Pershagen G, Wall S, Taube A, Linnman L
Scand J Work Environ Health. 1981 Dec;7(4):302-9. doi: 10.5271/sjweh.2544.
The interaction between occupational arsenic exposure and tobacco smoking and its relationship to lung cancer mortality among 228 deceased Swedish copper smelter workers was studied with the case-referent technique. Arsenic exposure was assessed via detailed company records, and information on smoking habits was gathered from the next of kin. The age standardized rate ratio for death from lung cancer was 3.0 for arsenic-exposed nonsmokers and 4.9 for smokers without occupational arsenic exposure in relation to nonarsenic-exposed nonsmokers. For arsenic-exposed smokers the rate ratio was 14.6, indicating a multiplicative effect of the two exposures. Eighty-five percent of all deaths from long cancer among the smelter workers could be "explained" by arsenic exposure and/or smoking. The interaction between arsenic and smoking suggests that a strong preventive effect on lung cancer incidence could be obtained by decreasing either one of the exposures or by disaggregating them.
采用病例对照技术，对228名已故瑞典铜冶炼工人中职业性砷暴露与吸烟之间的相互作用及其与肺癌死亡率的关系进行了研究。通过详细的公司记录评估砷暴露情况，并从近亲处收集吸烟习惯信息。与未接触砷的非吸烟者相比，接触砷的非吸烟者肺癌死亡的年龄标准化率比为3.0，未接触职业性砷的吸烟者为4.9。对于接触砷的吸烟者，率比为14.6，表明两种暴露存在相乘效应。冶炼工人中所有肺癌死亡病例的85%可由砷暴露和/或吸烟“解释”。砷与吸烟之间的相互作用表明，通过减少其中一种暴露或分别减少这两种暴露，对肺癌发病率可产生很强的预防作用。
