MRC-HPA Centre for Environment and Health, Department of Epidemiology and Biostatistics, Imperial College London, London, United Kingdom.
Am J Epidemiol. 2011 May 1;173(9):1069-77. doi: 10.1093/aje/kwq434. Epub 2011 Mar 28.
Interventions to reduce cancers related to certain occupations should be evidence-based. The authors have developed a method for forecasting the future burden of occupational cancer to inform strategies for risk reduction. They project risk exposure periods, accounting for cancer latencies of up to 50 years, forward in time to estimate attributable fractions for a series of forecast target years given past and projected exposure trends and under targeted reduction scenarios. Adjustment factors for changes in exposed numbers and levels are applied in estimation intervals within the risk-exposure periods. The authors illustrate the methods by using a range of scenarios for reducing lung cancer due to occupational exposure to respirable crystalline silica. Attributable fractions for lung cancer due to respirable crystalline silica could be potentially reduced from 2.07% in 2010 to nearly 0% by 2060, depending on the timing and success of interventions. Focusing on achieving compliance with current exposure standards in small industries can be more effective than setting standards at a lower level. The method can be used to highlight high-risk carcinogens, industries, and occupations. It is adaptable for other countries and other exposure situations in the general environment and can be extended to include socioeconomic impact assessment.
针对特定职业相关癌症的干预措施应当基于证据。作者开发了一种预测未来职业癌症负担的方法，以制定风险降低策略。他们根据过去和预测的暴露趋势以及有针对性的减少情景，向前预测风险暴露期，最长可达 50 年，以估计一系列预测目标年份的归因分数。在风险暴露期内的估计间隔中应用了调整暴露人数和水平变化的调整因素。作者通过使用一系列减少因职业性接触可吸入结晶硅肺病导致的肺癌的情景来说明这些方法。归因于可吸入结晶硅肺病的肺癌的比例可能会从 2010 年的 2.07%降低到 2060 年的接近 0%，具体取决于干预措施的时间和效果。专注于实现小行业当前暴露标准的合规性可能比设定更低的标准更有效。该方法可用于突出高风险致癌物质、行业和职业。它适用于其他国家和一般环境中的其他暴露情况，并可扩展到包括社会经济影响评估。
