Case B W, Dufresne A, McDonald A D, McDonald J C, Sébastien P
a Departments of Pathology, Epidemiology, Biostatistics, and Occupational Health , McGill University , Montreal , Quebec , Canada.
Inhal Toxicol. 2000 Jan;12 Suppl 3:411-8. doi: 10.1080/08958378.2000.11463253.
Excess lung cancer risk for a cohort of chrysotile textile plant workers was many times the risk observed in a cohort of chrysotile miners/millers. The latter had greater exposure to chrysotile/tremolite. A previous lung burden study confirmed this excess exposure in miners/millers and showed little difference in fiber length. Selection of too short a fiber length cut-off (5 µm or more) in the previous study could have masked differences in lung-retained fiber length. In this follow-up, we counted only those intrapulmonary fibers exceeding 18 µm in length. Lung fiber concentration and dimension were assessed by transmission electron microscopy (TEM) and energy-dispersive x-ray spectrometry (EDS) for autopsy samples from 64 textile workers and 43 chrysotile miners and millers. These long fibers were significantly more concentrated in the lungs of chrysotile miners and millers, consistent with their greater exposure. However, when only these longest fibers were compared, there was a somewhat greater mean and median intrapulmonary fiber length for chrysotile textile workers (mean fiber length, all fiber types combined, 25.2 ± 10.2 µm vs. 22.9 ± 6.6 µm in miners/millers, < .001; medians 21.6 vs. 20, p < .05). Despite their lesser apparent lung cancer risk, chrysotile, tremolite, total amphibole, and total long fiber asbestos concentrations were all highest in the lungs of miners/millers. Twenty-two of 64 textile workers had lung content of crocidolite and/or amosite (32.5% of 508). These amosite/crocidolite fibers were present in the lungs of workers who ceased employment prior to the first use of such fibers recorded in this industry. The results suggest that (I) asbestos fiber length differences cannot explain the difference in lung cancer risk excess and slope between cohorts and (2) the experience of textile workers should not be used to assess risk of lung cancer in miners, cement workers, and friction product workers, regardless of fiber type.
一组温石棉纺织厂工人患肺癌的额外风险是一组温石棉矿工/磨工所观察到风险的数倍。后者接触温石棉/透闪石的程度更高。此前一项肺部负荷研究证实了矿工/磨工存在这种过度接触,并且显示纤维长度差异不大。在前一项研究中选择过短的纤维长度截断值(5微米或更长)可能掩盖了肺部留存纤维长度的差异。在这项随访研究中,我们只统计那些长度超过18微米的肺内纤维。通过透射电子显微镜(TEM)和能量色散X射线光谱法(EDS)对64名纺织工人以及43名温石棉矿工和磨工的尸检样本进行肺纤维浓度和尺寸评估。这些长纤维在温石棉矿工和磨工的肺部明显更集中,这与其更高的接触程度一致。然而,当仅比较这些最长的纤维时,温石棉纺织工人的肺内纤维平均长度和中位数略长(所有纤维类型合并后的平均纤维长度,纺织工人为25.2±10.2微米,矿工/磨工为22.9±6.6微米,p<0.001;中位数分别为21.6和20,p<0.05)。尽管温石棉纺织厂工人患肺癌的风险较低,但温石棉、透闪石、总闪石和总长纤维石棉浓度在矿工/磨工的肺部都是最高的。64名纺织工人中有22人肺部含有青石棉和/或铁石棉(占508人的32.5%)。这些铁石棉/青石棉纤维存在于该行业首次使用此类纤维之前就已停止工作的工人肺部。结果表明:(1)石棉纤维长度差异无法解释不同队列之间肺癌额外风险和斜率的差异;(2)纺织工人的情况不应被用于评估矿工、水泥工人和摩擦产品工人患肺癌的风险,无论纤维类型如何。