Smith A H, Waxweiler R J, Tyroler H A
Am J Epidemiol. 1980 Dec;112(6):787-97. doi: 10.1093/oxfordjournals.aje.a113051.
The epidemiologic identification of occupational carcinogens is complicated by several problems including worker mobility between jobs, variation over time of chemicals and processes used, and the long latency period between exposure and discovery of a tumor. In the light of these problems, a method using the cumulative dose concept has been developed which involves calculating the expected yearly exposure for each case from work histories of all noncases close to the case in year of birth and year of hire. The data required for use of the method include information concerning exposure to the chemicals being studied for each job in each calendar year of the study. Use of the method is illustrated with a study of angiosarcoma of the liver and vinyl chloride exposure in a polymerization plant. The value of the method lies in the wealth of information generated concerning the association between chemical exposures and cancer, including exposure level relationships, latency information, and the possibility that two chemicals might be acting independently or jointly. The serially additive expected dose model is likely to prove particularly useful in the analysis of data collected by occupational health surveillance systems, as well as retrospective studies of the type illustrated.
职业致癌物的流行病学识别存在若干复杂问题，包括工人在不同工作间的流动、所用化学品和工艺随时间的变化，以及从接触到肿瘤发现的长潜伏期。鉴于这些问题，已开发出一种使用累积剂量概念的方法，该方法涉及根据出生年份和雇佣年份与病例相近的所有非病例的工作经历，计算每个病例的预期年接触量。使用该方法所需的数据包括研究中每个日历年每份工作中与所研究化学品接触相关的信息。通过对一家聚合工厂中肝血管肉瘤与氯乙烯接触情况的研究来说明该方法的应用。该方法的价值在于所产生的有关化学物质接触与癌症之间关联的丰富信息，包括接触水平关系、潜伏期信息，以及两种化学物质可能独立或联合起作用的可能性。连续相加预期剂量模型可能在职业健康监测系统收集的数据分析以及此类回顾性研究中证明特别有用。
