Miettinen O S, Rossiter C E
Department of Theory of Medicine, Free University, Amsterdam, The Netherlands.
Scand J Work Environ Health. 1990 Aug;16(4):221-31. doi: 10.5271/sjweh.1791.
Reviews of the epidemiologic literature point to a causal connection between lung cancer and exposure to airborne man-made mineral fibers. The present critical re-review starts with the requirements for epidemiologic evidence to be informative regarding a hypothesis on cancer etiology. The previous reviews relate lung cancer mortality to exposure that is too recent to be relevant. The relation to relevant (distant) exposure in the available data involves notable confounding by coexposure to other agents in the work environment, by the lower socioeconomic status of the exposed workers, and possibly by smoking. Moreover, analyses of trends in standardized mortality ratios according to timing and duration of exposure involve a lack of mutual comparability between the ratios. Given these problems, the available evidence is inadequate for testing the causal hypothesis. However, reanalyses of the available data, augmentation of the data with reanalyses, and new studies could eliminate the existing inadequacies.
对流行病学文献的综述指出肺癌与接触空气中的人造矿物纤维之间存在因果关系。本次批判性的重新综述首先从流行病学证据对癌症病因假说提供信息的要求开始。先前的综述将肺癌死亡率与近期接触相关联，而这种接触并无相关性。现有数据中与相关（远期）接触的关系存在显著的混杂因素，包括工作环境中同时接触其他因素、接触工人较低的社会经济地位以及可能的吸烟因素。此外，根据接触时间和持续时间对标准化死亡率比值趋势的分析存在比值之间缺乏相互可比性的问题。鉴于这些问题，现有证据不足以检验因果假说。然而，对现有数据的重新分析、通过重新分析增加数据以及开展新的研究可能会消除现有的不足之处。
