Fox A J, Lindars D C, Owen R
Br J Ind Med. 1974 Apr;31(2):140-51. doi: 10.1136/oem.31.2.140.
140-151. A mortality study of 40 867 subjects employed in the rubber and cablemaking industries on 1 February 1967 is reported. No evidence is found of a continued excess risk of neoplasms of the bladder in people who entered the industry after 1949. For those employed before that date, during the period when known bladder carcinogens were in use, the SMR is higher than predicted, indicating that men are still dying with occupationally induced tumours. An excess of all neoplasms was noted in the five years of the study. In certain sections of the industry (tyre manufacture, belting hose rubber with asbestos, and flooring industry) there is a particular excess of bronchial carcinoma. In those sections which use asbestos such an excess is not altogether surprising, but this does not apply to the tyre industry. The latter industry is sufficiently large (16 035 men in the study compared with 4 350 in the belting, hose rubber with asbestos, and flooring industry) for attention to be focused on particular operations. Two job groups are found to share the excess: moulding, press, autoclave, and pan curemen; and finished goods, packaging, and despatch. Job selection may play a part in the latter, as the work is generally considered suitable for older and perhaps less healthy people. Crude analyses have been undertaken to indicate whether the excesses are due to regional differences or to the population comprising an abnormally high proportion of smokers. No excesses are found in other smoking-related diseases. Although the effects of differences in smoking habit and regional differences cannot be ruled out, the indications are against these factors being the primary cause. The difficulties of this type of study are discussed. It is emphasized that the results can be used only as an indication of a problem area and the type of further study required. A more exact study would concentrate on five-year cohorts of people who left the industry between 1940 and 1960. A study of five-year cohorts of people who entered the industry in the same period would also be valuable. An attempt has been made to perform the latter, but it would be hazardous to draw too many conclusions from this because the population comprises those who `survive' in the industry until 1967.
140 - 151. 本文报告了一项针对1967年2月1日受雇于橡胶和电缆制造行业的40867名受试者的死亡率研究。未发现1949年之后进入该行业的人群存在膀胱癌持续超额风险的证据。对于在该日期之前受雇的人员,即在已知膀胱致癌物投入使用的期间,标准化死亡比(SMR)高于预期,这表明男性仍因职业性肿瘤而死亡。在研究的五年期间,所有肿瘤均出现超额情况。在该行业的某些部门(轮胎制造、含石棉的带管橡胶以及地板行业),支气管癌尤其超额。在使用石棉的那些部门,出现这种超额情况并不完全令人惊讶,但轮胎行业并非如此。后一行业规模足够大(研究中有16035名男性,而含石棉的带管橡胶和地板行业为4350名),因此应关注特定操作。发现有两个工作群体存在超额情况:成型、压制、高压釜及盘式硫化工人;以及成品、包装和发货工人。在后者中工作选择可能起到了一定作用,因为这项工作通常被认为适合年龄较大且可能健康状况较差的人。已进行粗略分析以表明这些超额情况是由于地区差异还是由于该人群中吸烟者比例异常高所致。在其他与吸烟相关的疾病中未发现超额情况。尽管不能排除吸烟习惯差异和地区差异的影响,但迹象表明这些因素并非主要原因。讨论了此类研究的困难。强调这些结果仅可用于指示问题领域以及所需的进一步研究类型。更精确的研究应聚焦于1940年至1960年间离开该行业的人群的五年队列。对同期进入该行业的人群的五年队列进行研究也将很有价值。已尝试进行后者的研究,但从中得出过多结论将是危险的,因为该人群包括那些在1967年仍“存活”在该行业的人。