Tola S, Kalliomäki P L, Pukkala E, Asp S, Korkala M L
Institute of Occupational Health, Helsinki, Finland.
Br J Ind Med. 1988 Apr;45(4):209-18. doi: 10.1136/oem.45.4.209.
The incidence of cancer in 12,693 shipyard and machine shop male workers (1689 welders, 4308 platers, 6003 machinists, 693 pipe fitters) employed for at least one year between 1945 and 1960 was investigated in a retrospective cohort study. The welders had welded only mild steel and had not been exposed to hexavalent chromium containing fume. The follow up was 99.7% complete and the total number of person-years was 304,682. The incidence of cancer in 1953-81 was ascertained through the Finnish Cancer Registry. The observed numbers of cases of cancer were compared with the expected numbers based on regional urban rates. The smoking habits of the cohort were surveyed with a postal questionnaire sent to a sample of 961 workers. The smoking habits of the cohorts were similar and smoking was not more common than among the general population. The total number of cases of cancer was 611 (exp 629) among the shipyard workers and 376 (exp 388) among the machine shop workers. The incidence of lung cancer was increased among the shipyard workers (obs 227, exp 192). This excess was observed in all the worker groups and was most evident for the pipe fitters and platers. Among the machine shop workers, the incidence of lung cancer was lower than expected with the exception of the welders who had a slightly raised risk of lung cancer (obs 14, exp 10). The incidence of laryngeal cancer was slightly raised among the shipyard workers (obs 24, exp 20) but not in the machine shop workers. No excess risk was observed among the welders. The incidence of cancer of the prostate was increased among the machine shop workers (obs 39, exp 31) but not in the shipyard workers. The excess was statistically significant for the welders. No pronounced excess could be found for other types of cancer. Analysis by the duration or exposure showed that the excess of lung cancer in the shipyard workers was most evident during the last period of observation (1972-81). No other trends were obvious and the slight excess of lung cancer observed among the welders did not increase with increasing follow up time. No excess risk for mesothelioma was found. The small excess of lung cancer in welders could be due to chance. The fact that only a small and statistically insignificant excess of lung cancer could be found among this group of heavily exposed welders suggest that if the risk of lung cancer was associated with welding this risk must nowadays be low and probably too low to be unequivocally detected in most epidemiological studies.
在一项回顾性队列研究中，对1945年至1960年间受雇至少一年的12693名造船厂和机械车间男性工人（1689名焊工、4308名镀工、6003名机械师、693名管道装配工）的癌症发病率进行了调查。这些焊工仅焊接低碳钢，未接触含六价铬的烟雾。随访完成率为99.7%，总人年数为304682。1953 - 1981年的癌症发病率通过芬兰癌症登记处确定。将观察到的癌症病例数与基于地区城市发病率的预期病例数进行比较。通过向961名工人样本发送邮政问卷来调查该队列的吸烟习惯。各队列的吸烟习惯相似，吸烟情况并不比普通人群更普遍。造船厂工人中癌症病例总数为611例（预期629例），机械车间工人中为376例（预期388例）。造船厂工人中肺癌发病率有所增加（观察到227例，预期192例）。这种超额在所有工人群体中都有观察到，在管道装配工和镀工中最为明显。在机械车间工人中，肺癌发病率低于预期，但焊工除外，焊工患肺癌的风险略有升高（观察到14例，预期10例）。造船厂工人中喉癌发病率略有升高（观察到24例，预期20例），但机械车间工人中没有。焊工中未观察到超额风险。机械车间工人中前列腺癌发病率有所增加（观察到39例，预期31例），但造船厂工人中没有。焊工的超额发病率具有统计学意义。其他类型癌症未发现明显超额。按暴露时间分析表明，造船厂工人中肺癌超额在观察的最后阶段（1972 - 1981年）最为明显。没有其他明显趋势，焊工中观察到的肺癌轻微超额并未随随访时间增加而增加。未发现间皮瘤的超额风险。焊工中肺癌的轻微超额可能是偶然因素。在这组高度暴露的焊工中仅发现少量且无统计学意义上的肺癌超额这一事实表明，如果肺癌风险与焊接有关，那么如今这种风险一定很低，可能低到在大多数流行病学研究中无法明确检测到。
