Doll R
Imperial Cancer Research Fund, Radcliffe Infirmary, Oxford, United Kingdom.
Scand J Work Environ Health. 1988 Apr;14(2):61-78. doi: 10.5271/sjweh.1943.
This paper reviews the possible effects of vinyl chloride on the mortality of occupationally exposed men and the carcinogenic effects that might be observed in the general population as a result of environmental pollution with vinyl chloride. The results of four studies fulfilling the criteria of providing substantial numbers of observations more than 25 years after first exposure and covering a period long enough for more than 10% of the workers to have been expected to die constitute the basis for the assessment of the occupational hazards. Other studies provide only supplementary information. The data permit two conclusions. First, men occupationally exposed to vinyl chloride have experienced a specific hazard of angiosarcoma of the liver. Second, any other occupational hazards that may have existed have been small. No positive evidence of a hazard of any nonmalignant disease or any type of cancer other than angiosarcoma of the liver has been found except possibly for a small hazard of lung cancer when exposure was heavy. More definite conclusions might be reached if those who have studied exposed employees could present their results in appropriate and comparable ways. A very small risk of angiosarcoma may have occurred as a result of vinyl chloride escaping into the environment around plants handling vinyl chloride in the past, but the evidence indicates that the current risk to the general public (if any) must be negligible.
本文综述了氯乙烯对职业暴露男性死亡率的可能影响,以及因氯乙烯环境污染可能在普通人群中观察到的致癌作用。四项研究的结果满足以下标准:首次接触25年多后提供了大量观察数据,且覆盖时间足够长,使得超过10%的工人预期死亡,这些结果构成了评估职业危害的基础。其他研究仅提供补充信息。这些数据可得出两个结论。第一,职业暴露于氯乙烯的男性经历了患肝血管肉瘤的特定风险。第二,可能存在的任何其他职业危害都很小。除了在高暴露情况下可能存在较小的肺癌风险外,未发现任何非恶性疾病或除肝血管肉瘤以外的任何类型癌症存在危害的阳性证据。如果研究暴露员工的人员能够以适当且可比的方式呈现其结果,可能会得出更明确的结论。过去,氯乙烯泄漏到处理氯乙烯的工厂周围环境中可能导致了极小的肝血管肉瘤风险,但有证据表明,目前对普通公众的风险(如果有)必定可以忽略不计。