Department of Occupational and Environmental Health, West China School of Public Health, Sichuan University, Sichuan, China.
Occup Environ Med. 2012 Feb;69(2):81-6. doi: 10.1136/oem.2011.064899. Epub 2011 Jul 8.
To describe mortality in workers exposed to chrysotile asbestos, and determine exposure-response relationships between asbestos exposure and mortality from lung cancer and asbestosis by fitting and comparing different models.
A prospective cohort consisting of 586 workers in an asbestos textile factory was followed from 1 January 1972 to 31 December 2006. A structured questionnaire was administered to collect personal information and exposure data. Paired concentration samples measured in the workshops were used to convert dust concentrations to fibre concentrations. Individual cumulative asbestos exposure was estimated as the product of fibre concentrations and duration of employment in each job and expressed as fibre-years/ml. The vital status of cohort members was followed annually. Poisson regression analysis was applied to fit log-linear, log-quadratic, power, additive relative risk and categorical models to estimate exposure-response relationships between cumulative fibre exposure and mortality from lung cancer and asbestosis.
Of the 226 deaths (14.6 per 1000 person-years) over the 35-year follow-up, 51 were from lung cancer (3.29 per 1000 person-years) and 37 from asbestosis (2.39 per 1000 person-years). A significant exposure-response relationships with either lung cancer or asbestosis (p<0.001) was observed in the final model. The power model with lagged 10 years was found to be the best model of those evaluated for both lung cancer (β coefficient=0.53) and asbestosis (β coefficient=0.63).
The study confirmed strong associations between exposure to chrysotile asbestos and lung cancer and asbestosis, in which clear exposure-response relationships were observed.
描述暴露于温石棉的工人的死亡率，并通过拟合和比较不同模型，确定石棉暴露与肺癌和石棉肺死亡率之间的暴露-反应关系。
对一家石棉纺织厂的 586 名工人进行了前瞻性队列研究，随访时间从 1972 年 1 月 1 日至 2006 年 12 月 31 日。通过问卷调查收集个人信息和暴露数据。对车间内采集的配对浓度样本进行分析，将粉尘浓度转换为纤维浓度。个体累计石棉暴露量估计为各工作岗位纤维浓度与工龄的乘积，以纤维年/毫升表示。每年随访队列成员的生存状况。应用泊松回归分析拟合对数线性、对数二次、幂函数、加性相对风险和分类模型，以估计累计纤维暴露与肺癌和石棉肺死亡率之间的暴露-反应关系。
在 35 年的随访中，共有 226 人死亡（14.6/1000 人年），其中 51 人死于肺癌（3.29/1000 人年），37 人死于石棉肺（2.39/1000 人年）。在最终模型中，观察到肺癌或石棉肺与暴露之间存在显著的暴露-反应关系（p<0.001）。对于肺癌（β系数=0.53）和石棉肺（β系数=0.63），滞后 10 年的幂函数模型被认为是评估的最佳模型。
该研究证实了暴露于温石棉与肺癌和石棉肺之间存在强烈关联，并且观察到了明确的暴露-反应关系。
