Division of Surveillance, Hazard Evaluations, and Field Studies, National Institute for Occupational Safety and Health, Centers for Disease Control and Prevention, Cincinnati, Ohio, USA.
Am J Ind Med. 2012 May;55(5):412-22. doi: 10.1002/ajim.22010. Epub 2012 Jan 11.
Although lung cancer risks can vary by race/ethnicity and by construction occupation, these risks have not been examined extensively.
This study analyzed 110,937 lung cancer cases identified from the California Cancer Registry between 1988 and 2007. Mean age at diagnosis, proportion diagnosed at an advanced stage, and proportion with 3-year survival were calculated for lung cancer cases employed in the construction industry. Case-control methodology was also used to assess the risk of lung cancer. Morbidity odds ratios (MORs) were estimated by conditional logistic regression.
Construction workers were found to have a significantly elevated risk for all lung cancer combined (MOR = 1.57) and for each lung cancer histologic subtype examined. All construction occupations, except managers/engineers and supervisors, had a significantly elevated risk for all lung cancer combined. Roofers and welders had the highest risks for total lung cancer and for each of the histologic subtypes. Construction workers in each of the four race/ethnicity groups also had significantly increased lung cancer risks. Compared to non-construction workers, construction workers were diagnosed at an earlier age, at a more advanced stage, and had significantly lower 3-year survival, though differences were modest.
These findings justify additional reductions in carcinogenic exposures in construction, and increased support for smoking cessation programs at construction sites.
尽管肺癌的风险因种族/民族和建筑职业而异,但这些风险尚未得到广泛研究。
本研究分析了 1988 年至 2007 年间加利福尼亚癌症登记处确定的 110,937 例肺癌病例。为从事建筑行业的肺癌病例计算了诊断时的平均年龄、晚期诊断的比例和 3 年生存率。还使用病例对照方法评估了肺癌的风险。通过条件逻辑回归估计发病率比值比 (MOR)。
发现建筑工人患所有肺癌(MOR = 1.57)和每种肺癌组织学亚型的风险显著增加。除经理/工程师和主管外,所有建筑职业的所有肺癌的风险都显著增加。屋顶工人和焊工患所有肺癌和每种组织学亚型的风险最高。四个种族/民族群体中的建筑工人也有明显增加的肺癌风险。与非建筑工人相比,建筑工人的诊断年龄更早,处于更晚期,3 年生存率显著降低,尽管差异较小。
这些发现证明在建筑行业中需要进一步减少致癌物质的暴露,并增加对建筑工地戒烟计划的支持。