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在一个海军核造船厂进行的白血病病例对照研究。

A case-control study of leukemia at a naval nuclear shipyard.

作者信息

Stern F B, Waxweiler R A, Beaumont J J, Lee S T, Rinsky R A, Zumwalde R D, Halperin W E, Bierbaum P J, Landrigan P J, Murray W E

出版信息

Am J Epidemiol. 1986 Jun;123(6):980-92. doi: 10.1093/oxfordjournals.aje.a114350.

Abstract

A matched case-control study was conducted of 53 leukemia deaths and of 212 controls within a previously studied cohort of 24,545 on-shore workers employed between January 1, 1952 and August 15, 1977 at the Portsmouth (New Hampshire) Naval Shipyard. The study sought to ascertain a priori whether there was an association between leukemia deaths and occupational exposure to either ionizing radiation or organic solvents. To obtain information on individual exposures, radiation dose histories and detailed work histories by job and shop were evaluated for each subject. No statistically significant associations were found either between ionizing radiation or presumed solvent exposure and myelogenous or lymphatic leukemia. However, when specific job categories and shops were examined without benefit of a priori hypotheses, two occupations, electrician and welder, were found to be associated with leukemia. For electricians, the Mantel-Haenszel odds ratio (ORMH) was significantly elevated for all leukemias (ORMH = 3.00, 95% confidence interval (CI) = 1.29-6.98), particularly for lymphatic leukemia (ORMH = 6.00, 95% CI = 1.47-24.45). For welders, the odds ratio was not significantly elevated for all leukemias (ORMH = 2.25, 95% CI = 0.92-5.53), but was significantly elevated for myeloid leukemia (ORMH = 3.83, 95% CI = 1.28-11.46). These findings persisted when potential confounders were adjusted by means of a conditional logistic regression model.

摘要

在一个先前研究过的队列中,对1952年1月1日至1977年8月15日期间在朴茨茅斯(新罕布什尔州)海军造船厂工作的24545名岸上工人进行了一项匹配病例对照研究,其中有53例白血病死亡病例和212名对照。该研究旨在预先确定白血病死亡与职业性接触电离辐射或有机溶剂之间是否存在关联。为了获取个体接触信息,对每个受试者的辐射剂量史以及按工作和车间划分的详细工作史进行了评估。在电离辐射或假定的溶剂接触与髓性或淋巴性白血病之间未发现具有统计学意义的关联。然而,在没有先验假设的情况下检查特定的工作类别和车间时,发现电工和焊工这两个职业与白血病有关。对于电工,所有白血病的Mantel-Haenszel优势比(ORMH)显著升高(ORMH = 3.00,95%置信区间(CI)= 1.29 - 6.98),特别是淋巴性白血病(ORMH = 6.00,95% CI = 1.47 - 24.45)。对于焊工,所有白血病的优势比没有显著升高(ORMH = 2.25,95% CI = 0.92 - 5.53),但髓细胞性白血病的优势比显著升高(ORMH = 3.83,95% CI = 1.28 - 11.46)。当通过条件逻辑回归模型对潜在混杂因素进行调整后,这些发现仍然存在。

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