Coggon David, Ntani Georgia, Harris E Clare, Jayakody Nimeshi, Palmer Keith T
MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton, UK.
Occup Environ Med. 2015 Jun;72(6):435-41. doi: 10.1136/oemed-2014-102654. Epub 2015 Feb 18.
To provide further information on the possible carcinogenicity of phenoxy herbicides, and in particular their relationship to soft tissue sarcoma (STS), non-Hodgkin's lymphoma (NHL) and chronic lymphocytic leukaemia (CLL).
We extended follow-up to December 2012 for 8036 men employed at five factories in the UK which had manufactured phenoxy herbicides, or in a contract spraying business. Mortality was compared with that for England and Wales by the person-years method. Nested case-control analyses compared men with incident or fatal STS (n=15) or NHL/CLL (n=74) and matched controls (up to 10 per case).
4093 men had died, including 2303 since the last follow-up. Mortality from all causes and all cancers was close to expectation, but an excess of deaths from NHL was observed among men who had worked for ≥1 year in jobs with more than background exposure to phenoxy herbicides (19 deaths, SMR 1.85, 95% CI 1.12 to 2.89). Four deaths from STS occurred among men potentially exposed above background (3.3 expected). In the nested case-control analyses, there were no significantly elevated risks or consistent trends across categories of potential exposure for either STS or NHL/CLL. Among men who had worked for ≥1 year in potentially exposed jobs, the highest OR (for STS) was only 1.30 (95% CI 0.30 to 5.62).
Our findings are consistent with the current balance of epidemiological evidence. If phenoxy herbicides pose a hazard of either STS or NHL, then any absolute increase in risk is likely to be small.
提供关于苯氧基除草剂潜在致癌性的更多信息,尤其是它们与软组织肉瘤(STS)、非霍奇金淋巴瘤(NHL)和慢性淋巴细胞白血病(CLL)的关系。
我们将在英国五家生产苯氧基除草剂的工厂或从事合同喷洒业务的8036名男性的随访延长至2012年12月。采用人年法将死亡率与英格兰和威尔士的死亡率进行比较。巢式病例对照分析比较了发生或死于STS(n = 15)或NHL/CLL(n = 74)的男性与匹配的对照(每个病例最多10个对照)。
4093名男性死亡,其中自上次随访以来有2303人死亡。所有原因和所有癌症的死亡率接近预期,但在接触苯氧基除草剂超过背景水平的工作中工作≥1年的男性中,观察到NHL死亡人数过多(19例死亡,标准化死亡比1.85,95%可信区间1.12至2.89)。在可能接触水平高于背景的男性中,有4例死于STS(预期3.3例)。在巢式病例对照分析中,对于STS或NHL/CLL,潜在接触类别之间没有显著升高的风险或一致的趋势。在可能接触工作中工作≥1年的男性中,最高的比值比(对于STS)仅为1.30(95%可信区间0.30至5.62)。
我们的研究结果与当前的流行病学证据平衡一致。如果苯氧基除草剂对STS或NHL构成危害,那么任何绝对风险增加可能都很小。