生产硬金属工人的死亡率：德国历史队列研究。
Mortality Among Hardmetal Production Workers: German Historical Cohort Study.
机构信息
Institute for Occupational Epidemiology and Risk Assessment of Evonik Industries AG, Essen, Germany (IERA) (Drs Morfeld, Noll, Yong); Institute and Policlinic for Occupational Medicine, Environmental Medicine and Prevention Research of Cologne University Hospital, Cologne, Germany (IPOEP) (Drs Morfeld, Groß, Erren, Yong); Division of Environmental and Occupational Health Sciences, School of Public Health, University of Illinois at Chicago, Chicago, Illinois (Drs Kennedy, Esmen); Center for Occupational Biostatistics and Epidemiology, Department of Biostatistics, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, Pennsylvania (Drs Zimmerman, Buchanich, Marsh).
出版信息
J Occup Environ Med. 2017 Dec;59(12):e288-e296. doi: 10.1097/JOM.0000000000001061.
OBJECTIVE
The aim of this study was to investigate a cohort in German hardmetal industry, especially relationship between exposures to cobalt, with and without tungsten, and risks of total and cause-specific mortality.
METHODS
The cohort comprises blue-collar workers at three German plants who were employed in hardmetal processing. Individual cumulative exposures and long-term average concentrations were estimated for cobalt, nickel, tungsten, respirable, and inhalable dust. Standardized mortality ratios (SMRs) were calculated for external comparisons. Time-dependent multivariable Cox models were performed for internal analyses.
RESULTS
Elevated SMRs were found for all-cause, heart diseases, and nonmalignant respiratory diseases mortality, but not for lung cancer. Internal analyses did not show increased risks for any endpoints, and no exposure-response relationship was indicated.
CONCLUSIONS
This study does not provide evidence for elevated lung cancer risks. Methodologic limitations, incomplete ascertainment of death causes in particular, impede conclusions about exposure effects.
目的
本研究旨在调查德国硬金属行业的一个队列，特别是接触钴（是否含钨）与全因和特定原因死亡率之间的关系。
方法
该队列包括在德国三家工厂从事硬金属加工的蓝领工人。对钴、镍、钨、可吸入和总粉尘的个体累积暴露量和长期平均浓度进行了估计。为外部比较计算了标准化死亡率比（SMR）。对内部分析进行了时间依赖性多变量 Cox 模型。
结果
全因、心脏病和非恶性呼吸道疾病死亡率的 SMR 升高，但肺癌死亡率未升高。内部分析未显示任何终点的风险增加，也未表明存在暴露-反应关系。
结论
本研究没有提供肺癌风险增加的证据。方法学上的限制，特别是对死因不完全确定，妨碍了对暴露效应的结论。
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