Division of Cancer Epidemiology and Genetics, NCI, NIH, DHHS, Bethesda, Maryland 20892-7240, USA.
Am J Ind Med. 2012 Jan;55(1):5-10. doi: 10.1002/ajim.21014. Epub 2011 Oct 10.
Xuanwei, China, experiences some of the highest rates of lung cancer in China. While lung cancer risk has been linked to the household use of bituminous coal, no study has comprehensively evaluated the risk of lung cancer associated with the mining of this coal in Xuanwei. In Xuanwei, coal is typically extracted from underground mines, without ventilation, and transported to the surface using carts powered by manpower or electricity.
We evaluated the risk of lung cancer and working as a coal miner, in the absence of diesel exhaust exposure, in a population-based case-control study of 260 male lung cancer cases and 260 age-matched male controls with information on occupational histories. Odds ratios (ORs) and 95% confidence intervals (CIs) for working as a coal miner and years of working as a coal miner were calculated by conditional logistic regression, adjusting for potential confounders, such as smoking and household coal use.
We observed an increased risk of lung cancer among coal miners (OR = 2.7; 95%CI = 1.3-5.6) compared to noncoal miners. Further, a dose-response relationship was observed for the risk of lung cancer and the number of years working as a coal miner (P(trend) = 0.02), with those working as miners for more than 10 years experiencing an almost fourfold increased risk (OR = 3.8; 95%CI = 1.4-10.3) compared to noncoal miners.
These findings suggest that coal mining in Xuanwei may be a risk factor for lung cancer.
中国宣威的肺癌发病率位居全国前列。虽然肺癌风险与家庭使用烟煤有关,但尚无研究全面评估宣威烟煤开采对肺癌的风险。在中国宣威,煤炭通常从无通风的地下矿山中开采出来,然后使用人力或电力驱动的手推车运到地面。
我们在一项基于人群的 260 例男性肺癌病例和 260 例年龄匹配的男性对照的病例对照研究中,评估了在没有接触柴油废气的情况下,作为煤矿工人工作与肺癌风险之间的关系,并对职业史信息进行了分析。采用条件逻辑回归,调整了吸烟和家庭用煤等潜在混杂因素后,计算了作为煤矿工人工作和从事煤矿工作年限的比值比(OR)及其 95%置信区间(CI)。
与非煤矿工人相比,煤矿工人患肺癌的风险增加(OR=2.7;95%CI=1.3-5.6)。此外,肺癌风险与从事煤矿工作年限之间存在剂量-反应关系(P(trend)=0.02),与非煤矿工人相比,从事煤矿工作 10 年以上的人群患肺癌的风险几乎增加了四倍(OR=3.8;95%CI=1.4-10.3)。
这些发现表明,宣威的煤矿开采可能是肺癌的一个危险因素。