Wong O
Environmental Health Associates, Inc., Oakland, California 94607.
Am J Ind Med. 1988;14(4):417-31. doi: 10.1002/ajim.4700140406.
The cohort of this historical prospective mortality study consisted of 697 male employees at a chlorination plant. A majority of the cohort was potentially exposed to benzotrichloride, benzyl chloride, benzoyl chloride, and other related chemicals. The mortality experience of the cohort was observed from 1943 through 1982. For the cohort as a whole, no statistically significant mortality excess was detected. The overall Standardized Mortality Ratio (SMR) was 100, and the SMR for all cancers combined was 122 (not significant). The respiratory cancer SMR for the cohort as a whole was 246 (7 observed vs. 2.8 expected). The excess was of borderline statistical significance, the lower 95% confidence limit being 99. Analysis by race showed that all 7 respiratory cancer deaths came from the white male employees, with an SMR of 265 (p less than 0.05). The respiratory cancer mortality excess was higher among employees in maintenance (SMR = 229) than among those in operations or production (SMR = 178). The lung cancer mortality excess among the laboratory employees was statistically significant (SMR = 1292). However, this observation should be viewed with caution, since it was based on only 2 deaths. Further analysis indicated that the respiratory cancer mortality excess was limited to the male employees with 15 or more years of employment (SMR = 379, p less than 0.05). Based on animal data as well as other epidemiologic studies, together with the internal consistency of analysis by length of employment, the data suggest an association between the chlorination process of toluene at the plant and an increased risk of respiratory cancer.(ABSTRACT TRUNCATED AT 250 WORDS)
这项历史性前瞻性死亡率研究的队列由一家氯化工厂的697名男性员工组成。该队列中的大多数人可能接触过三氯甲苯、苄基氯、苯甲酰氯及其他相关化学品。对该队列的死亡情况从1943年观察至1982年。就整个队列而言,未检测到具有统计学意义的死亡率过高情况。总体标准化死亡率(SMR)为100,所有癌症合并的SMR为122(无统计学意义)。整个队列的呼吸道癌症SMR为246(观察到7例,预期为2.8例)。该过高情况具有临界统计学意义,95%置信下限为99。按种族分析表明,7例呼吸道癌症死亡均来自白人男性员工,SMR为265(p<0.05)。维修部门员工的呼吸道癌症死亡率过高情况高于运营或生产部门员工(SMR = 229与SMR = 178)。实验室员工中的肺癌死亡率过高情况具有统计学意义(SMR = 1292)。然而,这一观察结果应谨慎看待,因为它仅基于2例死亡。进一步分析表明,呼吸道癌症死亡率过高情况仅限于工作15年及以上的男性员工(SMR = 379,p<0.05)。基于动物数据以及其他流行病学研究,再加上按工作时长分析的内部一致性,数据表明该工厂甲苯的氯化过程与呼吸道癌症风险增加之间存在关联。(摘要截选至250词)