Thomas D C, Whittemore A S
Department of Preventive Medicine, University of Southern California, Los Angeles 90033.
Am J Ind Med. 1988;13(1):131-47. doi: 10.1002/ajim.4700130109.
Various approaches to assessing the interaction between smoking and occupational exposures are described. The definition of interaction depends on the measure of association under consideration and can be expressed in terms of disease risk, time, or dose. Simple descriptive methods and maximum likelihood model fitting methods are presented for analyzing interactions in terms of joint effects on disease risk. Methods for assessing the influence of exposures on times to disease, using appropriate denominators, are also described. The various approaches are illustrated with published data on lung cancer in relation to asbestos, radon daughters, chloromethyl ethers, and arsenic. Some of the mechanisms that can be invoked to explain the observed patterns include initiation and promotion, lung clearance, transport across cell membranes, and mucous secretion.
描述了评估吸烟与职业暴露之间相互作用的各种方法。相互作用的定义取决于所考虑的关联度量，并且可以用疾病风险、时间或剂量来表示。介绍了用于分析对疾病风险的联合效应方面的相互作用的简单描述性方法和最大似然模型拟合方法。还描述了使用适当分母评估暴露对疾病发生时间影响的方法。用已发表的关于肺癌与石棉、氡子体、氯甲醚和砷相关的数据说明了各种方法。可以用来解释观察到的模式的一些机制包括启动和促进、肺清除、跨细胞膜转运和粘液分泌。
