挪威消防部门队列研究中男性消防员的职业暴露与尿路癌症风险。
Occupational exposures of firefighting and urinary tract cancer risk among men in the Norwegian Fire Departments Cohort.
机构信息
Department of Research, Cancer Registry of Norway, Oslo, Norway
Oslo Centre for Biostatistics and Epidemiology, Department of Biostatistics, Institute of Basic Medical Sciences, University of Oslo, Oslo, Norway.
出版信息
Occup Environ Med. 2023 Nov 23;80(12):659-666. doi: 10.1136/oemed-2023-109003.
OBJECTIVES
Increased risks of bladder cancer and mesothelioma were the strongest evidence for the recent reclassification of firefighting as carcinogenic (Group 1) by the International Agency for Research on Cancer. Our study aim was to develop indicators for specific firefighting exposures and examine associations with urinary tract cancer (UTC), including bladder cancer.
METHODS
We developed indicators for exposure from employment at a fire department or in firefighting jobs, to fire and smoke, and to diesel exhaust for men in the Norwegian Fire Departments Cohort (n=4250). Incident UTC cases were obtained from the Cancer Registry of Norway (1960-2021). Poisson regression was used to estimate incidence rate ratios (IRR) with cumulative exposures grouped into tertiles (reference: lowest exposed tertile) with 0-year, 10-year and 15-year lagging of exposures.
RESULTS
During 125 090 person-years of follow-up, there were 76 cases of UTC. IRRs were mostly non-significantly increased in the middle tertile and at or below 1 in the highest tertile for total duration of employment, number of fires attended and fire exposure score with and without lags. In the middle tertile for diesel exhaust exposure, UTC risk was elevated over twofold with 10-year (IRR 2.27, 95% CI 1.22 to 4.20) and 15- year (2.21, 1.18 to 4.16) lags, and near 1 in the highest tertile. Findings for bladder cancer were similar to those for UTC.
CONCLUSIONS
Dose-response associations between the exposure indicators and UTC were not observed. Future studies using the indicators with more cases are needed.
目的
国际癌症研究机构（IARC）最近将消防工作重新归类为致癌因素（第 1 组），这一分类的依据是膀胱癌和间皮瘤风险增加。本研究旨在开发特定消防暴露的指标，并研究其与尿路上皮癌（UTC）的关联，包括膀胱癌。
方法
我们为挪威消防部门队列（n=4250）中的男性开发了与在消防部门工作或从事消防工作、接触火灾和烟雾以及接触柴油机废气相关的暴露指标。从挪威癌症登记处（1960-2021 年）获取 UTC 发病病例。使用泊松回归估计累积暴露量分组为三分位数（参考：暴露最低三分位数）时的发病率比（IRR），暴露的 0 年、10 年和 15 年滞后。
结果
在 125090 人年的随访期间，有 76 例 UTC 病例。在总就业时间、参加火灾次数和火灾暴露评分的中间三分位数，以及没有滞后的最高三分位数中，IRR 大多无显著增加。在柴油机废气暴露的中间三分位数中，UTC 风险升高了两倍以上，10 年（IRR 2.27，95%CI 1.22-4.20）和 15-年（2.21，1.18-4.16）的滞后，以及最高三分位数中接近 1。膀胱癌的结果与 UTC 相似。
结论
未观察到暴露指标与 UTC 之间的剂量反应关系。需要使用更多病例的未来研究来验证这些指标。
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