三氯乙烯职业暴露与非霍奇金淋巴瘤的病例对照研究。
A case-control study of occupational exposure to trichloroethylene and non-Hodgkin lymphoma.
机构信息
Division of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, Maryland 20892, USA.
出版信息
Environ Health Perspect. 2011 Feb;119(2):232-8. doi: 10.1289/ehp.1002106.
BACKGROUND
Previous epidemiologic findings suggest an association between exposure to trichloroethylene (TCE), a chlorinated solvent primarily used for vapor degreasing of metal parts, and non-Hodgkin lymphoma (NHL).
OBJECTIVES
We investigated the association between occupational TCE exposure and NHL within a population-based case-control study using detailed exposure assessment methods.
METHODS
Cases (n = 1,189; 76% participation rate) and controls (n = 982; 52% participation rate) provided information on their occupational histories and, for selected occupations, on possible workplace exposure to TCE using job-specific interview modules. An industrial hygienist assessed potential TCE exposure based on this information and a review of the TCE industrial hygiene literature. We computed odds ratios (ORs) and 95% confidence intervals (CIs) relating NHL and different metrics of estimated TCE exposure, categorized using tertiles among exposed controls, with unexposed subjects as the reference group.
RESULTS
We observed associations with NHL for the highest tertiles of estimated average weekly exposure (23 exposed cases; OR = 2.5; 95% CI, 1.1–6.1) and cumulative exposure (24 exposed cases; OR = 2.3; 95% CI, 1.0-5.0) to TCE. Tests for trend with these metrics surpassed or approached statistical significance (p-value for trend = 0.02 and 0.08, respectively); however, we did not observe dose–response relationships across the exposure levels. Overall, neither duration nor intensity of exposure was associated with NHL, although we observed an association with the lowest tertile of exposure duration (OR = 2.1; 95% CI, 1.0-4.7).
CONCLUSIONS
Our findings offer additional support for an association between high levels of exposure to TCE and increased risk of NHL. However, we cannot rule out the possibility of confounding from other chlorinated solvents used for vapor degreasing and note that our exposure assessment methods have not been validated.
背景
先前的流行病学研究结果表明，接触三氯乙烯（TCE）——一种主要用于金属零件蒸气除油的氯化溶剂，与非霍奇金淋巴瘤（NHL）之间存在关联。
目的
我们采用详细的暴露评估方法，在一项基于人群的病例对照研究中，调查职业性 TCE 暴露与 NHL 之间的关系。
方法
病例组（n = 1189；参与率为 76%）和对照组（n = 982；参与率为 52%）提供了关于职业史的信息，并且针对某些职业，根据特定工作的访谈模块，提供了有关可能的工作场所 TCE 暴露的信息。一位工业卫生学家根据这些信息以及对 TCE 工业卫生文献的回顾，评估了潜在的 TCE 暴露。我们根据暴露组和对照组中 TCE 估计暴露量的不同指标（以 tertiles 分类）计算了 NHL 与不同指标的比值比（OR）和 95%置信区间（CI），未暴露组作为参考组。
结果
我们观察到 NHL 与估计平均每周暴露量最高 tertiles（23 例暴露病例；OR = 2.5；95%CI，1.1-6.1）和累积暴露量（24 例暴露病例；OR = 2.3；95%CI，1.0-5.0）之间存在关联。这些指标的趋势检验均具有统计学意义（趋势检验的 p 值分别为 0.02 和 0.08）；然而，我们没有观察到暴露水平之间的剂量-反应关系。总的来说，暴露的持续时间或强度与 NHL 均无关联，尽管我们观察到暴露持续时间最低 tertiles（OR = 2.1；95%CI，1.0-4.7）与 NHL 之间存在关联。
结论
我们的研究结果为 TCE 高水平暴露与 NHL 风险增加之间存在关联提供了进一步的证据。然而，我们不能排除其他用于蒸气除油的氯化溶剂引起混杂的可能性，并且我们注意到我们的暴露评估方法尚未得到验证。
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