Division of Environmental Health and Occupational Medicine, National Health Research Institutes, Miaoli, Taiwan.
Department of Public Health, China Medical University, Taichung, Taiwan.
Environ Res. 2014 Jul;132:370-8. doi: 10.1016/j.envres.2014.04.026. Epub 2014 May 15.
Shipbreaking remains one of the most dangerous jobs worldwide. Shipbreaking workers are exposed to many hazardous chemicals, especially asbestos. Unfortunately, long-term follow-up studies of cancer incidence patterns in shipbreaking workers are lacking. This study examines whether there is an increased risk of cancer among male shipbreaking workers over a 24-year follow-up period.
4155 male shipbreaking worker's information was retrospectively collected from Kaohsiung's Shipbreaking Workers Union database from 1985. The study cohort was linked to the Taiwan Cancer Registry from 1985 to 2008 for new cancer cases. The expected number of cancers for shipbreaking workers was calculated by using the age (5-year intervals) and calendar time-specific annual rates of cancer incidence with reference to the general population of Taiwan from 1985 to 2008. Standardized incidence ratios (SIRs) were calculated as relative risk estimates. The hazard ratio (HR) for cancer was calculated for the shipbreaking workers with Total Exposure Potential Scores for asbestos.
After consideration of a 5-year latency period, an elevated incidence of overall cancer (N=368; SIR=1.13 (1.01-1.25)), oral cavity cancer (N=83; SIR=1.99 (1.58-2.46)), and trachea, bronchus, and lung cancers (N=53; SIR=1.36 (1.02-1.78)) was found among male shipbreaking employees. Moreover, mesothelioma cases were found in those who had the occupation of flame cutter. The high asbestos exposure group was associated with an increased SIR of developing overall cancer and oral cancer, whether we considered a 5-year or 10-year latency period.
Asbestos-related diseases, including lung cancer and mesothelioma, were seen in excess in these shipbreaking workers and some cases appeared to have a dose-dependent relationship. Preventative measures among male shipbreaking workers should be researched further.
拆船业仍然是全球最危险的职业之一。拆船工人会接触到许多危险化学品，尤其是石棉。不幸的是，目前缺乏对拆船工人癌症发病率模式的长期随访研究。本研究旨在探讨在 24 年的随访期间，拆船男性工人的癌症发病风险是否会增加。
本研究从高雄拆船工人协会数据库中回顾性地收集了 1985 年的 4155 名男性拆船工人的信息。该研究队列与台湾癌症登记处（1985 年至 2008 年）相联系，以确定新的癌症病例。使用 1985 年至 2008 年台湾普通人群的年龄（5 年间隔）和日历时间特异性癌症发病率的特定年度率来计算拆船工人的预期癌症数量。标准化发病比（SIR）作为相对风险估计值进行计算。对于石棉总暴露潜在评分的拆船工人，计算了癌症的风险比（HR）。
考虑到 5 年潜伏期后，男性拆船工人的总体癌症（N=368；SIR=1.13（1.01-1.25））、口腔癌（N=83；SIR=1.99（1.58-2.46））和气管、支气管和肺癌（N=53；SIR=1.36（1.02-1.78））的发病率升高。此外，火焰切割工患有间皮瘤病例。无论我们考虑 5 年还是 10 年潜伏期，高石棉暴露组与总体癌症和口腔癌的 SIR 升高相关。
这些拆船工人中出现了与石棉有关的疾病，包括肺癌和间皮瘤，而且有些病例似乎存在剂量依赖性关系。应进一步研究男性拆船工人的预防措施。
