Wiebert Pernilla, Andersson Tomas, Feychting Maria, Sjögren Bengt, Plato Nils, Gustavsson Per
Unit of Occupational Medicine, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
Centre for Occupational and Environmental Medicine, Region Stockholm, Stockholm, Sweden.
Occup Environ Med. 2022 Dec 13;80(1):21-6. doi: 10.1136/oemed-2022-108505.
Occupational exposure to respirable crystalline silica (RCS) is common. The study aimed to assess the risk for acute myocardial infarction (AMI) after long-term exposure to RCS and to explore differences in risk between men and women.
The cohort included all manual workers identified from the Swedish National Census in 1980 using data on job titles and demography altogether from five censuses from 1960 to 1990, in total 605 246 men and 480 607 women. Information on AMI was obtained from nationwide registers from 1992 to 2006. Exposure to RCS was assessed with a job-exposure matrix. HRs and 95% CIs were estimated by Cox regression, adjusted for age, socioeconomic status and urbanisation index.
Among manual workers ever exposed to RCS, the adjusted risk of AMI was HR 1.29 (95% CI 1.15 to 1.46) in women, and HR 1.02 (95% CI 1.00 to 1.04) in men. In the highest quartile of cumulative exposure, the risk of AMI was HR 1.66 (95% CI 1.27 to 2.18) for women, and HR 1.06 (95% CI 1.03 to 1.10) for men, respectively. The risk of AMI increased with cumulative exposure to RCS both in women (p=0.001) and in men (p=0.016). An interaction analysis showed that the relative risk from exposure to RCS was statistically significantly lower in men than in women at similar exposure levels.
Occupational exposure to RCS was related to the risk of AMI. Women were more sensitive to exposure to RCS than men.
职业性接触可吸入结晶二氧化硅（RCS）很常见。本研究旨在评估长期接触RCS后急性心肌梗死（AMI）的风险，并探讨男性和女性之间的风险差异。
该队列包括1980年瑞典全国人口普查中通过1960年至1990年共五次人口普查的职业头衔和人口统计学数据确定的所有体力劳动者，共有605246名男性和480607名女性。1992年至2006年的AMI信息来自全国登记册。使用工作暴露矩阵评估RCS暴露情况。通过Cox回归估计HR和95%CI，并对年龄、社会经济地位和城市化指数进行调整。
在曾经接触过RCS的体力劳动者中，女性AMI的调整后风险为HR 1.29（95%CI 1.15至1.46），男性为HR 1.02（95%CI 1.00至1.04）。在累积暴露的最高四分位数中，女性AMI的风险为HR 1.66（95%CI 1.27至2.18），男性为HR 1.06（95%CI 1.03至1.10）。女性（p=0.001）和男性（p=0.016）的AMI风险均随RCS累积暴露增加。交互分析表明，在相似暴露水平下，男性接触RCS的相对风险在统计学上显著低于女性。
职业性接触RCS与AMI风险相关。女性比男性对RCS暴露更敏感。
