Burns P B, Swanson G M
College of Human Medicine, Michigan State University, East Lansing 48824-1316.
Am J Ind Med. 1991;19(5):655-71. doi: 10.1002/ajim.4700190510.
This case-referent study assesses occupational risk factors associated with lung cancer, utilizing colon and rectum cancer referents. Complete occupational and tobacco use histories were obtained by telephone interview for 5,935 incident lung cancer cases and 3,956 incident colon and rectum cancer referents. The analysis included 43 usual occupational groups and 48 usual industry groups comprised of at least 10 cases. Among all cases, there were significant elevated risks for excavating and mining workers (OR = 4.01), furnace workers (OR = 3.11), armed services personnel (OR = 3.10), agricultural workers (OR = 2.05), driver sales (OR = 2.21), mechanics (OR = 1.72), painters (OR = 1.96), and drivers (OR = 1.88). Industries with significant elevated lung cancer risk included farming (OR = 2.21), mining (OR = 2.98), and primary ferrous metals manufacturing (OR = 2.43). Analyses of white and black men separately revealed that the excess of lung cancer among mechanics is restricted to black males (OR = 4.16). The risk of lung cancer among armed services personnel is higher among black men (OR = 10.54) than among white men (OR = 3.06). Five of the occupations observed more often among lung cancer cases have probable exposure to diesel exhaust.
这项病例对照研究利用结肠癌和直肠癌对照评估了与肺癌相关的职业风险因素。通过电话访谈获取了5935例肺癌新发病例和3956例结肠癌和直肠癌对照的完整职业史和烟草使用史。分析包括43个常见职业组和48个常见行业组，每组至少有10例病例。在所有病例中，挖掘和采矿工人（比值比=4.01）、熔炉工人（比值比=3.11）、武装部队人员（比值比=3.10）、农业工人（比值比=2.05）、司机销售员（比值比=2.21）、机械师（比值比=1.72）、油漆工（比值比=1.96）和司机（比值比=1.88）的风险显著升高。肺癌风险显著升高的行业包括农业（比值比=2.21）、采矿（比值比=2.98）和黑色金属初级制造业（比值比=2.43）。分别对白人男性和黑人男性进行分析发现，机械师中肺癌过量仅局限于黑人男性（比值比=4.16）。武装部队人员中，黑人男性的肺癌风险（比值比=10.54）高于白人男性（比值比=3.06）。在肺癌病例中更常观察到的职业中有5种可能接触柴油废气。
