Qiao Y L, Taylor P R, Yao S X, Schatzkin A, Mao B L, Lubin J, Rao J Y, McAdams M, Xuan X Z, Li J Y
Department of Epidemiology, Chinese Academy of Medical Sciences, Beijing.
Am J Ind Med. 1989;16(5):511-21. doi: 10.1002/ajim.4700160504.
We studied the relation of radon exposure and tobacco use to lung cancer among tin miners in Yunnan Province in the People's Republic of China. Interviews were conducted in 1985 with 107 living tin miners with lung cancer and an equal number of age-matched controls from among tin miners without lung cancer to obtain information on lung cancer risk factors including a detailed history of employment and tobacco use. Occupational history was combined with extensive industrial hygiene data to estimate cumulative working level months (WLM) of radon daughter exposure. Similar data were also used to estimate arsenic exposure for control in the analysis. Results indicate an increased risk of lung cancer for water pipe smoking, a traditional form of tobacco use practiced in 91% of cases and 85% of controls. Ever use of water pipes was associated with a twofold elevation in risk when compared with tobacco abstainers, and a dose-response relation was observed with increasing categories of pipe-year (dose times duration) usage. Estimated WLM of radon exposure varied from 0 to 1,761 among subjects but averaged 515 in cases versus only 244 in controls. Analyses indicated that the persons in the highest quarter of the radon exposure distribution had an odds ratio (OR) = 9.5 (95% confidence interval = 2.7-33.1) compared to persons without radon exposure after controlling for arsenic exposure and other potential confounders. Examination of duration and rate of radon exposure indicated higher risk associated with long duration as opposed to high rate of exposure. Cross-categorizations of radon exposure and tobacco use suggest greater risk associated with radon exposure than tobacco in these workers.
我们研究了中华人民共和国云南省锡矿矿工中氡暴露与烟草使用和肺癌之间的关系。1985年，我们对107名患有肺癌的在世锡矿矿工以及同等数量年龄匹配的未患肺癌的锡矿矿工进行了访谈，以获取有关肺癌风险因素的信息，包括详细的就业和烟草使用史。职业史与广泛的工业卫生数据相结合，以估计氡子体暴露的累积工作水平月数（WLM）。类似的数据也用于估计分析中作为对照的砷暴露。结果表明，水烟吸食会增加患肺癌的风险，91%的病例和85%的对照采用这种传统的烟草使用形式。与不吸烟者相比，曾经使用水烟与风险升高两倍相关，并且随着水烟年使用类别（剂量乘以持续时间）的增加观察到剂量反应关系。受试者的氡暴露估计WLM在0至1761之间，但病例组平均为515，而对照组仅为244。分析表明，在控制砷暴露和其他潜在混杂因素后，氡暴露分布最高四分位数的人与未暴露于氡的人相比，比值比（OR）=9.5（95%置信区间=2.7-33.1）。对氡暴露的持续时间和速率的检查表明，与高暴露速率相比，长时间暴露与更高的风险相关。氡暴露和烟草使用的交叉分类表明，这些工人中氡暴露比烟草使用带来的风险更大。
