Occup Environ Med. 2020 Mar;77(3):151-159. doi: 10.1136/oemed-2019-106012.
This study provides a detailed analysis of the global and regional burden of cancer due to occupational carcinogens from the Global Burden of Disease 2016 study.
The burden of cancer due to 14 International Agency for Research on Cancer Group 1 occupational carcinogens was estimated using the population attributable fraction, based on past population exposure prevalence and relative risks from the literature. The results were used to calculate attributable deaths and disability-adjusted life years (DALYs).
There were an estimated 349 000 (95% Uncertainty Interval 269 000 to 427 000) deaths and 7.2 (5.8 to 8.6) million DALYs in 2016 due to exposure to the included occupational carcinogens-3.9% (3.2% to 4.6%) of all cancer deaths and 3.4% (2.7% to 4.0%) of all cancer DALYs; 79% of deaths were of males and 88% were of people aged 55 -79 years. Lung cancer accounted for 86% of the deaths, mesothelioma for 7.9% and laryngeal cancer for 2.1%. Asbestos was responsible for the largest number of deaths due to occupational carcinogens (63%); other important risk factors were secondhand smoke (14%), silica (14%) and diesel engine exhaust (5%). The highest mortality rates were in high-income regions, largely due to asbestos-related cancers, whereas in other regions cancer deaths from secondhand smoke, silica and diesel engine exhaust were more prominent. From 1990 to 2016, there was a decrease in the rate for deaths (-10%) and DALYs (-15%) due to exposure to occupational carcinogens.
Work-related carcinogens are responsible for considerable disease burden worldwide. The results provide guidance for prevention and control initiatives.
本研究通过 2016 年全球疾病负担研究,对职业性致癌剂导致的全球和区域癌症负担进行了详细分析。
根据文献中的既往人群暴露流行率和相对风险,利用人群归因分数来估算 14 种国际癌症研究机构第 1 组职业性致癌剂导致的癌症负担。结果用于计算归因死亡和伤残调整生命年(DALYs)。
2016 年,由于接触纳入的职业性致癌剂,估计有 34.9 万人(95%不确定区间 26.9 万至 42.7 万)死亡和 720 万(580 万至 860 万)伤残调整生命年(DALYs),占所有癌症死亡人数的 3.9%(3.2%至 4.6%)和所有癌症 DALYs 的 3.4%(2.7%至 4.0%);79%的死亡发生在男性,88%发生在 55-79 岁的人群。肺癌导致 86%的死亡,间皮瘤占 7.9%,喉癌占 2.1%。石棉导致的职业性致癌剂相关死亡人数最多(63%);其他重要的危险因素包括二手烟(14%)、二氧化硅(14%)和柴油机废气(5%)。高收入地区的死亡率最高,主要与石棉相关的癌症有关,而在其他地区,二手烟、二氧化硅和柴油机废气导致的癌症死亡更为突出。1990 年至 2016 年,由于接触职业性致癌剂,死亡率(-10%)和 DALYs(-15%)呈下降趋势。
与工作相关的致癌剂在全球范围内造成了相当大的疾病负担。研究结果为预防和控制工作提供了指导。