单个造船厂工人中按工作类型划分的Lung-RADS类别分布情况。
Distribution of Lung-RADS categories according to job type in a single shipyard workers.
作者信息
Chung Eui Yup, Shin Young Hoo, Kim Young Wook, Son Jun Seok, Kim Chan Woo, Park Hyoung Ouk, Lee Jun Ho, Park Seung Hyun, Woo Sung Joon, Chae Chang Ho
机构信息
Department of Occupational and Environmental Medicine, Samsung Changwon Hospital, Sungkyunkwan University School of Medicine, Changwon, Korea.
出版信息
Ann Occup Environ Med. 2021 Jun 23;33:e22. doi: 10.35371/aoem.2021.33.e22. eCollection 2021.
BACKGROUND
Recently, lung cancer screenings based on age and smoking history using low-dose computed tomography (LDCT) have begun in Korea. This study aimed to evaluate the distribution of lung imaging reporting and data system (Lung-RADS) categories in shipyard workers exposed to lung carcinogens such as nickel, chromium, and welding fumes according to job type, to provide basic data regarding indications for LDCT in shipyard workers.
METHODS
This study included 6,326 workers from a single shipyard, who underwent health examinations with LDCT between January 2010 and December 2018. Data on age, smoking status and history, medical history, and job type were investigated. The participants were categorized into high-exposure, low-exposure, and non-exposure job groups based on the estimated exposure level of nickel, chromium, and welding fumes according to job type. Cox proportional hazard regression analysis was used to determine the difference between exposure groups in Lung-RADS category ≥ 3 (3, 4A, and 4B).
RESULTS
Out of all participants, 97 (1.5%) participants were classified into Lung-RADS category ≥ 3 and 7 (0.1%) participants were confirmed as lung cancer. The positive predictive value (ratio of diagnosed lung cancer cases to Lung-RADS category ≥ 3) was 7.2%. The hazard ratio (HR) of Lung-RADS category ≥ 3 was 1.451 (95% confidence interval [CI]: 0.911-2.309) in low-exposure and 1.692 (95% CI: 1.007-2.843) in high-exposure job group. Adjusting for age and pack-years, the HR was statistically significant only in the high-exposure job group (HR: 1.689; 95% CI: 1.004-2.841).
CONCLUSIONS
Based on LDCT and Lung-RADS, among male shipyard workers, Lung-RADS category ≥ 3 were significantly higher in the high-exposure job group. Their HR tended to be > 1.0 and was statistically significant in the high-exposure job group. Additional studies should be conducted to establish more elaborate LDCT indications for occupational health examination.
背景
最近，韩国已开始基于年龄和吸烟史采用低剂量计算机断层扫描（LDCT）进行肺癌筛查。本研究旨在根据工作类型评估接触镍、铬和焊接烟尘等肺癌致癌物的造船厂工人的肺影像报告和数据系统（Lung-RADS）分类分布情况，为造船厂工人LDCT检查指征提供基础数据。
方法
本研究纳入了一家造船厂的6326名工人，他们在2010年1月至2018年12月期间接受了LDCT健康检查。调查了年龄、吸烟状况及史、病史和工作类型等数据。根据工作类型对镍、铬和焊接烟尘的估计暴露水平，将参与者分为高暴露、低暴露和非暴露工作组。采用Cox比例风险回归分析来确定暴露组之间Lung-RADS分类≥3（3、4A和4B）的差异。
结果
在所有参与者中，97名（1.5%）参与者被归类为Lung-RADS分类≥3，7名（0.1%）参与者被确诊为肺癌。阳性预测值（确诊肺癌病例与Lung-RADS分类≥3的比例）为7.2%。低暴露工作组中Lung-RADS分类≥3的风险比（HR）为1.451（95%置信区间[CI]：0.911 - 2.309），高暴露工作组为1.692（95%CI：1.007 - 2.843）。在调整年龄和吸烟包年数后，HR仅在高暴露工作组具有统计学意义（HR：1.689；95%CI：1.004 - 2.841）。
结论
基于LDCT和Lung-RADS，在男性造船厂工人中，高暴露工作组的Lung-RADS分类≥3显著更高。其HR倾向于>1.0，且在高暴露工作组具有统计学意义。应开展更多研究以建立更精细的职业健康检查LDCT指征。
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