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多发性骨髓瘤与务农的病例对照研究。

Case-control study of multiple myeloma and farming.

作者信息

Pearce N E, Smith A H, Howard J K, Sheppard R A, Giles H J, Teague C A

出版信息

Br J Cancer. 1986 Sep;54(3):493-500. doi: 10.1038/bjc.1986.202.

Abstract

A previous case-control study which utilised the occupational information available on the New Zealand Cancer Registry found an increased risk of multiple myeloma in agricultural workers consistent with previous findings in the United States. The findings are now presented for the second phase of the study which involved interviewing 76 cases of multiple myeloma (who had been included in the previous study) together with 315 controls with other types of cancer. The previous finding on an excess of farmers in the case group was confirmed by the interview data (odds ratio = 1.7, 95% confidence limits 1.0-2.9, P = 0.04). There were no significant differences between cases and controls regarding potential exposure to phenoxy herbicides or chlorophenols. There were also no significant differences regarding activities involving potential exposure to other agricultural chemicals, although the odds ratio for fencing work, which may involve exposure to arsenic and sodium pentachlorophenate, was 1.6 (95% confidence limits 0.9-2.7, P = 0.11). The odds ratios were significantly elevated for sheep farming (odds ratio = 1.9, 95% confidence limits 1.0-3.6, P = 0.04) and exposure to beef cattle (odds ratio = 1.7, 95% confidence limits 1.0-2.9, P = 0.05). The odds ratio was also elevated for persons reporting a history of hay fever (odds ratio = 1.9, 95% confidence limits 1.0-3.5, P = 0.05). Overall, these findings suggest that the search for the causes of elevated mortality in farmers from multiple myeloma should be directed to potential causes other than pesticide exposure.

摘要

此前一项病例对照研究利用了新西兰癌症登记处的职业信息,发现农业工人患多发性骨髓瘤的风险增加,这与美国此前的研究结果一致。现在展示该研究第二阶段的结果,此阶段涉及对76例多发性骨髓瘤患者(这些患者已纳入此前研究)以及315例患其他类型癌症的对照者进行访谈。访谈数据证实了此前病例组中农民比例过高的发现(优势比=1.7,95%置信区间1.0 - 2.9,P = 0.04)。在病例组和对照组之间,关于潜在接触苯氧基除草剂或氯酚方面没有显著差异。在涉及潜在接触其他农用化学品的活动方面也没有显著差异,不过可能接触砷和五氯酚钠的围栏工作的优势比为1.6(95%置信区间0.9 - 2.7,P = 0.11)。养羊业(优势比=1.9,95%置信区间1.0 - 3.6,P = 0.04)和接触肉牛(优势比=1.7,95%置信区间1.0 - 2.9,P = 0.05)的优势比显著升高。报告有花粉热病史者的优势比也升高了(优势比=1.9,95%置信区间1.0 - 3.5,P = 0.05)。总体而言,这些发现表明,对于农民中多发性骨髓瘤死亡率升高原因的探寻应指向除农药接触之外的潜在原因。

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