Rinsky R A, Melius J M, Hornung R W, Zumwalde R D, Waxweiler R J, Landrigan P J, Bierbaum P J, Murray W E
National Institute for Occupational Safety and Health, Cincinnati, OH 45226.
Am J Epidemiol. 1988 Jan;127(1):55-64. doi: 10.1093/oxfordjournals.aje.a114791.
Case-control analysis of deaths due to lung cancer (International Classification of Diseases, Eighth Revision, code 162) among persons who worked at the Portsmouth Naval Shipyard, Kittery, Maine, between 1952 and 1977 found elevated odds ratios for exposures to ionizing radiation, asbestos, and welding byproducts. The radiation-related excess was statistically significant in persons with cumulative lifetime exposures of 1.0-4.999 rem. When asbestos and welding histories were combined into a single risk factor, odds ratios for the combined exposure were significantly elevated for two of three duration-of-exposure categories examined. Further analysis of data on radiation exposure, controlling for exposures to asbestos and welding, found reductions in initial estimates of radiation risk at all levels of radiation exposure. This reduction suggests that radiation workers were more heavily exposed to asbestos and/or welding fumes than were other workers and that those exposures confounded the observed association between radiation and lung cancer. Analysis of mortality by time since first exposure to radiation revealed no pattern of progressive increase as latency increased. By contrast, odds ratios for asbestos/welding increased with latency. Data on cigarette smoking and socioeconomic status were not available. The results of this study do not preclude a possible association between radiation exposure at the Portsmouth Naval Shipyard and excess mortality from lung cancer. However, they provide no evidence in support of such a relation.
对1952年至1977年间在缅因州基特里的朴茨茅斯海军造船厂工作的人员中因肺癌死亡(国际疾病分类第八版,代码162)进行的病例对照分析发现,接触电离辐射、石棉和焊接副产品的比值比升高。对于累积终生暴露量为1.0 - 4.999雷姆的人员,与辐射相关的超额风险在统计学上具有显著性。当将石棉和焊接史合并为一个风险因素时,在所检查的三个暴露持续时间类别中的两个类别中,联合暴露的比值比显著升高。在控制石棉和焊接暴露的情况下,对辐射暴露数据进行进一步分析发现,在所有辐射暴露水平下,辐射风险的初始估计值均有所降低。这种降低表明,辐射工人比其他工人更多地接触石棉和/或焊接烟雾,并且这些暴露混淆了所观察到的辐射与肺癌之间的关联。对首次接触辐射后的时间进行死亡率分析发现,随着潜伏期增加,没有呈现出逐渐上升的模式。相比之下,石棉/焊接的比值比随潜伏期增加。关于吸烟和社会经济地位的数据不可用。本研究结果并不排除朴茨茅斯海军造船厂的辐射暴露与肺癌超额死亡率之间可能存在关联。然而,它们没有提供支持这种关系的证据。