Finkelstein M M
Health and Safety Studies Unit, Ontario Ministry of Labour, Toronto, Canada.
Health Phys. 1995 Sep;69(3):396-9. doi: 10.1097/00004032-199509000-00012.
The presence of radiographic silicosis was assessed as a risk factor for lung cancer in a cohort and case-control study of miners in the Ontario Silicosis Surveillance Database. Subjects were 328 miners with silicosis matched on age to 970 miners with normal radiographs. In a cancer incidence follow-up, there was a significant excess of lung cancer among miners with silicosis (Standardized Incidence Ratio 2.55; 95% Confidence Interval 1.43-8.28). Miners with normal radiographs had lung cancer incidence about the same as the Ontario average (Standardized Incidence Ratio 0.90; 95% Confidence Interval 0.51-1.47). In a matched case-control analysis of lung cancer, cumulative radon exposure was associated with lung cancer risk (increase in odds ratio 0.4% per WLM; 95% Confidence Interval -0.3% to 1.1%). When the presence of silicosis was added to the model, silicosis was a highly significant risk factor for lung cancer (Odds Ratio 6.99 95% Confidence Interval 1.91-25) and the risk factor for radon was diminished (increase in Odds Ratio -0.5% per WLM; 95% confidence Interval -1.4% to 0.4%). This finding suggests that additional study is warranted before concluding that radon risk factors derived from mining populations do not need to be modified for application to the general population.
在安大略矽肺监测数据库中，针对矿工开展的一项队列研究和病例对照研究，评估了影像学矽肺的存在情况作为肺癌风险因素。研究对象为328名患有矽肺的矿工，按照年龄匹配了970名胸片正常的矿工。在癌症发病率随访中，患有矽肺的矿工中肺癌显著超额（标准化发病率比2.55；95%置信区间1.43 - 8.28）。胸片正常的矿工肺癌发病率与安大略省平均水平大致相同（标准化发病率比0.90；95%置信区间0.51 - 1.47）。在肺癌的匹配病例对照分析中，累积氡暴露与肺癌风险相关（每工作水平月（WLM）比值比增加0.4%；95%置信区间 -0.3%至1.1%）。当将矽肺的存在情况加入模型时，矽肺是肺癌的一个高度显著风险因素（比值比6.99，95%置信区间1.91 - 25），而氡的风险因素减弱（每WLM比值比增加 -0.5%；95%置信区间 -1.4%至0.4%）。这一发现表明，在得出源自矿工群体的氡风险因素无需针对一般人群进行调整这一结论之前，有必要进行进一步研究。
