Omenn G S, Merchant J, Boatman E, Dement J M, Kuschner M, Nicholson W, Peto J, Rosenstock L
Environ Health Perspect. 1986 Dec;70:51-6. doi: 10.1289/ehp.867051.
This article reviews studies of the carcinogenicity of mineral fibers, notably asbestos, and presents seven major recommendations for further research. Mineral fibers represent the greatest cause--after cigarette smoke--of respiratory cancer due to air pollutants. Past asbestos exposure may currently account for 2000 mesothelioma deaths per year and 4000 to 6000 lung cancer deaths per year. All major commercial types of asbestos (crocidolite, amosite, and chrysotile) can cause each of the major asbestos-related respiratory diseases. Lung cancers in asbestos-exposed individuals probably do not have a different distribution of histological types from that of non-asbestos-related lung cancers. Nonoccupational exposures are likely to be associated with malignant disease outcomes qualitatively similar to those associated with occupational exposures. Further investigations of fibers are needed to characterize the relationships among physicochemical properties, patterns of migration and clearance, dose, and adverse health effects. Transmission electron microscopy has been found to be the preferred method of analysis of environmental fibers. Relations among time factors (e.g., age at first exposure), dose, and risk for adverse health effects require analyses of existing and new epidemiologic studies of exposed cohorts. Concomitant exposure, behavioral factors, and host factors affecting susceptibility to asbestos should be identified.
本文回顾了关于矿物纤维尤其是石棉致癌性的研究，并提出了七项进一步研究的主要建议。矿物纤维是仅次于香烟烟雾的因空气污染物导致呼吸道癌症的最大诱因。过去接触石棉目前可能每年导致2000例间皮瘤死亡以及4000至6000例肺癌死亡。所有主要商业类型的石棉（青石棉、铁石棉和温石棉）都可引发每一种主要的石棉相关呼吸道疾病。接触石棉个体的肺癌组织学类型分布可能与非石棉相关肺癌并无不同。非职业性接触可能在性质上与职业性接触一样会导致恶性疾病。需要对纤维进行进一步研究，以明确其物理化学性质、迁移和清除模式、剂量及不良健康影响之间的关系。透射电子显微镜已被发现是分析环境纤维的首选方法。时间因素（如首次接触年龄）、剂量与不良健康影响风险之间的关系需要对现有及新的接触人群流行病学研究进行分析。应确定伴随接触、行为因素以及影响对石棉易感性的宿主因素。
