Bulbulyan M A, Figgs L W, Zahm S H, Savitskaya T, Goldfarb A, Astashevsky S, Zaridze D
Department of Cancer Epidemiology and Prevention, N N Blokhin Cancer Research Centre, Moscow, Russia.
Int J Epidemiol. 1995 Apr;24(2):266-75. doi: 10.1093/ije/24.2.266.
Cancer incidence and mortality were evaluated among 4581 aniline dye production workers in Moscow.
A historical cohort was assembled and followed-up from 1 January 1975 to 31 December 1989. Moscow district oncologic dispensary registries furnished case ascertainment and employer records provided job exposure data. Expected cancers and deaths were calculated based on gender-, age-, and calendar time-specific incidence and mortality rates for the Moscow general population applied to the cohort's person-years of follow-up. Disease-specific standardized mortality and incidence values were derived from ratios of observed to expected cancers.
Men experienced elevated total cancer mortality (standardized mortality ratio [SMR] = 125; 95% CI: 110-142) and urinary bladder cancer mortality (SMR = 279; 95% CI: 192-391), and increased all malignancy (standardized incidence ratio [SIR] = 142; 95% CI: 125-160), oesophageal (SIR = 203; 95% CI: 108-347), respiratory tract (SIR = 154; 95% CI: 120-194) and bladder (SIR = 394; 95% CI: 268-559) cancer incidence. Women had elevated oesophageal (SMR = 313; 95% CI: 124-664) and bladder (SMR = 311; 95% CI: 149-571) cancer mortality and elevated all malignancy (SIR = 124; 95% CI: 106-144), oesophageal (SIR = 348; 95% CI: 140-719), and bladder (SIR = 861; 95% CI: 458-8002) cancer incidence. Bladder cancer rate increased with employment duration and younger age first hired. Rate estimates were highest among beta-naphthylamine exposed workers but was also increased among workers with other chemical exposures. A cancer prevention and control effort that limited benzidine exposure to < or = 3 years was apparently unsuccessful as indicated by a significant excess of bladder cancer (SIR = 1773; 95% CI: 356-5180) among these workers.
Relative rates of oesophageal, lung, and stomach cancer were also elevated among all workers, but did not increase with total years worked, age first hired, or year first hired, suggesting a non-occupational aetiology.
对莫斯科4581名苯胺染料生产工人的癌症发病率和死亡率进行了评估。
组建了一个历史性队列,并于1975年1月1日至1989年12月31日进行随访。莫斯科地区肿瘤防治所登记处提供病例确诊信息,雇主记录提供工作接触数据。根据适用于该队列随访人年数的莫斯科普通人群按性别、年龄和日历时间划分的发病率和死亡率,计算预期癌症病例数和死亡数。特定疾病的标准化死亡率和发病率值由观察到的癌症病例数与预期数的比值得出。
男性的总癌症死亡率升高(标准化死亡率比[SMR]=125;95%可信区间:110 - 142),膀胱癌死亡率升高(SMR = 279;95%可信区间:192 - 391),所有恶性肿瘤发病率升高(标准化发病率比[SIR]=142;95%可信区间:125 - 160),食管癌(SIR = 203;95%可信区间:108 - 347)、呼吸道癌(SIR = 154;95%可信区间:120 - 194)和膀胱癌(SIR = 394;95%可信区间:268 - 559)发病率升高。女性的食管癌死亡率升高(SMR = 313;95%可信区间:124 - 664),膀胱癌死亡率升高(SMR = 311;95%可信区间:149 - 571),所有恶性肿瘤发病率升高(SIR = 124;95%可信区间:106 - 144),食管癌(SIR = 348;95%可信区间:140 - 719)和膀胱癌(SIR = 861;95%可信区间:458 - 8002)发病率升高。膀胱癌发病率随工作年限和首次雇佣时年龄的降低而增加。发病率估计值在接触β-萘胺的工人中最高,但在接触其他化学物质的工人中也有所增加。一项将联苯胺接触限制在≤3年的癌症预防和控制措施显然未成功,因为这些工人中膀胱癌显著超额(SIR = 1773;95%可信区间:356 - 5180)。
所有工人中食管癌、肺癌和胃癌的相对发病率也有所升高,但未随总工作年限、首次雇佣年龄或首次雇佣年份增加,提示为非职业性病因。