Gustavsson P, Gustavsson A, Hogstedt C
Division of Occupational Medicine, National Institute of Occupational Health, Solna, Sweden.
Br J Ind Med. 1988 Nov;45(11):777-81. doi: 10.1136/oem.45.11.777.
The incidence of cancer was investigated among 5266 Swedish chimney sweeps employed for any period between 1918 and 1980. An analysis of the mortality has been reported earlier and showed an increased number of deaths from coronary heart disease, respiratory diseases, and lung, oesophageal, and liver cancer. Excess risks for cancer of the lung and oesophagus were confirmed in this analysis. Among the lung cancers, both squamous cell carcinoma and oatcell/undifferentiated carcinoma were in excess. In addition, a more than doubled risk for bladder cancer (23 observed v 9.8 expected cases) and an increase of malignancies of the haematopoietic system was found. There were, however, no cases of scrotal cancer, the classic occupational hazard among chimney sweeps. Chimney sweeps are exposed to polycyclic aromatic hydrocarbons generated by the combustion of organic material (coal, wood, coke, and oil). They are also exposed to cancerogenic metals (arsenic, nickel, and chromium). These results support the need for improved working conditions.
对1918年至1980年期间曾受雇工作过的5266名瑞典烟囱清洁工的癌症发病率进行了调查。此前已报告过对死亡率的分析，结果显示冠心病、呼吸系统疾病以及肺癌、食管癌和肝癌导致的死亡人数有所增加。本次分析证实了肺癌和食管癌存在超额风险。在肺癌病例中，鳞状细胞癌和燕麦细胞/未分化癌均呈超额状态。此外，还发现膀胱癌风险增加了一倍多（观察到23例，预期9.8例），造血系统恶性肿瘤也有所增加。然而，未发现阴囊癌病例，而阴囊癌是烟囱清洁工的典型职业危害。烟囱清洁工接触有机材料（煤、木材、焦炭和石油）燃烧产生的多环芳烃。他们还接触致癌金属（砷、镍和铬）。这些结果表明有必要改善工作条件。
