Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada.
Occupational Cancer Research Centre, Ontario Health, Toronto, Ontario, Canada.
Am J Ind Med. 2021 Jun;64(6):476-487. doi: 10.1002/ajim.23245. Epub 2021 Apr 8.
We sought to characterize detailed patterns of mesothelioma and asbestosis incidence in the workforce as part of an occupational disease surveillance program in Ontario, Canada.
The Occupational Disease Surveillance System (ODSS) cohort was established using workers' compensation claims data and includes 2.18 million workers employed from 1983 to 2014. Workers were followed for mesothelioma and asbestosis diagnoses in Ontario Cancer Registry, physician, hospital, and ambulatory care records through 2016. Trends in incidence rates were estimated over the study period. Cox proportional hazard models were used to estimate adjusted hazard ratios (HRs) and 95% confidence intervals (CIs).
A total of 854 mesothelioma and 737 asbestosis cases were diagnosed during follow-up. Compared with all other workers in the ODSS, those employed in construction trades occupations had the greatest adjusted incidence rate of both mesothelioma (223 cases; HR, 2.38; 95% CI: 2.03-2.78) and asbestosis (261 cases; HR, 3.64; 95% CI: 3.11-4.25). Rates were particularly elevated for insulators, pipefitters and plumbers, and carpenters. Workers in welding and flame cutting, boiler making, and mechanic and machinery repair occupations, as well as those in industrial chemical and primary metal manufacturing industries, had strongly elevated rates of both diseases. Rates were greater than anticipated for workers in electrical utility occupations and education and related services.
Results substantiate the risk of mesothelioma and asbestosis in occupation and industry groups in the Ontario workforce with known or suspected asbestos exposure. Sustained efforts to prevent the occurrence of additional cases of disease in high-risk groups are warranted.
我们旨在描述间皮瘤和石棉肺在加拿大安大略省职业病监测计划中的劳动力中的发病模式，以此作为职业疾病监测计划的一部分。
职业疾病监测系统（ODSS）队列是利用工人赔偿索赔数据建立的，包括 1983 年至 2014 年期间就业的 218 万工人。通过安大略癌症登记处、医生、医院和门诊护理记录，对工人进行间皮瘤和石棉肺诊断，随访至 2016 年。在研究期间估计发病率趋势。使用 Cox 比例风险模型估计调整后的风险比（HR）和 95%置信区间（CI）。
在随访期间共诊断出 854 例间皮瘤和 737 例石棉肺病例。与 ODSS 中的所有其他工人相比，从事建筑行业的工人患间皮瘤（223 例；HR，2.38；95%CI：2.03-2.78）和石棉肺（261 例；HR，3.64；95%CI：3.11-4.25）的调整发病率最高。绝缘工、管工和水管工以及木匠的发病率尤其高。从事焊接和火焰切割、锅炉制造以及机械和机械维修职业以及工业化学和初级金属制造业的工人，这两种疾病的发病率也很高。从事电力公用事业和教育及相关服务的工人的发病率高于预期。
结果证实了安大略省劳动力中具有已知或疑似石棉暴露的职业和行业群体患间皮瘤和石棉肺的风险。有必要持续努力防止高危人群中出现更多疾病病例。
