Borgia P, Forastiere F, Rapiti E, Rizzelli R, Magliola M E, Perucci C A, Axelson O
Epidemiologic Unit, Latium Health Authority, Rome, Italy.
Am J Ind Med. 1994 Apr;25(4):507-17. doi: 10.1002/ajim.4700250405.
The mortality pattern of taxi drivers in Rome as possibly exposed mainly to gasoline engine exhausts was evaluated by means of a historical cohort study. A total of 2,311 male subjects registered as taxi drivers between 1950 and 1975 was followed from 1965 through 1988. The overall mortality was lower than expected on the basis of regional (Latium) reference rates (692 deaths, standardized mortality ratio [SMR] = 0.89, 95% confidence interval [CI] 0.82-0.96), whereas the number of recorded deaths for malignant neoplasms was about the expected (205 deaths, SMR = 0.99, 95% CI 0.86-1.13). Mortality from circulatory and respiratory diseases was lower than expected. Diabetes was significantly increased (42 deaths, SMR = 1.73, 95% CI = 1.25-2.34). An increased SMR appeared for respiratory cancer (SMR = 1.23, 95% CI = 0.98-1.50), mainly due to lung cancer (observed [O] = 76, SMR = 1.23, 95% CI = 0.97-1.54); two pleural cancers were also recorded. The excess of lung cancer deaths was present only among those enrolled in the most recent period (1965-1975) (45 deaths, SMR = 1.40, 95% CI = 1.02-1.87), especially among those of younger age (< 65 years) (SMR = 1.86); there was no relation between lung cancer mortality and latency since first enrollment in the cooperatives or duration of membership. There are difficulties in interpreting the excess of lung cancer on the basis of occupational exposures; however, the increased risk observed among workers employed in more recent calendar periods may be due to heavier exposure in the last decades; further follow-up of the cohort may elucidate whether there is an increasing lung cancer risk among taxi drivers.
通过一项历史性队列研究，对主要可能暴露于汽油发动机尾气的罗马出租车司机的死亡模式进行了评估。在1950年至1975年期间注册为出租车司机的总共2311名男性受试者，从1965年至1988年进行了随访。总体死亡率低于基于地区（拉齐奥）参考率预期的死亡率（692例死亡，标准化死亡比[SMR]=0.89，95%置信区间[CI]0.82 - 0.96），而记录的恶性肿瘤死亡人数约为预期人数（205例死亡，SMR = 0.99，95% CI 0.86 - 1.13）。循环系统疾病和呼吸系统疾病的死亡率低于预期。糖尿病死亡率显著升高（42例死亡，SMR = 1.73，95% CI = 1.25 - 2.34）。呼吸系统癌症的SMR升高（SMR = 1.23，95% CI = 0.98 - 1.50），主要是由于肺癌（观察到的[O]=76，SMR = 1.23，95% CI = 0.97 - 1.54）；还记录了2例胸膜癌。肺癌死亡人数的超额仅出现在最近时期（1965 - 1975年）登记的人群中（45例死亡，SMR = 1.40，95% CI = 1.02 - 1.87），特别是在年龄较小（<65岁）的人群中（SMR = 1.86）；肺癌死亡率与首次加入合作社后的潜伏期或会员期限之间没有关联。基于职业暴露来解释肺癌超额情况存在困难；然而，在最近几个日历时期受雇的工人中观察到的风险增加可能是由于过去几十年中暴露更严重；对该队列的进一步随访可能会阐明出租车司机中肺癌风险是否在增加。
