Davies J M, Easton D F, Bidstrup P L
Section of Epidemiology, Institute of Cancer Research, Sutton, Surrey.
Br J Ind Med. 1991 May;48(5):299-313. doi: 10.1136/oem.48.5.299.
This report updates a 1981 study of mortality at three United Kingdom chromate producing factories, and pays special attention to workers engaged after major plant and process changes were completed during 1958-60. The study covers 2298 payroll workers in post on 1 January 1950 or entering employment up to 30 June 1976 and remaining at least one year, with mortality observed up to 31 December 1988. Expected numbers of deaths were calculated from national death rates adjusted for social class and area differences. At the two largest factories 1422 men starting work before the process changes showed a highly significant excess of deaths from lung cancer (observed deaths/adjusted expected deaths (obs/expA) 175/88.97, adjusted standardised mortality ratio (SMRA) 197). They also had a significant excess of deaths from nasal cancer (obs/expA 4/0.26, SMRA 1538); the four affected men all had over 20 years of employment. Six hundred and seventy seven men starting work after the completion of process changes showed no excess of lung cancer deaths (obs/expA 14/13.7, SMRA 102, 95% confidence interval (95% CI) 56-171), but the possibility of the risk persisting at a reduced level cannot be excluded. The risk among earlier entrants affected men with two or more years of employment and was highest among those working for 10 years or longer (SMRA 225). The relative risk was already raised 5-14 years after first employment; it was highest in the 25-40 year period, but was still raised 50 years after first exposure. The risk showed most clearly at young ages, with a SMRA of 355 for ages under 50 (obs/expA 21/5.91). The excess was greater among men in jobs with high exposure to chromates (obs/expA 151/61.73, SMRA 245) than among men in less exposed jobs (obs/expA 21/19.57, SMRA 107). Less evidence of a lung cancer excess was found among 199 men employed at a third small factory (obs/expA 12/9.91, SMRA 121). No risk was apparent in further groups of 214 salaried works staff (obs/expA 1/2.53), or 95 workers at an adjacent fertiliser plant (obs/expA 3/3.95). No significant excesses of deaths from cancers of other sites were found.
本报告更新了1981年对英国三家铬酸盐生产厂死亡率的研究,并特别关注了1958 - 1960年主要工厂和生产流程变更完成后入职的工人。该研究涵盖了1950年1月1日在职或截至1976年6月30日入职且至少工作一年的2298名在册工人,观察其死亡率直至1988年12月31日。预期死亡人数根据针对社会阶层和地区差异调整后的全国死亡率计算得出。在两家最大的工厂,1422名在流程变更前开始工作的男性显示出肺癌死亡人数显著过多(观察到的死亡人数/调整后的预期死亡人数(obs/expA)为175/88.97,调整后的标准化死亡率(SMRA)为197)。他们的鼻癌死亡人数也显著过多(obs/expA为4/0.26,SMRA为1538);4名患病男性的工作年限均超过20年。677名在流程变更完成后开始工作的男性未显示出肺癌死亡人数过多(obs/expA为14/13.7,SMRA为102,95%置信区间(95%CI)为56 - 171),但不能排除风险在较低水平持续存在的可能性。早期入职者中的风险影响了工作两年或更长时间的男性,在工作10年或更长时间的男性中风险最高(SMRA为225)。首次就业后5 - 14年相对风险就已升高;在25 - 40岁期间最高,但首次接触后50年仍有升高。风险在年轻时最为明显,50岁以下人群的SMRA为355(obs/expA为21/5.91)。与接触铬酸盐较少的工作岗位上的男性相比(obs/expA为21/19.57,SMRA为107),从事高暴露工作岗位的男性中肺癌死亡人数过多的情况更严重(obs/expA为151/61.73,SMRA为245)。在第三家小工厂工作的199名男性中,肺癌死亡人数过多的证据较少(obs/expA为12/9.91,SMRA为121)。在另外214名受薪工作人员群体(obs/expA为1/2.53)或相邻化肥厂的95名工人中(obs/expA为3/3.95)未发现明显风险。未发现其他部位癌症死亡人数有显著过多的情况。