Siemiatycki J, Richardson L, Gérin M, Goldberg M, Dewar R, Désy M, Campbell S, Wacholder S
Am J Epidemiol. 1986 Feb;123(2):235-49. doi: 10.1093/oxfordjournals.aje.a114232.
A multi-cancer site, multi-factor case-control study was undertaken to generate hypotheses about possible occupational carcinogens. Probing interviews were carried out with over 2,000 subjects. All incident cases of 19 sites of cancer in males aged 35-70 and resident in Montreal were eligible. The interview was designed to obtain detailed lifetime job histories, and information on potential confounders. Each job history was reviewed by a team of chemists who translated it into a history of occupational exposures. These occupational exposures were then analyzed as potential risk factors in relation to the sites of cancer included. For each site of cancer analyzed as a case series, controls were selected from among the other cancer sites in the study. This report concerns the associations between sites of cancer for which there were over 100 cases processed (stomach; colorectal, also analyzed by subsites; lung; prostate; bladder; kidney; non-Hodgkin's lymphoma) and nine organic dusts (wood; paper; grain; flour; fabrics; cotton; wool; synthetics; fur). All site-exposure combinations were investigated. The ones that provided the most interesting leads were lung-wood dust (odds ratio (OR) = 1.5), stomach-wood dust (OR = 1.5), colorectal-synthetic fiber (OR = 1.5), bladder-synthetic fiber (OR = 1.8), non-Hodgkin's lymphoma-cotton dust (OR = 1.9), colon-grain dust (OR = 2.6), prostate-grain dust (OR = 2.2), and prostate-paper dust (OR = 2.0). Only the associations with wood dust, synthetic fibers and cotton dust showed some evidence of "dose-response" with duration of exposure. Because it is such a common exposure and appears to increase lung and stomach cancer risks, wood dust may be responsible for a great deal of occupational cancer.
开展了一项多癌症部位、多因素病例对照研究，以生成关于可能的职业致癌物的假设。对2000多名受试者进行了深入访谈。所有年龄在35至70岁、居住在蒙特利尔的男性中19种癌症部位的新发病例均符合条件。访谈旨在获取详细的终生工作经历以及有关潜在混杂因素的信息。一组化学家对每份工作经历进行审查，并将其转化为职业接触史。然后将这些职业接触作为与所纳入癌症部位相关的潜在风险因素进行分析。对于作为病例系列分析的每个癌症部位，从研究中的其他癌症部位选取对照。本报告涉及处理病例超过100例的癌症部位（胃；结肠直肠癌，也按亚部位分析；肺；前列腺；膀胱；肾；非霍奇金淋巴瘤）与九种有机粉尘（木材；纸张；谷物；面粉；织物；棉花；羊毛；合成材料；毛皮）之间的关联。对所有部位 - 接触组合进行了调查。其中最具吸引力的线索包括：肺癌 - 木尘（优势比（OR）= 1.5）、胃癌 - 木尘（OR = 1.5）、结肠直肠癌 - 合成纤维（OR = 1.5）、膀胱癌 - 合成纤维（OR = 1.8）、非霍奇金淋巴瘤 - 棉尘（OR = 1.9）、结肠癌 - 谷物粉尘（OR = 2.6）、前列腺癌 - 谷物粉尘（OR = 2.2）以及前列腺癌 - 纸张粉尘（OR = 2.0）。只有与木尘、合成纤维和棉尘的关联显示出一些与接触持续时间相关的“剂量反应”证据。由于木尘是一种非常常见的接触物质，且似乎会增加肺癌和胃癌风险，因此木尘可能是大量职业性癌症的病因。
