Wright W E, Bernstein L, Peters J M, Garabrant D H, Mack T M
Department of Preventive Medicine, University of Southern California School of Medicine, Los Angeles 90033.
Am J Epidemiol. 1988 Jul;128(1):64-73. doi: 10.1093/oxfordjournals.aje.a114959.
The authors studied 1,342 cases of adenocarcinoma of the stomach identified by a population-based cancer registry in Los Angeles County, California. The cases were males aged 20-64 years first diagnosed between 1972 and 1982. To determine whether exposure to occupational dust increased the risk of developing stomach cancer, occupational titles were rated for the likelihood of exposure to various kinds of dust. Men who worked in dusty jobs had a risk for developing stomach cancer 1.3 times that of unexposed men (95% confidence interval = 1.2-1.4). The association of exposure to dust with stomach cancer was stronger at higher levels of exposure. The risk was not uniform throughout the stomach: the highest risk (1.8 times that of unexposed men) was found for the antrum/pylorus. At that site, exposure to mineral dust carried the greatest risk for cancer (3.7 times the risk for unexposed men). The highest risks from dust exposure were observed in blacks. Risk was related to race, socioeconomic status, and immigrant status, but these factors did not entirely explain the association with dust exposure. The observed relation between dust exposure and stomach cancer is consistent with results of previous mortality and case-control studies of cancer in men who worked in dusty occupations. Ingested dust may be one factor in the etiology of adenocarcinoma of the stomach.
作者研究了加利福尼亚州洛杉矶县基于人群的癌症登记处确定的1342例胃癌腺癌病例。这些病例为年龄在20至64岁之间、于1972年至1982年首次确诊的男性。为了确定接触职业粉尘是否会增加患胃癌的风险,对职业头衔接触各种粉尘的可能性进行了评级。从事多尘工作的男性患胃癌的风险是未接触者的1.3倍(95%置信区间=1.2-1.4)。在较高接触水平下,粉尘接触与胃癌的关联更强。整个胃部的风险并不一致:胃窦/幽门处的风险最高(是未接触者的1.8倍)。在该部位,接触矿物粉尘患癌风险最大(是未接触者的3.7倍)。黑人中观察到粉尘接触的风险最高。风险与种族、社会经济地位和移民身份有关,但这些因素并不能完全解释与粉尘接触的关联。观察到的粉尘接触与胃癌之间的关系与之前对从事多尘职业男性癌症的死亡率和病例对照研究结果一致。摄入的粉尘可能是胃腺癌病因中的一个因素。