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职业性接触氯化溶剂与肾癌:一项病例对照研究。

Occupational exposure to chlorinated solvents and kidney cancer: a case-control study.

作者信息

Purdue Mark P, Stewart Patricia A, Friesen Melissa C, Colt Joanne S, Locke Sarah J, Hein Misty J, Waters Martha A, Graubard Barry I, Davis Faith, Ruterbusch Julie, Schwartz Kendra, Chow Wong-Ho, Rothman Nathaniel, Hofmann Jonathan N

机构信息

Division of Cancer Epidemiology and Genetics, Department of Health and Human Services, National Cancer Institute, National Institutes of Health, Bethesda, Maryland, USA.

Stewart Exposure Assessments, LLC, Arlington, USA.

出版信息

Occup Environ Med. 2017 Mar;74(4):268-274. doi: 10.1136/oemed-2016-103849. Epub 2016 Nov 1.

Abstract

OBJECTIVES

Trichloroethylene, a chlorinated solvent widely used for metal degreasing, is classified by the International Agency for Research on Cancer as a kidney carcinogen. Other chlorinated solvents are suspected carcinogens, most notably the cleaning solvent perchloroethylene, although it is unclear whether they are associated with kidney cancer. We investigated kidney cancer associations with occupational exposure to 6 chlorinated solvents (trichloroethylene, perchloroethylene, 1,1,1-trichloroethane, carbon tetrachloride, chloroform, and methylene chloride) within a case-control study using detailed exposure assessment methods.

METHODS

Cases (n=1217) and controls (n=1235) provided information on their occupational histories and, for selected occupations, on tasks involving potential exposure to chlorinated solvents through job-specific interview modules. Using this information, an industrial hygienist assessed potential exposure to each solvent. We computed ORs and 95% CIs for different exposure metrics, with unexposed participants as the referent group.

RESULTS

1,1,1-trichloroethane, carbon tetrachloride, chloroform, and methylene chloride were not associated with kidney cancer. Among jobs with high exposure intensity, high cumulative hours exposed to perchloroethylene was associated with increased risk, both overall (third tertile vs unexposed: OR 3.1, 95% CI 1.3 to 7.4) and after excluding participants with ≥50% exposure probability for trichloroethylene (OR 3.0, 95% CI 0.99 to 9.0). A non-significant association with high cumulative hours exposed to trichloroethylene was observed (OR 1.7, 95% CI 0.8 to 3.8).

CONCLUSIONS

In this study, high exposure to perchloroethylene was associated with kidney cancer, independent of trichloroethylene. Additional studies are needed to further investigate this finding.

摘要

目的

三氯乙烯是一种广泛用于金属脱脂的氯化溶剂,被国际癌症研究机构列为肾脏致癌物。其他氯化溶剂被怀疑是致癌物,最显著的是清洁溶剂全氯乙烯,不过尚不清楚它们是否与肾癌有关。我们在一项病例对照研究中,使用详细的暴露评估方法,调查了职业性接触6种氯化溶剂(三氯乙烯、全氯乙烯、1,1,1 - 三氯乙烷、四氯化碳、氯仿和二氯甲烷)与肾癌之间的关联。

方法

病例组(n = 1217)和对照组(n = 1235)提供了他们的职业史信息,对于选定的职业,通过特定工作的访谈模块提供了涉及潜在接触氯化溶剂任务的信息。利用这些信息,一名工业卫生学家评估了对每种溶剂的潜在接触情况。我们以未接触者作为参照组,计算了不同暴露指标的比值比(OR)和95%可信区间(CI)。

结果

1,1,1 - 三氯乙烷、四氯化碳、氯仿和二氯甲烷与肾癌无关。在高暴露强度的工作中,全氯乙烯的高累积暴露小时数与风险增加相关,总体上(第三三分位数与未接触者相比:OR 3.1,95% CI 1.3至7.4)以及在排除三氯乙烯暴露概率≥50%的参与者后(OR 3.0,95% CI 0.99至9.0)均如此。观察到三氯乙烯的高累积暴露小时数与肾癌有非显著关联(OR 1.7,95% CI 0.8至3.8)。

结论

在本研究中,高暴露于全氯乙烯与肾癌有关,且独立于三氯乙烯。需要进一步的研究来深入调查这一发现。

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