Nynäs Pia, Pukkala Eero, Vainio Harri, Oksa Panu
Finnish Institute of Occupational Health, Tampere, Finland.
Finnish Cancer Registry, Institute for Statistical and Epidemiological Cancer Research, Finland.
Saf Health Work. 2017 Jun;8(2):169-174. doi: 10.1016/j.shaw.2016.11.003. Epub 2016 Nov 20.
We assessed the cancer risks of four different Finnish asbestos-exposed cohorts. We also explored if the cohorts with varying profiles of asbestos exposure exhibited varying relative risks of cancer.
The incident cancer cases for the asbestos-exposed worker cohorts were updated to the end of 2012 using the files of the Finnish Cancer Registry. The previously formed cohorts consisted of asbestos mine workers, asbestosis patients, asbestos sprayers, and workers who had taken part in a screening study based on asbestos exposure at work.
The standardized incidence ratio (SIR) for mesothelioma varied from about threefold to > 100-fold in the different cohorts. In the screening cohort the SIR for mesothelioma was highest in 2003-2007, In other cohorts it was more constant in 5-year period inspection. The SIR for lung cancer was about twofold to tenfold in all except the screening cohort. Asbestos sprayers were at the highest risk of mesothelioma and lung cancer.
The SIR for mesothelioma is high in all of the cohorts that represent different kinds of asbestos exposure. The smaller SIR for mesothelioma in the screening cohort with lowest level of asbestos exposure might suggest dose-responsiveness between asbestos exposure and mesothelioma. It does seem that the highest risk of lung cancer in these cohorts except in the youngest of the cohorts, the screening cohort, is over. The highest SIR for lung cancer of the asbestosis patient and sprayers cohort is explained by their heavy asbestos exposure.
我们评估了四个不同的芬兰石棉暴露队列的癌症风险。我们还探讨了石棉暴露情况不同的队列是否表现出不同的癌症相对风险。
利用芬兰癌症登记处的档案,将石棉暴露工人队列的新发癌症病例更新至2012年底。先前形成的队列包括石棉矿工、石棉肺患者、石棉喷涂工以及参加过基于工作中石棉暴露的筛查研究的工人。
不同队列中,间皮瘤的标准化发病比(SIR)从约3倍到超过100倍不等。在筛查队列中,2003 - 2007年间皮瘤的SIR最高,在其他队列中,5年期间的检查结果更为稳定。除筛查队列外,所有队列中肺癌的SIR约为2倍到10倍。石棉喷涂工患间皮瘤和肺癌的风险最高。
在所有代表不同类型石棉暴露的队列中,间皮瘤的SIR都很高。石棉暴露水平最低的筛查队列中间皮瘤的SIR较小,这可能表明石棉暴露与间皮瘤之间存在剂量反应关系。似乎除了最年轻的队列即筛查队列外,这些队列中肺癌的最高风险期已经过去。石棉肺患者和喷涂工队列中肺癌的最高SIR是由他们大量的石棉暴露所解释的。