Cincinnati, Ohio, USA.
Risk Anal. 2024 Jun;44(6):1413-1429. doi: 10.1111/risa.14231. Epub 2023 Oct 24.
Diesel exhaust in the latter half of the 20th century has been found to be a lung carcinogen. Conventional diesel emissions continue in the transportation, mining, construction, and farming industries. From the Diesel Exhaust in Miners Study, a public-use dataset was used to calculate the excess lifetime risk of lung cancer associated with diesel exposure (1947-1997). Excess rates of lung cancer mortality associated with respirable elemental carbon (REC) and possible other mining exposures (e.g., oil mists, explosives emissions) were investigated using Poisson regression methods. Lung cancer mortality declined with increasing employment duration while increasing with cumulative REC and non-diesel exposures, suggesting a strong worker survivor effect. Attenuation of the REC effect was observed with increasing cumulative exposure. After adjustment for employment duration, the excess rate ratio for lung cancer mortality was 0.67 (95% CI = 0.35-0.99) for a 10-year lagged exposure to 200 μg/m REC, a typical below-ground exposure in the study mines. At exposures of 200, 10, and 1 μg/m REC, the estimated excess lifetime risks, respectively, were 119, 43, and 8.7 per thousand. Analysis of an inception cohort hired after dieselization commenced produced smaller and less certain estimates of lifetime risk. From exposures to conventional diesel engine exhaust common in occupational groups in the past, the excess lifetime risk of lung cancer was more than 5%. Ambient REC exposures in the general population were estimated to confer lifetime risks of 0.14 to 14 per thousand, depending on assumptions made.
20 世纪后半叶,人们发现柴油废气是一种肺癌致癌物。在交通运输、采矿业、建筑和农业等行业,传统的柴油排放仍在继续。从矿工柴油废气研究中,使用了一个公共使用数据集来计算与柴油暴露相关的肺癌超额终生风险(1947-1997 年)。使用泊松回归方法研究了与可吸入元素碳(REC)和其他可能的采矿暴露(例如油雾、炸药排放)相关的肺癌死亡率超额率。肺癌死亡率随着就业时间的增加而下降,而随着 REC 和非柴油暴露的累积而增加,这表明工人幸存者效应很强。随着累积暴露的增加,观察到 REC 效应的衰减。在调整就业时间后,对于 REC 暴露 10 年滞后 200μg/m 的情况,肺癌死亡率的超额率比为 0.67(95%置信区间=0.35-0.99),这是研究矿中典型的地下暴露水平。在 200、10 和 1μg/m REC 的暴露水平下,估计的超额终生风险分别为每千分之 119、43 和 8.7。对在柴油化开始后招聘的起始队列进行分析得出的终生风险估计值较小且不太确定。从过去职业群体中常见的常规柴油发动机废气暴露来看,肺癌的超额终生风险超过 5%。根据所做的假设,一般人群中 REC 的环境暴露估计会导致终生风险为每千分之 0.14 至 14。