Levin L I, Gao Y T, Blot W J, Zheng W, Fraumeni J F
National Cancer Institute, Division of Cancer Etiology, Bethesda, Maryland 20892.
Cancer Res. 1987 Nov 1;47(21):5777-81.
The relationship between lung cancer risk and work in the cotton textile industry was investigated in a large population-based case-control study in urban Shanghai, where the industry is a major employer of men and women. Personal interviews obtained occupational, smoking, and other information from 1405 newly diagnosed lung cancer cases and 1495 controls. A significantly low risk of lung cancer was associated with cotton textile employment [odds ratio (OR) = 0.7,95% confidence interval (CI) = 0.6-0.9]. In men, the decreased risk was observed among both smokers (OR = 0.7, 95% CI = 0.5-1.1) and nonsmokers (OR = 0.3, 95% CI = 0.1-1.0). In women, the risk was also decreased regardless of smoking status (OR = 0.8, 95% CI = 0.4-1.6 among smokers; OR = 0.9, 95% CI = 0.6-1.2 among nonsmokers). In both sexes, the reductions in risk tended to be greater for lung cancer cell types other than adenocarcinoma. Low risks were found regardless of occupations within the cotton textile industry; the OR for workers in textile processing who potentially had greater dust exposure was 0.8 (95% CI = 0.6-1.2), whereas the OR for those in other industry jobs was 0.7 (95% CI = 0.4-1.0). There was little difference in risk according to self-reported exposure to textile dust, and no clear trend with duration of employment or dust exposure. Reasons for the reduced risk of lung cancer in cotton textile workers without a dose response are unclear, although several methodological explanations were considered. The findings, however, appear consistent with prior epidemiological studies and are interesting in light of speculation about tumor-inhibitory factors, such as bacterial endotoxins, that are found in dusts from cotton and other fiber crops.
在上海市区一项基于人群的大型病例对照研究中，对肺癌风险与从事棉纺织业工作之间的关系进行了调查，在该地区，棉纺织业是男性和女性的主要雇主。通过个人访谈，从1405例新诊断的肺癌病例和1495名对照者那里获取了职业、吸烟及其他信息。从事棉纺织业与肺癌风险显著降低相关[比值比（OR）=0.7，95%置信区间（CI）=0.6 - 0.9]。在男性中，吸烟者（OR = 0.7，95% CI = 0.5 - 1.1）和不吸烟者（OR = 0.3，95% CI = 0.1 - 1.0）的风险均降低。在女性中，无论吸烟状况如何，风险也都降低（吸烟者中OR = 0.8，95% CI = 0.4 - 1.6；不吸烟者中OR = 0.9，95% CI = 0.6 - 1.2）。在男女两性中，除腺癌外的其他肺癌细胞类型的风险降低往往更大。无论在棉纺织业内从事何种职业，风险都较低；纺织加工行业中可能接触粉尘较多的工人的OR为0.8（95% CI = 0.6 - 1.2），而从事其他行业工作的人的OR为0.7（95% CI = 0.4 - 1.0）。根据自我报告的接触纺织粉尘情况，风险差异不大，且在就业时长或粉尘接触方面没有明显趋势。棉纺织工人肺癌风险降低且无剂量反应关系的原因尚不清楚，尽管考虑了几种方法学上的解释。然而，这些发现似乎与先前的流行病学研究一致，并且鉴于对肿瘤抑制因子（如在棉花和其他纤维作物粉尘中发现的细菌内毒素）的推测，这些发现很有意思。
