铅冶炼工人的死亡率：一项伴有暴露评估的随访研究。
Mortality of lead smelter workers: A follow-up study with exposure assessment.
作者信息
Bertke Stephen J, Lehman Everett J, Wurzelbacher Steven J, Hein Misty J
机构信息
Division of Surveillance, Hazard Evaluations, and Field Studies, Industrywide Studies Branch, National Institute for Occupational Safety and Health, Cincinnati, Ohio.
出版信息
Am J Ind Med. 2016 Nov;59(11):979-986. doi: 10.1002/ajim.22618. Epub 2016 Jun 28.
BACKGROUND
Lead exposure has been linked to impaired renal function and kidney failure. High lead exposures have been associated with increased mortality from certain cancers, hypertension, cardiovascular disease, and amyotrophic lateral sclerosis (ALS).
METHODS
We extended vital status follow-up on a cohort of 1,990 lead smelter workers by 25 years and computed standardized mortality ratios and rate ratios (RR) stratified by cumulative lead exposure.
RESULTS
The update added 13,823 person-years at risk and 721 deaths. Increased risk of mortality was observed for the a priori outcomes of lung cancer, cardiovascular disease (including cerebrovascular disease), chronic kidney disease, and ALS. However, of these outcomes, only cardiovascular, cerebrovascular, and chronic kidney diseases were associated with a positive exposure-response in RR analyses.
CONCLUSIONS
This study reaffirms the association of lead exposure with cardiovascular and kidney diseases; however, increased mortality observed for certain cancers is not likely to be due to lead exposure. Am. J. Ind. Med. 59:979-986, 2016. Published 2016. This article is a U.S. Government work and is in the public domain in the USA.
背景
铅暴露与肾功能受损和肾衰竭有关。高铅暴露与某些癌症、高血压、心血管疾病和肌萎缩侧索硬化症（ALS）的死亡率增加有关。
方法
我们将一组1990名铅冶炼工人的生命状态随访延长了25年，并计算了按累积铅暴露分层的标准化死亡比和率比（RR）。
结果
此次更新增加了13823人年的风险暴露时间和721例死亡病例。观察到肺癌、心血管疾病（包括脑血管疾病）、慢性肾病和ALS等预先设定结局的死亡风险增加。然而，在这些结局中，RR分析显示只有心血管疾病、脑血管疾病和慢性肾病与正暴露-反应相关。
结论
本研究再次证实了铅暴露与心血管疾病和肾脏疾病之间的关联；然而，某些癌症死亡率的增加不太可能是由于铅暴露所致。《美国工业医学杂志》59:979 - 986，2016年。2016年发表。本文为美国政府作品，在美国属于公共领域。
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