Stayner L T, Elliott L, Blade L, Keenlyside R, Halperin W
Division of Surveillance, Hazard Evaluations, and Field Studies, National Institute for Occupational Safety and Health, Cincinnati OH 45226.
Am J Ind Med. 1988;13(6):667-81. doi: 10.1002/ajim.4700130606.
In order to assess the possible human carcinogenicity of formaldehyde we conducted a retrospective cohort mortality study of workers exposed for at least three months to formaldehyde in three garment facilities which produced permanent press garments. A total of 11,030 workers contributing 188,025 person-years were included in the study. Vital status was successfully ascertained through 1982 for over 96% of the cohort. The average (TWA) formaldehyde exposure at the three plants monitored in 1981 and 1984 by NIOSH was 0.15 ppm but past exposures may have been substantially higher. In general, mortality from nonmalignant causes was less than expected. A statistically significant excess in mortality from cancers of the buccal cavity (SMR = 343) and connective tissue (SMR = 364) was observed. Statistically nonsignificant excesses in mortality were observed for cancers of the trachea, bronchus and lung (SMR = 114), pharynx (SMR = 112), bladder (SMR = 145), leukemia and aleukemia (SMR = 113), and other lymphopoietic neoplasms (SMR = 170). Mortality from cancers of the trachea, bronchus and lung was inversely related to duration of exposure and latency. In contrast, mortality from cancers of the buccal cavity, leukemias, and other lymphopoietic neoplasms increased with duration of formaldehyde exposure and/or latency. These neoplasms also were found to be highest among workers first exposed during a time period of high potential formaldehyde exposures in this industry (1955-1962). However, it should be recognized that these findings are based on relatively small numbers and that confounding by other factors may still exist. The results from this investigation, although far from conclusive, do provide evidence of a possible relationship between formaldehyde exposure and the development of upper respiratory cancers (buccal), leukemias, and other lymphopoietic neoplasms in humans.
为评估甲醛对人类的潜在致癌性，我们对三家生产免烫服装的制衣厂中接触甲醛至少三个月的工人进行了一项回顾性队列死亡率研究。该研究共纳入了11,030名工人，贡献了188,025人年的数据。截至1982年，超过96%的队列成员的生命状态已成功确定。美国国家职业安全与健康研究所（NIOSH）在1981年和1984年监测的三家工厂中，甲醛的平均（时间加权平均）暴露量为0.15 ppm，但过去的暴露量可能要高得多。总体而言，非恶性病因导致的死亡率低于预期。观察到口腔癌（标准化死亡比=343）和结缔组织癌（标准化死亡比=364）的死亡率有统计学意义的显著增加。气管、支气管和肺癌（标准化死亡比=114）、咽癌（标准化死亡比=112）、膀胱癌（标准化死亡比=145）、白血病和非白血病（标准化死亡比=113）以及其他淋巴造血系统肿瘤（标准化死亡比=170）的死亡率虽有增加，但无统计学意义。气管、支气管和肺癌的死亡率与暴露持续时间和潜伏期呈负相关。相比之下，口腔癌、白血病和其他淋巴造血系统肿瘤的死亡率随甲醛暴露持续时间和/或潜伏期的增加而升高。这些肿瘤在该行业甲醛暴露可能性较高的时期（1955 - 1962年）首次接触甲醛的工人中也最高。然而，应该认识到这些发现基于相对较少的病例数，并且可能仍然存在其他因素的混杂影响。本调查结果虽然远非结论性的，但确实提供了证据表明甲醛暴露与人类上呼吸道癌症（口腔）、白血病和其他淋巴造血系统肿瘤的发生之间可能存在关联。
