Energy Workers Department, CPWR - The Center for Construction Research and Training, Seattle, Washington.
Division of Occupational and Environmental Medicine, Duke University Medical Center, Durham, North Carolina.
Am J Ind Med. 2019 Sep;62(9):742-754. doi: 10.1002/ajim.23018. Epub 2019 Aug 5.
To determine if construction and trades workers employed at U.S. Department of Energy (DOE) nuclear sites facilities are at significant risk for diseases associated with occupational exposures, we compared the mortality experience of participants in the Building Trades National Medical Screening Program (BTMed) to that of the US population.
The cohort includes 24,086 BTMed participants enrolled between 1998 and 2016 and 5203 deaths. Cause-specific standardized mortality ratios were calculated based on US death rates.
Mortality was elevated for all causes, all cancers, cancers of the trachea, bronchus, and lung and lymphatic and hematopoietic system, mesothelioma, chronic obstructive pulmonary disease, asbestosis, transportation injuries, and other injuries, particularly those caused by accidental poisoning, suggesting a possible effect of the opioid epidemic.
Apart from other injuries, mortality patterns were very similar to those reported in the past in this population. Construction workers employed at DOE sites have a significantly increased risk for occupational illnesses. Risks are associated with employment during all time periods covered including possibly after 1990. The cancer risks closely match the cancers identified for DOE compensation from radiation exposures. The high risk of lung cancer supports the value of early lung cancer detection. Continued medical surveillance is important.
为了确定在美国能源部（DOE）核设施工作的建筑和行业工人是否存在与职业暴露相关的疾病的高风险，我们将建筑行业国家医疗筛查计划（BTMed）参与者的死亡率与美国人口的死亡率进行了比较。
该队列包括 1998 年至 2016 年间登记的 24086 名 BTMed 参与者和 5203 例死亡。根据美国死亡率计算了特定原因的标准化死亡率比。
所有原因、所有癌症、气管、支气管和肺以及淋巴和造血系统、间皮瘤、慢性阻塞性肺疾病、石棉沉着病、交通伤害和其他伤害的死亡率都升高，尤其是那些由意外中毒引起的伤害，这表明可能存在阿片类药物流行的影响。
除了其他伤害外，死亡率模式与该人群过去报告的模式非常相似。在 DOE 现场工作的建筑工人患职业疾病的风险显著增加。风险与所涵盖的所有时期的就业有关，包括可能在 1990 年后。癌症风险与 DOE 因辐射暴露而获得赔偿的癌症非常吻合。肺癌风险高支持早期肺癌检测的价值。持续的医疗监测很重要。
