Beall C, Delzell E, Macaluso M
Department of Behavioral and Community Medicine, College of Community Health Sciences, University of Alabama Tuscaloosa 35487-0377, USA.
Am J Ind Med. 1995 Sep;28(3):325-37. doi: 10.1002/ajim.4700280303.
This retrospective follow-up study evaluated the mortality experience of 11,271 women employed in a large motor vehicle manufacturing company in 1973. Company computerized personnel records were used to identify subjects and to obtain their employment histories. Follow-up through December 31, 1985, was conducted using company, state, and national data sources. The mortality rates of the cohort were compared with the rates of the U.S. general population of white or black women, adjusting for age and calendar time and using the standardized mortality ratio (SMR) as the measure of association. The overall mortality rate of the cohort was lower than the U.S. rate by 15% among whites (SMR = 85, 95% confidence interval (CI) = 78-93) and by 40% among blacks (SMR = 59, CI = 49-70). Among whites, the low mortality rate was due primarily to deficits of noncancer deaths, although a 32% deficit also was observed for breast cancer (SMR = 68, CI = 48-92). Black female workers had 40% fewer deaths than expected overall, and their all cancer SMR also was below expectation (SMR = 82, CI = 60-109). Despite evidence of a strong healthy worker effect among women in the motor vehicle manufacturing industry, the study found excesses of lung cancer among white women in assembly jobs (SMR = 158, CI = 107-226) and of pancreatic cancer among white assembly workers in upholstery and trim operations (SMR = 302, CI = 97-704).
这项回顾性随访研究评估了1973年受雇于一家大型汽车制造公司的11271名女性的死亡情况。利用公司计算机化的人事记录来确定研究对象并获取她们的工作经历。通过公司、州和国家数据源对截至1985年12月31日进行随访。将该队列的死亡率与美国白人或黑人女性总体人群的死亡率进行比较,对年龄和日历时间进行调整,并使用标准化死亡比(SMR)作为关联度的衡量指标。该队列的总体死亡率在白人中比美国总体水平低15%(SMR = 85,95%置信区间(CI)= 78 - 93),在黑人中低40%(SMR = 59,CI = 49 - 70)。在白人中,低死亡率主要归因于非癌症死亡人数不足,不过乳腺癌也有32%的不足(SMR = 68,CI = 48 - 92)。黑人女性工人的死亡人数总体比预期少40%,她们的所有癌症SMR也低于预期(SMR = 82,CI = 60 - 109)。尽管有证据表明汽车制造业女性存在很强健的工人效应,但该研究发现从事装配工作的白人女性肺癌过多(SMR = 158,CI = 107 - 226),以及从事内饰和装饰作业的白人装配工人胰腺癌过多(SMR = 302,CI = 97 - 704)。