Morton W E, Treyve E L
Am J Ind Med. 1982;3(4):441-57. doi: 10.1002/ajim.4700030409.
A five-year total community study of lung cancer incidence by occupation revealed that 1) virtually all the cases occurred in smokers; 2) all major histologic types of lung cancer were strongly associated with smoking behavior; 3) in most high-risk occupations the significant elevations of risk were limited to one or two histologic types, a specificity suggestive of the importance of workplace carcinogen exposure; and 4) both sensitivity and specificity of the search for occupations with lung cancer hazards were greatly increased by use of histologic type rates rather than total lung cancer rates. The epidemiologic differences among histologic types suggest that the lung cancers might be a group of neoplastic diseases which share a major risk factor (smoking) in common but which differ in respect to exposure to other carcinogens. Eventual control of our lung cancer epidemic will require the allocation of much greater resources to documentation of the occupational risks.
1）几乎所有病例都发生在吸烟者中；2）肺癌的所有主要组织学类型都与吸烟行为密切相关；3）在大多数高风险职业中，风险的显著升高仅限于一两种组织学类型，这种特异性表明工作场所致癌物暴露的重要性；4）通过使用组织学类型发病率而非肺癌总发病率，寻找有肺癌危害职业的敏感性和特异性都大大提高。组织学类型之间的流行病学差异表明，肺癌可能是一组肿瘤性疾病，它们有一个共同的主要风险因素（吸烟），但在接触其他致癌物方面存在差异。最终控制我们的肺癌流行将需要分配更多资源来记录职业风险。
