Gubéran E, Usel M, Raymond L, Tissot R, Sweetnam P M
Geneva Medical Inspectorate of Factories, Switzerland.
Br J Ind Med. 1989 Jan;46(1):16-23. doi: 10.1136/oem.46.1.16.
The 1916 painters and the 1948 electricians who resided in the Canton of Geneva at the time of the 1970 census were identified and followed up to 1984. During the study period 121 disability pensions were awarded to painters and 59 to electricians. Age standardised incidence of disability per 1000 man-years at risk was higher among painters than among electricians for all neuropsychiatric causes (1.23/1000 and 0.68/1000, respectively) and for all other causes (5.50/1000 and 3.41/1000, respectively). No case of presenile dementia was diagnosed among painters. There was inadequate evidence to indicate that the higher risk of neuropsychiatric disability for painters might have been due to their occupational exposure to organic solvents. A possible toxic effect of these substances on the central nervous system was confounded with alcoholism which was associated with disability from neuropsychiatric disease in 12 of 20 painters and in only one of 10 electricians. Mortality and incidence of cancer were assessed among both cohorts and compared with the expected figures calculated from Geneva rates. Among painters there was a significant increase in overall mortality (O = 254, E = 218.5), in mortality from all cancers (O = 96, E = 75.4), and in incidence from all cancers (O = 159, E = 132.0). For the specific cancer sites, there was a significant excess risk for lung cancer (mortality: O = 40, E = 23.0), which was possibly related to occupational exposure to asbestos and to zinc chromate, although cigarette smoking was not controlled. The significant excesses of biliary tract cancer and of bladder cancer were in accordance with previous observations among painters from other countries. There was also a significant increase in incidence from testicular cancer (O=5, E=1.6), which has not been reported before. For causes of death other than cancer the excesses for alcoholism (O=5, E=0.8). for liver cirrhosis (O=14, E=8.8), for motor vehicle accidents (O=12, E=5.9), and for cerebrovascular disease when allowing for ten years of latency (O=8, E=4.0), were consistent with a probable increased risk of alcohol abuse. Among electricians overall mortality was similar to that expected (O=137, E=139.0). No significant excess risk was found for all cancers or for any specific cancer site. Because of the small number of expected deaths the statistical power was low for the assessment of a possible risk for leukaemia or for brain tumour.
我们确定了1970年人口普查时居住在日内瓦州的1916年的油漆工和1948年的电工，并对他们进行随访直至1984年。在研究期间，有121名油漆工和59名电工获得了残疾抚恤金。在所有神经精神疾病病因方面（分别为每1000人年有1.23例和0.68例）以及所有其他病因方面（分别为每1000人年有5.50例和3.41例），油漆工每1000人年的年龄标准化残疾发病率高于电工。在油漆工中未诊断出早老性痴呆病例。没有足够证据表明油漆工神经精神残疾风险较高可能是由于其职业接触有机溶剂所致。这些物质对中枢神经系统可能的毒性作用与酗酒相混淆，在20名油漆工中有12名因神经精神疾病导致残疾与酗酒有关，而在10名电工中只有1名如此。我们评估了两个队列的死亡率和癌症发病率，并与根据日内瓦发病率计算出的预期数字进行比较。在油漆工中，总死亡率（观察值O = 254，预期值E = 218.5）、所有癌症的死亡率（O = 96，E = 75.4）以及所有癌症的发病率（O = 159，E = 132.0）均有显著增加。对于特定癌症部位，肺癌存在显著的额外风险（死亡率：O = 40，E = 23.0），这可能与职业接触石棉和铬酸锌有关，尽管未对吸烟进行控制。胆管癌和膀胱癌的显著超额发病率与之前其他国家油漆工中的观察结果一致。睾丸癌的发病率也有显著增加（O = 5，E = 1.6），此前未见报道。在除癌症以外的死因方面，酗酒（O = 5，E = 0.8）、肝硬化（O = 14，E = 8.8）、机动车事故（O = 12，E = 5.9）以及考虑到十年潜伏期后的脑血管疾病（O = 8，E = 4.0）的超额发病率，均表明酗酒风险可能增加。在电工中，总死亡率与预期死亡率相似（O = 137，E = 139.0）。在所有癌症或任何特定癌症部位均未发现显著的额外风险。由于预期死亡人数较少，在评估白血病或脑瘤的可能风险时，统计效力较低。
