阿根廷、巴西、哥伦比亚和墨西哥与石棉相关癌症的职业负担。
Occupational burden of asbestos-related cancer in Argentina, Brazil, Colombia, and Mexico.
机构信息
Istituto Superiore di Sanità, Rome, Italy.
University of Turin, (Retired), Turin, Italy.
出版信息
Ann Glob Health. 2014 Jul-Aug;80(4):263-8. doi: 10.1016/j.aogh.2014.09.003. Epub 2014 Nov 25.
BACKGROUND
An estimate at the national level of the occupational cancer burden brought about by the industrial use of asbestos requires detailed routine information on such uses as well as on vital statistics of good quality. A causal association with asbestos exposure has been established for mesothelioma and cancers of the lung, larynx, and ovary.
OBJECTIVES
The aim of this study was to provide estimates of the occupational burden of asbestos-related cancer for the Latin American countries that are or have been the highest asbestos consumers in the region: Argentina, Brazil, Colombia, and Mexico.
METHODS
The burden of multifactorial cancers has been estimated through the approach suggested for the World Health Organization using the population attributable fraction. The following data were used: Proportion of workforce employed in each economic sector. Proportion of workers exposed to asbestos in each sector. Occupational turnover. Levels of exposure. Proportion of the population in the workforce. Relative risk for each considered disease for 1 or more levels of exposure. Data on the proportion of workers exposed to asbestos in each sector are not available for Latin American countries; therefore, data from the European CAREX database (carcinogen exposure database) were used.
FINDINGS
Using mortality data of the World Health Organization Health Statistics database for the year 2009 and applying the estimated values for population attributable fractions, the number of estimated deaths in 5 years for mesothelioma and for lung, larynx, and ovary cancers attributable to occupational asbestos exposures, were respectively 735, 233, 29, and 14 for Argentina; 340, 611, 68, and 43 for Brazil; 255, 97, 14, and 9 for Colombia, and 1075, 219, 18, and 22 for Mexico.
CONCLUSIONS
The limitations in compiling the estimates highlight the need for improvement in the quality of asbestos-related environmental and health data. Nevertheless, the figures are already usable to promote a ban on asbestos use.
背景
要对全国范围内因工业使用石棉而导致的职业性癌症负担进行评估，需要详细的常规信息，包括此类用途的信息以及高质量的人口统计数据。石棉暴露与间皮瘤以及肺癌、喉癌和卵巢癌之间的因果关系已得到确立。
目的
本研究旨在为拉美国家提供石棉相关癌症的职业负担估计，这些国家是或曾经是该地区石棉消费最高的国家：阿根廷、巴西、哥伦比亚和墨西哥。
方法
通过世界卫生组织建议的方法，使用人群归因分数来估计多因素癌症的负担。使用了以下数据：每个经济部门就业劳动力的比例；每个部门接触石棉的工人比例；职业更替率；接触水平；劳动力中的人口比例；每个考虑疾病的 1 个或多个暴露水平的相对风险。由于没有关于拉美国家每个部门接触石棉工人的数据，因此使用了欧洲 CAREX 数据库（致癌剂暴露数据库）的数据。
结果
根据 2009 年世界卫生组织卫生统计数据库的死亡率数据，并应用估计的人群归因分数值，估计 5 年内因职业性石棉暴露导致的间皮瘤以及肺癌、喉癌和卵巢癌的死亡人数分别为：阿根廷 735 例、233001 例、29 例和 14 例；巴西 340 例、611014 例、68 例和 43 例；哥伦比亚 255 例、97014 例、14 例和 9 例；墨西哥 1075 例、219022 例、18 例和 22 例。
结论
在编制这些估计数时存在的限制突出表明需要提高与石棉有关的环境和健康数据的质量。尽管如此，这些数字已经可以用来推动石棉使用的禁令。
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