University of Arkansas for Medical Sciences, Department of Epidemiology, Little Rock, AR, USA.
University of North Texas Health Science Center, Department of Epidemiology, Fort Worth, TX, USA.
Environ Int. 2015 Apr;77:70-5. doi: 10.1016/j.envint.2015.01.009. Epub 2015 Feb 3.
Meat cutters and meat wrappers in the meat department of supermarkets are exposed to oncogenic viruses present in raw meat from cattle, pigs, sheep, and poultry, and their products (unpasteurized milk and raw eggs). Up to the mid 1970s, meat wrappers were also exposed to carcinogens present in fumes emitted from the machine used to wrap meat. Because of this we studied cancer mortality in a cohort of 10,701 workers in the meat and delicatessen departments of supermarkets, and we report here the findings after the third follow-up. Standardized mortality ratios (SMR) were estimated in the cohort as a whole and in race/sex subgroups, using the US population for comparison. Study subjects were followed up from January 1950 to December 2006. Significantly increased SMRs of 1.3 (95% CI, 1.2-1.5), and 2.7 (95% CI, 1.2-5.3) were recorded for cancers of the lung, and tonsils/oropharynx, respectively, in the entire cohort, affecting nearly all race/sex subgroups. SMRs of 4.6 (95% CI, 1.0-13.6) for cancer of the floor of the mouth, and 2.8 (95% CI, 1.3-5.3) for cancer of the gall bladder and biliary tract were recorded only in White male meatcutters. Significantly decreased SMRs were observed for a few cancers. It is not known if the observed excess of cancers is a result of occupational exposures. However, substantial evidence points to fumes from the wrapping machine as a possible candidate for explaining the excess in female meat wrappers. Nested case-control studies that can examine risks from occupational exposures in greater detail, and adequately control for confounding factors are now needed, to permit specifically investigate the role of the oncogenic viruses, fumes and non-occupational risk factors in the occurrence of these cancers. The findings are important, not only occupationally but also because the general population may also experience these exposures, albeit to a lesser degree.
超市肉品部门的切肉工和肉品包装工接触到生牛、猪、羊和家禽肉及其产品(未经巴氏消毒的牛奶和生鸡蛋)中存在的致癌病毒。直到 20 世纪 70 年代中期,肉品包装工还会接触到包装机散发的烟雾中存在的致癌物。正因为如此,我们对超市肉品和熟食部门的 10701 名工人进行了一项队列研究,并在此报告第三次随访后的结果。使用美国人口作为对照,对整个队列和按种族/性别划分的亚组进行了标准化死亡率比(SMR)的估计。研究对象从 1950 年 1 月至 2006 年 12 月进行了随访。整个队列中,肺癌和扁桃体/口咽癌的 SMR 分别显著升高至 1.3(95%CI,1.2-1.5)和 2.7(95%CI,1.2-5.3),几乎所有种族/性别亚组均受到影响。在白种男性切肉工中,还记录到了口腔底部癌症的 SMR 为 4.6(95%CI,1.0-13.6),胆囊和胆道癌症的 SMR 为 2.8(95%CI,1.3-5.3)。观察到少数癌症的 SMR 显著降低。目前尚不清楚观察到的癌症过多是否是职业暴露的结果。然而,大量证据表明,包装机的烟雾可能是解释女性肉品包装工过量的一个可能因素。现在需要进行嵌套病例对照研究,以便更详细地检查职业暴露风险,并充分控制混杂因素,从而能够专门研究致癌病毒、烟雾和非职业危险因素在这些癌症发生中的作用。这些发现不仅在职业上很重要,而且因为普通人群也可能会接触到这些暴露,尽管程度较轻。