Cho Soo Hun, Sung Joohon, Kim Jonghoon, Ju Young Su, Han Minji, Jung Kyu Won
Department of Preventive Medicine, Seoul National University College of Medicine, Seoul, Korea.
J Prev Med Public Health. 2011 Jul;44(4):185-9. doi: 10.3961/jpmph.2011.44.4.185.
In 1995, an outbreak survey in Gozan-dong concluded that an association between fiberglass exposure in drinking water and cancer outbreak cannot be established. This study follows the subjects from a study in 1995 using a data linkage method to examine whether an association existed. The authors will address the potential benefits and methodological issues following outbreak surveys using data linkage, particularly when informed consent is absent.
This is a follow-up study of 697 (30 exposed) individuals out of the original 888 (31 exposed) participants (78.5%) from 1995 to 2007 assessing the cancer outcomes and deaths of these individuals. The National Cancer Registry (KNCR) and death certificate data were linked using the ID numbers of the participants. The standardized incidence ratio (SIR) and standardized mortality ratio (SMR) from cancers were calculated by the KNCR.
The SIR values for all cancer or gastrointestinal cancer (GI) occurrences were the lowest in the exposed group (SIR, 0.73; 95% CI, 0.10 to 5.21; 0.00 for GI), while the two control groups (control 1: external, control 2: internal) showed slight increases in their SIR values (SIR, 1.18 and 1.27 for all cancers; 1.62 and 1.46 for GI). All lacked statistical significance. All-cause mortality levels for the three groups showed the same pattern (SMR 0.37, 1.29, and 1.11).
This study did not refute a finding of non-association with a 13-year follow-up. Considering that many outbreak surveys are associated with a small sample size and a cross-sectional design, follow-up studies that utilize data linkage should become standard procedure.
1995年在高赞洞进行的一次疫情调查得出结论,无法确定饮用水中玻璃纤维暴露与癌症暴发之间存在关联。本研究对1995年一项研究中的受试者进行跟踪,采用数据链接方法来检验是否存在关联。作者将探讨在疫情调查中使用数据链接,尤其是在缺乏知情同意的情况下,潜在的益处和方法学问题。
这是一项对1995年最初的888名参与者(31名暴露者)中的697名(30名暴露者)个体进行的随访研究,随访时间为1995年至2007年,评估这些个体的癌症结局和死亡情况。通过参与者的身份证号码将国家癌症登记处(KNCR)的数据与死亡证明数据进行链接。KNCR计算了癌症的标准化发病率(SIR)和标准化死亡率(SMR)。
暴露组中所有癌症或胃肠道癌症(GI)发生的SIR值最低(SIR为0.73;95%可信区间为0.10至5.21;GI为0.00),而两个对照组(对照组1:外部对照,对照组2:内部对照)的SIR值略有升高(所有癌症的SIR分别为1.18和1.27;GI为1.62和1.46)。所有结果均缺乏统计学意义。三组的全因死亡率水平呈现相同模式(SMR分别为0.37、1.29和1.11)。
这项为期13年的随访研究并未反驳无关联的结论。鉴于许多疫情调查样本量小且采用横断面设计,利用数据链接的随访研究应成为标准程序。