Sodhi-Berry Nita, Reid Alison, Fritschi Lin, Musk Aw Bill, Vermeulen Roel, de Klerk Nicholas, Peters Susan
Occupational Respiratory Epidemiology, School of Population and Global Health, The University of Western Australia, 35 Stirling Hwy., Perth, WA 6009, Australia.
School of Public Health, Curtin University, Kent St., Perth, WA 6102, Australia.
Cancer Epidemiol. 2017 Aug;49:8-18. doi: 10.1016/j.canep.2017.05.001. Epub 2017 May 18.
Miners are frequently exposed to established and potential carcinogens. We aimed to assess cancer incidence in miners relative to the general population and identify high-risk subgroups.
Incident cancers in Western Australian miners (n=153,922; 86% male) during 1996-2013 were identified. Indirectly standardised incidence ratios (SIRs) were calculated and mixed-effects Poisson models were used to calculate Incidence Rate Ratios (IRRs) to identify high-risk within-cohort subgroups.
Compared with the general population, the overall cancer incidence in miners (n=4194 cases) was lower for both females (SIR:0.83, 95%CI:0.74-0.92) and males (SIR:0.96, 95%CI:0.93-0.99). Overall, cancer incidence did not differ by employment duration or employment commencement time. Ever-underground work was associated with lung cancer (IRR:1.81, 95%CI:1.11-2.93). Relative to multi-ore miners, IRRs for specific cancers were significantly different when exclusively mining: iron (prostate:0.73, 95%CI:0.56-0.94); gold (lung:1.77, 95%CI:1.04-3.01 and colorectum:1.70, 95%CI:1.16-2.51); and other metals (urinary tract:1.85, 95%CI:1.03-3.31 and leukaemia:0.36, 95%CI:0.14-0.96).
Working underground emerged as a significant determinant of lung cancer risk in our contemporary mining cohort. Increased risks of lung, prostate, colorectal and urinary tract cancers and leukaemia were identified in miners of specific ores. These findings underline the importance of continued surveillance of the health and exposures of this relatively young cohort of miners.
矿工经常接触已确定的和潜在的致癌物。我们旨在评估矿工相对于一般人群的癌症发病率，并确定高危亚组。
确定了1996年至2013年期间西澳大利亚矿工（n = 153,922；86%为男性）的新发癌症病例。计算间接标准化发病率（SIR），并使用混合效应泊松模型计算发病率比（IRR），以确定队列内的高危亚组。
与一般人群相比，矿工（n = 4194例）中女性（SIR：0.83，95%CI：0.74 - 0.92）和男性（SIR：0.96，95%CI：0.93 - 0.99）的总体癌症发病率均较低。总体而言，癌症发病率在就业年限或就业起始时间方面没有差异。曾经从事地下工作与肺癌相关（IRR：1.81，95%CI：1.11 - 2.93）。相对于多矿种矿工，在专门开采特定矿石时，特定癌症的IRR有显著差异：铁（前列腺癌：0.73，95%CI：0.56 - 0.94）；金（肺癌：1.77，95%CI：1.04 - 3.01和结直肠癌：1.70，95%CI：1.16 - 2.51）；以及其他金属（泌尿系统癌症：1.85，95%CI：1.03 - 3.31和白血病：0.36，95%CI：0.14 - 0.96）。
在我们当代的矿工队列中，从事地下工作是肺癌风险的一个重要决定因素。在特定矿石的矿工中，发现肺癌、前列腺癌、结直肠癌和泌尿系统癌症以及白血病的风险增加。这些发现强调了持续监测这一相对年轻的矿工队列的健康和暴露情况的重要性。
