Department of Medical and Surgical Sciences (DIMEC), Bologna University, Bologna, Italy (Dr Farioli and Dr Violante); Department of Clinical Sciences and Community Health, Milan University, Milan, Italy (Dr La Vecchia and Mr Pelucchi); Department of Biomedical and Clinical Sciences, Milan University, Milan, Italy (Ms Negri); Department of Environmental Science, Safety, Territory, Food and Health, Messina University, Messina, Italy (Dr Spatari); Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, New York (Dr Boffetta); Department of Public Health Sciences and Pediatrics, Turin University, Turin, Italy (Dr Pira).
J Occup Environ Med. 2018 Jun;60(6):536-541. doi: 10.1097/JOM.0000000000001260.
The aim of the study was to assess the risk of asbestosis death based on the temporal pattern of exposure to asbestos.
We followed up a cohort of asbestos textile workers, employed in 1946 to 1984, until November 2013. We measured the duration of the employment, the time since last employment (TSLE), the age, and the year of first employment. Hazard ratios (HR) were estimated through multivariable Cox regression models.
We observed 51 asbestosis deaths among 1823 workers. The HR of asbestosis death increased with exposure duration (HR 2.4 for ≥15 years compared with <5 years, P trend = 0.014) and declined with TSLE (HR 0.3 for ≥25 compared with <5 years, P = 0.004). The risk of asbestosis mortality strongly declined for exposure starting after 1968.
The risk of asbestosis death strongly declines in the decades after cessation of the exposure.
本研究旨在评估基于石棉暴露时间模式的石棉肺死亡风险。
我们对 1946 年至 1984 年期间就业的一批石棉纺织工人进行了随访,直至 2013 年 11 月。我们测量了就业时间、末次就业时间(TSLE)、年龄和首次就业年份。通过多变量 Cox 回归模型估计危险比(HR)。
我们在 1823 名工人中观察到 51 例石棉肺死亡。石棉肺死亡的 HR 随暴露时间的增加而增加(≥15 年与<5 年相比,HR 2.4,P 趋势=0.014),随 TSLE 的增加而降低(≥25 年与<5 年相比,HR 0.3,P=0.004)。暴露开始于 1968 年后的石棉肺死亡风险显著降低。
暴露停止后的几十年,石棉肺死亡的风险大幅下降。