Lynge E
Br J Cancer. 1985 Aug;52(2):259-70. doi: 10.1038/bjc.1985.186.
The purpose of this cohort study is to shed further light on the potential carcinogenic effect indicated by a Swedish case control study of the 2,4-dichlorophenol and 4-chloro-ortho-cresol based phenoxy herbicides, unlikely to be contaminated with 2,3,7,8-tetrachlorodibenzo-p-dioxin (2,3,7,8-TCDD). In the present study it was the intention to include all persons employed in manufacture of phenoxy herbicides in Denmark before 1982. The predominant product was MCPA and only a very limited amount of 2,4,5-T was processed in one of the two factories included in the study. Registration of the cohort was based on company records, supplemented with data from a public pension scheme from 1964 onwards. Ninety-nine percent of registered employees could be followed up. Cancer cases were identified by linkage with the National Cancer Register. Totals of 3,390 males and 1,069 females were included in the study. In the analysis special attention was given to soft tissue sarcomas (STS) and malignant lymphomas (ML) which are the diagnostic groups indicated to be associated with exposure to phenoxy herbicides in the Swedish studies. Five cases of STS were observed among male employees in contrast to 1.84 expected cases. This result supports the Swedish observation of an increased risk of STS following exposure to phenoxy herbicides unlikely to be contaminated with 2,3,7,8-TCDD. However, several potential biases have to be taken into account in interpretation of this observation and these are discussed. Seven cases of ML were observed among male employees in contrast to 5.37 expected which does not support the Swedish observation of an excess risk. The total cancer risk among persons employed in manufacture and packaging of phenoxy herbicides was equivalent to the cancer risk in the Danish population. Among males thus employed 11 lung cancer cases were observed in contrast to 5.33 expected. Attention should be given to exposure to spray dried MCPA-sodium salt in the plants, but other work place exposures and tobacco consumption may have contributed to the increased risk. The tabulation of data by many diagnostic groups may explain the excesses observed for rectum cancer among males and cervical cancer among females. The study has revealed that several potential biases have to be taken into account when the Swedish observations are tested in other settings.
这项队列研究的目的是进一步阐明瑞典一项病例对照研究表明的基于2,4 - 二氯苯酚和4 - 氯邻甲酚的苯氧基除草剂的潜在致癌作用，这些除草剂不太可能被2,3,7,8 - 四氯二苯并 - 对 - 二恶英（2,3,7,8 - TCDD）污染。在本研究中，计划纳入1982年以前在丹麦从事苯氧基除草剂生产的所有人员。主要产品是灭草灵，在纳入研究的两家工厂之一中，仅加工了极少量的2,4,5 - T。队列登记基于公司记录，并辅以1964年起公共养老金计划的数据。99%登记的员工能够被随访。通过与国家癌症登记处的数据关联来识别癌症病例。该研究共纳入3390名男性和1069名女性。在分析中，特别关注软组织肉瘤（STS）和恶性淋巴瘤（ML）这两种诊断类别，瑞典的研究表明它们与接触苯氧基除草剂有关。在男性员工中观察到5例STS病例，而预期病例数为1.84例。这一结果支持了瑞典关于接触不太可能被2,3,7,8 - TCDD污染的苯氧基除草剂后STS风险增加的观察结果。然而，在解释这一观察结果时必须考虑到几个潜在的偏差，并对此进行了讨论。在男性员工中观察到7例ML病例，而预期病例数为5.37例，这并不支持瑞典关于风险过高的观察结果。从事苯氧基除草剂生产和包装工作的人员中的总体癌症风险与丹麦人群中的癌症风险相当。在从事此项工作的男性中，观察到11例肺癌病例，而预期病例数为5.33例。应关注工厂中喷雾干燥的灭草灵钠盐接触情况，但其他工作场所接触和烟草消费可能也导致了风险增加。按许多诊断类别进行的数据列表可能解释了男性直肠癌和女性宫颈癌观察到的数据过剩情况。该研究表明在其他环境中检验瑞典的观察结果时必须考虑到几个潜在的偏差。
