Dipartimento di Area Medica, University of Udine, Via Colugna 50, 33100, Udine, Italy.
Health and Safety at Work Department (SPISAL), Local Health Authority No 12, Region of Veneto, Mestre, Italy.
Int Arch Occup Environ Health. 2018 Oct;91(7):831-841. doi: 10.1007/s00420-018-1326-3. Epub 2018 Jun 5.
To compare a local cohort of 2488 men occupationally exposed to asbestos and enrolled in a public health surveillance program with the 1995-2009 cancer incidence of the general population of Friuli Venezia Giulia (FVG) region, Northeast Italy, we conducted a historical cohort study.
Standardized incidence ratios (SIRs), with 95% confidence interval (95% CI), for specific cancer sites were estimated in the cohort and in subgroups of workers employed in shipbuilding between 1974 and 1994. For internal comparisons, we calculated incidence rate ratios (IRRs) for all cancers, lung cancer and mesothelioma, by level of exposure to asbestos and sector of employment adjusted for smoking habits and age at start of follow-up.
Among cohort members the SIR was 8.82 (95% CI 5.95-12.61) for mesothelioma and 1.61 (95% CI 1.26-2.04) for lung cancer. In subgroup analyses, the SIR for lung cancer in subjects hired in shipbuilding between 1974 and 1984 was 2.09 (95% CI 1.32-3.13). In the overall cohort, a borderline increased incidence was also found for stomach cancer (SIR = 1.53 95% CI 0.96-2.31). Internal comparisons within the cohort show that among men with high asbestos exposure level the relative risk was almost threefold for lung cancer (IRR = 2.94 95% CI 1.01-8.57).
This cohort experienced an excess in the incidence of both mesothelioma and lung cancer, showing increasing incidence rates at higher level of asbestos exposure. For lung cancer, the relative incidence was highest among workers hired in shipbuilding between 1974 and 1984.
我们对在公共卫生监测计划中登记的、曾在意大利东北部弗留利-威尼斯朱利亚（Friuli Venezia Giulia，简称 FVG）地区职业性接触石棉的 2488 名男性进行了当地队列研究，并将其与 1995-2009 年该地区普通人群的癌症发病率进行了比较。
我们在队列中以及在 1974 年至 1994 年期间从事造船工作的工人亚组中，估计了特定癌症部位的标准化发病比（SIR）及其 95%置信区间（95%CI）。为了进行内部比较，我们根据吸烟习惯和随访开始时的年龄，调整了暴露于石棉的水平和就业部门，计算了所有癌症、肺癌和间皮瘤的发病率比值（IRR）。
在队列成员中，间皮瘤的 SIR 为 8.82（95%CI 5.95-12.61），肺癌为 1.61（95%CI 1.26-2.04）。在亚组分析中，1974 年至 1984 年期间雇佣的造船工人的肺癌 SIR 为 2.09（95%CI 1.32-3.13）。在整个队列中，胃癌的发病率也略有增加（SIR=1.53，95%CI 0.96-2.31）。队列内的内部比较显示，在高石棉暴露水平的男性中，肺癌的相对风险几乎增加了三倍（IRR=2.94，95%CI 1.01-8.57）。
该队列中同时出现了间皮瘤和肺癌发病率的增加，且随着石棉暴露水平的增加，发病率呈上升趋势。对于肺癌，在 1974 年至 1984 年期间雇佣的造船工人中的相对发病率最高。
