英国间皮瘤死亡率：造船厂还将主导多久？

Mesothelioma mortality in Great Britain: how much longer will dockyards dominate?

机构信息

National Heart & Lung Institute, Imperial College London, London, UK

National Heart & Lung Institute, Imperial College London, London, UK.

出版信息

Occup Environ Med. 2019 Dec;76(12):908-912. doi: 10.1136/oemed-2019-105878. Epub 2019 Oct 29.

DOI:10.1136/oemed-2019-105878

PMID:31662422

Abstract

OBJECTIVES

We aimed to investigate whether there has been a geographic shift in the distribution of mesothelioma deaths in Great Britain given the decline of shipbuilding and progressive exposure regulation.

METHODS

We calculated age-adjusted mesothelioma mortality rates and estimated rate ratios for areas with and without a dockyard. We compared spatial autocorrelation statistics (Moran's I) for age-adjusted rates at local authority district level for 2002-2008 and 2009-2015. We measured the mean distance of the deceased's postcode to the nearest dockyard at district level and calculated the association of average distance to dockyard and district mesothelioma mortality using simple linear regression for men, for 2002-2008 and 2009-2015.

RESULTS

District age-adjusted male mortality rates fell during 2002-2015 for 80 of 348 districts (23%), rose for 267 (77%) and were unchanged for one district; having one or more dockyards in a district was associated with rates falling (OR=2.43, 95% CI 1.22 to 4.82, p=0.02). The mortality rate ratio for men in districts with a dockyard, compared with those without a dockyard was 1.41 (95% CI 1.35 to 1.48, p<0.05) for 2002-2008 and 1.18 (95% CI 1.13 to 1.23, p<0.05) for 2009-2015. Spatial autocorrelation (measured by Moran's I) decreased from 0.317 (95% CI 0.316 to 0.319, p=0.001) to 0.312 (95% CI 0.310 to 0.314, p=0.001) for men and the coefficient of the association between distance to dockyard and district level age-adjusted male mortality (per million population) from -0.16 (95% CI -0.21 to -0.10, p<0.01) to -0.13 (95% CI -0.18 to -0.07, p<0.01) for men, when comparing 2002-2008 with 2009-2015.

CONCLUSION

For most districts age-adjusted mesothelioma mortality rates increased through 2002-2015 but the relative contribution from districts with a dockyard fell. Dockyards remain strongly spatially associated with mesothelioma mortality but the strength of this association appears to be falling and mesothelioma deaths are becoming more dispersed.

摘要

目的

鉴于造船业的衰落和逐步加强的监管，我们旨在调查英国间皮瘤死亡的分布是否存在地理转移。

方法

我们计算了有和没有船坞的地区的年龄调整间皮瘤死亡率，并估计了比率比。我们比较了 2002-2008 年和 2009-2015 年地方当局地区年龄调整率的空间自相关统计数据（Moran's I）。我们测量了死者所在邮区的平均距离到地区一级的最近船坞，并使用简单线性回归计算了男性 2002-2008 年和 2009-2015 年的平均距离与地区间皮瘤死亡率之间的关联。

结果

2002-2015 年间，348 个地区中有 80 个（23%）地区的年龄调整男性死亡率下降，267 个（77%）地区上升，一个地区不变；一个地区有一个或多个船坞与死亡率下降相关（OR=2.43，95%CI 1.22 至 4.82，p=0.02）。与没有船坞的地区相比，有船坞的地区的男性死亡率比为 1.41（95%CI 1.35 至 1.48，p<0.05），2002-2008 年为 1.18（95%CI 1.13 至 1.23，p<0.05）。2009-2015 年。男性的空间自相关（由 Moran's I 衡量）从 0.317（95%CI 0.316 至 0.319，p=0.001）降至 0.312（95%CI 0.310 至 0.314，p=0.001），与船坞距离和地区一级年龄调整男性死亡率（每百万人口）之间的关联系数从-0.16（95%CI -0.21 至-0.10，p<0.01）降至-0.13（95%CI -0.18 至-0.07，p<0.01），比较 2002-2008 年与 2009-2015 年。