Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK.
Research Division, Institute of Occupational Medicine, Edinburgh, UK.
Occup Environ Med. 2020 May;77(5):316-323. doi: 10.1136/oemed-2019-106269. Epub 2020 Jan 23.
To examine associations between occupational exposures to rubber dust, rubber fumes and N-nitrosamines and non-cancer mortality.
A cohort of 36 441 males aged 35+ years employed in British rubber factories was followed-up to 2015 (94% deceased). Competing risk survival analysis was used to assess risks of dying from non-cancer diseases (respiratory, urinary, cerebrovascular, circulatory and digestive diseases). Occupational exposures to rubber dust, rubber fumes, N-nitrosamines were derived based on a population-specific quantitative job-exposure matrix which in-turn was based on measurements in the EU-EXASRUB database.
Exposure-response associations of increased risk with increasing exposure were found for N-nitrosomorpholine with mortality from circulatory diseases (subdistribution hazard ratio (SHR) 1.17; 95% CI 1.12 to 1.23), ischaemic heart disease (IHD) (SHR 1.19; 95% CI 1.13 to 1.26), cerebrovascular disease (SHR 1.19; 95% CI 1.07 to 1.32) and exposures to N-nitrosodimethylamine with respiratory disease mortality (SHR 1.41; 95% CI 1.30 to 1.53). Increased risks for mortality from circulatory disease, IHD and digestive diseases were found with higher levels of exposures to rubber dust, rubber fumes and N-nitrosamines sum, without an exposure-dependent manner. No associations were observed between rubber dust, rubber fumes and N-nitrosamines exposures with mortality from asthma, urinary disease, bronchitis, emphysema, liver disease and some digestive diseases.
In a cohort of rubber factory workers with 49 years of follow-up, increased risk for mortality from circulatory, cerebrovascular, respiratory and digestive diseases were found to be associated with cumulative occupational exposures to specific agents.
研究橡胶粉尘、橡胶烟雾和 N-亚硝胺职业暴露与非癌症死亡的关联。
对英国橡胶厂 35 岁以上的 36441 名男性进行了随访，随访至 2015 年（94%已死亡）。使用竞争风险生存分析评估死于非癌症疾病（呼吸、泌尿、脑血管、循环和消化系统疾病）的风险。根据特定人群的定量职业暴露矩阵，评估了橡胶粉尘、橡胶烟雾和 N-亚硝胺的职业暴露，该矩阵是基于欧盟 EXASRUB 数据库中的测量值。
发现随着暴露量的增加，N-亚硝吗啉与循环系统疾病（亚分布危险比 (SHR) 1.17；95%置信区间 (CI) 1.12 至 1.23）、缺血性心脏病（IHD）（SHR 1.19；95%CI 1.13 至 1.26）、脑血管疾病（SHR 1.19；95%CI 1.07 至 1.32）和 N-亚硝二甲胺与呼吸系统疾病死亡率（SHR 1.41；95%CI 1.30 至 1.53）的死亡率增加相关。较高水平的橡胶粉尘、橡胶烟雾和 N-亚硝胺总和暴露与循环系统疾病、IHD 和消化系统疾病死亡率增加相关，而没有暴露依赖性。未观察到橡胶粉尘、橡胶烟雾和 N-亚硝胺暴露与哮喘、泌尿系统疾病、支气管炎、肺气肿、肝病和一些消化系统疾病死亡率之间存在关联。
在一项随访 49 年的橡胶厂工人队列中，发现循环系统、脑血管、呼吸系统和消化系统疾病死亡率增加与特定职业暴露的累积暴露相关。
