Department of Effects and Risks of Ionizing and Non-Ionizing Radiation, Federal Office for Radiation; Protection, Neuherberg, Germany.
Dtsch Arztebl Int. 2021 Jan 29;118(4):41-48. doi: 10.3238/arztebl.m2021.0001.
From 1946 to 1990, more than 400 000 people were employed by Wismut AG, a Soviet/Soviet-German corporation (German abbreviation: SAG/ SDAG), in the East German states of Saxony and Thuringia. In the early years in particular, employees were exposed to large amounts of radon and respirable crystalline silica.
In a cohort of 35 204 former underground employees of Wismut AG, mortality was analyzed in comparison to the general male population of East Germany, and the pertaining standardized mortality ratios (SMRs) were calculated.
18 510 persons in the study cohort died in the follow-up period 1960-2013. Mortality from lung cancer was 2.36 higher in the study cohort than in the general population (95% confidence interval, [2.28; 2.45]); the associated SMRs rose markedly with increasing radon exposure. Mortality from silicosis and other types of pneumoconiosis was elevated by a factor of 22.62 [21.20; 24.11], and the associated SMRs rose exponentially with increasing exposure to respirable crystalline silica. Mortality from both of these causes was still markedly elevated more than 20 years after Wismut AG had ceased its activities. Mortality from a wide range of other diseases was elevated as well, with the following SMRs: stomach cancer, 1.28 [1.17; 1.40]; liver cancer, 1.34 [1.15; 1.55]; all tumors other than lung cancer, 1.06 [1.02; 1.09]; infections, 1.18 [1.01; 1.38]; cerebrovascular diseases, 1.33 [1.26; 1.41]; and influenza/pneumonia, 1.13 [1.01; 1.27]. Mortality from a small number of other causes was found to be markedly lowered in the study cohort (mental illness, renal diseases, and nervous system diseases). The role of occupational risk factors, lifestyle differences and other reasons for the latter results is unclear.
Underground miners employed by Wismut AG displayed marked excess mortality due to silicosis/other pneumoconiosis and lung cancer. The contribution of individual occupational risk factors for these and other causes of death with increased SMR are being further investigated in analyses within the study cohort.
1946 年至 1990 年间,有超过 40 万人受雇于苏联/苏德合资企业 Wismut AG,在东德的萨克森州和图林根州工作。尤其是在早期,员工们接触到了大量的氡气和可吸入结晶硅。
在 Wismut AG 的 35204 名前地下矿工队列中,将死亡率与东德男性总人口进行了比较,并计算了相应的标准化死亡率比(SMR)。
在 1960 年至 2013 年的随访期间,研究队列中有 18510 人死亡。与普通人群相比,研究队列中肺癌的死亡率高出 2.36 倍(95%置信区间[2.28;2.45]);与氡暴露量增加相关的 SMR 显著升高。矽肺和其他类型尘肺的死亡率升高了 22.62 倍(21.20;24.11),与可吸入结晶硅接触量增加呈指数相关。在 Wismut AG 停止运营 20 多年后,这两种病因导致的死亡率仍然明显升高。其他多种疾病的死亡率也有所升高,以下是 SMR:胃癌 1.28 [1.17;1.40];肝癌 1.34 [1.15;1.55];非肺癌肿瘤 1.06 [1.02;1.09];感染 1.18 [1.01;1.38];脑血管疾病 1.33 [1.26;1.41];流感/肺炎 1.13 [1.01;1.27]。研究队列中发现,少数其他原因导致的死亡率明显降低(精神疾病、肾脏疾病和神经系统疾病)。对于后一种结果,职业风险因素、生活方式差异和其他原因的作用尚不清楚。
Wismut AG 的地下矿工因矽肺/其他尘肺和肺癌导致死亡率明显增加。正在对研究队列中的分析进一步调查这些和其他 SMR 升高原因的个别职业风险因素的作用。