前瞻性荷兰队列研究中职业性石棉暴露与胸膜间皮瘤、肺癌和喉癌的风险。

Occupational asbestos exposure and risk of pleural mesothelioma, lung cancer, and laryngeal cancer in the prospective Netherlands cohort study.

机构信息

From the Department of Epidemiology (Ms Offermans and Mr van den Brandt), GROW School for Oncology and Developmental Biology, Maastricht University Medical Centre, Maastricht, the Netherlands; Institute for Risk Assessment Sciences (Dr Vermeulen and Mr Kromhout), Environmental Epidemiology Division, Utrecht University, Utrecht, the Netherlands; Julius Center for Health Sciences and Primary Care (Dr Vermeulen), University Medical Center, Utrecht, the Netherlands; Department of Public Health (Mr Burdorf), Erasmus MC, Rotterdam, the Netherlands; TNO (Dr Goldbohm), Leiden, the Netherlands; and Finnish Institute of Occupational Health (Dr Kauppinen), Helsinki, Finland.

出版信息

J Occup Environ Med. 2014 Jan;56(1):6-19. doi: 10.1097/JOM.0000000000000060.

DOI:10.1097/JOM.0000000000000060

PMID:24351898

Abstract

OBJECTIVE

To study the association between occupational asbestos exposure and pleural mesothelioma, lung cancer, and laryngeal cancer, specifically addressing risk associated with the lower end of the exposure distribution, risk of cancer subtypes, and the interaction between asbestos and smoking.

METHODS

Using the Netherlands Cohort Study (n = 58,279 men, aged 55 to 69 years), asbestos exposure was estimated by linkage to job-exposure matrices. After 17.3 years of follow-up, 132 pleural mesothelioma, 2324 lung cancer, and 166 laryngeal cancer cases were available.

RESULTS

The multivariable-adjusted model showed overall positive associations between all levels of asbestos exposure and mesothelioma, lung cancer, and laryngeal cancer. Lung adenocarcinoma and glottis cancer showed only a positive association after prolonged higher asbestos exposure (hazard ratio per 10 years increment, 1.43 [95% confidence interval, 1.06 to 1.93] and 1.95 [95% confidence interval, 1.36 to 2.80], respectively). There was no statistically significant interaction between asbestos and smoking.

CONCLUSIONS

Asbestos levels encountered at the lower end of the exposure distribution may be associated with an increased risk of pleural mesothelioma, lung cancer, and laryngeal cancer.

摘要

目的

研究职业性石棉暴露与间皮瘤、肺癌和喉癌之间的关联，特别关注暴露分布低端相关的风险、癌症亚型风险以及石棉与吸烟之间的相互作用。

方法

利用荷兰队列研究（n=58279 名年龄在 55 至 69 岁的男性），通过与职业暴露矩阵关联来估计石棉暴露情况。随访 17.3 年后，共出现 132 例间皮瘤、2324 例肺癌和 166 例喉癌病例。

结果

多变量调整模型显示，所有水平的石棉暴露与间皮瘤、肺癌和喉癌均呈正相关。只有在长期高石棉暴露后，肺腺癌和声门癌才显示出正相关（每 10 年递增的危险比分别为 1.43 [95%置信区间，1.06 至 1.93] 和 1.95 [95%置信区间，1.36 至 2.80]）。石棉与吸烟之间没有统计学意义上的相互作用。