了一项回顾性队列研究,以评估其工作场所暴露因素与死亡率之间的关系。目的是确定接触溶剂,特别是三氯乙烯,是否会带来任何额外的死亡风险。研究组由1952年1月1日至1956年12月31日期间在犹他州希尔空军基地工作至少一年的所有文职雇员组成。工作经历来自密苏里州圣路易斯市国家人事记录中心的记录,对该队列进行随访以确定生命状态,直至1982年12月31日。将白人中的观察到的死亡人数与基于犹他州白人人口的预期死亡人数进行比较,并根据年龄、性别和日历时间段进行调整。所有原因导致的死亡率出现显著不足(标准化死亡比(SMR)为92,95%置信区间(95%CI)为90 - 95),所有恶性肿瘤(SMR为90,95%CI为83 - 97),缺血性心脏病(SMR为93,95%CI为88 - 98),非恶性呼吸道疾病(SMR为87,95%CI为76 - 98),以及事故(SMR为61,95%CI为52 - 70)。白人女性多发性骨髓瘤(MM)的死亡率升高(SMR为236,95%CI为87 - 514),白人女性非霍奇金淋巴瘤(NHL)的死亡率升高(SMR为212,95%CI为102 - 390),1980年后死亡的白人男性胆管和肝癌的死亡率升高(SMR为358,95%CI为116 - 836)。对6929名职业性接触三氯乙烯的员工进行详细分析,三氯乙烯是20世纪50年代和60年代该基地使用最广泛的溶剂,结果未显示三氯乙烯的几种接触量度与任何癌症过量之间存在任何显著或有说服力的关联。在进行织物清洁和降落伞修理操作的部门工作的女性,其MM和NHL死亡人数高于预期。性别、多种和重叠接触导致的死亡率模式不一致,且人数较少,因此难以将这些过量死亡归因于任何特定物质。对于总体队列中未显示过量的死因,按各种接触情况给出了产生假设的结果。