Coggon D, Wield G
MRC Environmental Epidemiology Unit, University of Southampton, Southampton General Hospital.
Occup Environ Med. 1995 Mar;52(3):157-9. doi: 10.1136/oem.52.3.157.
To explore a suspected hazard of lung cancer in butchers and cooks.
4018 male butchers and 2062 male cooks were identified from the 1961 census of England and Wales. 4857 (79.9%) of these men were traced through the National Health Service Central Register, and 3518 deaths were recorded during follow up to the end of 1992. Mortality from lung cancer and other causes was compared with that of the general population by the person-years method.
Mortality from all causes was significantly below that of the national population in both butchers (standardized mortality ratio (SMR) 0.94, 95% confidence interval (95% CI) 0.90-0.98) and cooks (SMR 0.89, 95% CI 0.84-0.95). When allowance was made for a latency of 20 years from entry to follow up, the deficit in butchers was reduced, but that in cooks persisted, and was largely explained by a shortfall of deaths from cancer and circulatory disease. Mortality from lung cancer was close to expectation in the butchers (SMR 1.01, 95% CI 0.90-1.13) and below expectation in the cooks (SMR 0.93, 95% CI 0.75-1.13). Cooks had increased mortality from cancers of the oral cavity (SMR 5.57) and pharynx (SMR 2.66).
The findings provide no support for an occupational hazard of lung cancer in either butchers or cooks. The possibility of excess risk in sub-groups of these occupations cannot be discounted. The high rates of oral and pharyngeal cancer in cooks are probably a consequence of high alcohol consumption.
探讨屠夫和厨师患肺癌的疑似风险。
从1961年英格兰和威尔士人口普查中确定了4018名男性屠夫和2062名男性厨师。通过国家医疗服务中央登记处对其中4857名(79.9%)男性进行了追踪,截至1992年底的随访期间记录了3518例死亡。采用人年法将肺癌及其他原因导致的死亡率与普通人群进行比较。
屠夫(标准化死亡率(SMR)0.94,95%置信区间(95%CI)0.90 - 0.98)和厨师(SMR 0.89,95%CI 0.84 - 0.95)的全因死亡率均显著低于全国人口。考虑到从进入随访开始有20年的潜伏期后,屠夫的死亡率差距有所缩小,但厨师的死亡率差距仍然存在,且主要是由于癌症和循环系统疾病死亡人数不足所致。屠夫的肺癌死亡率接近预期(SMR 1.01,95%CI 0.90 - 1.13),而厨师的肺癌死亡率低于预期(SMR 0.93,95%CI 0.75 - 1.13)。厨师口腔癌(SMR 5.57)和咽癌(SMR 2.66)的死亡率有所增加。
研究结果不支持屠夫或厨师存在患肺癌的职业风险这一观点。不能排除这些职业亚组中存在额外风险的可能性。厨师口腔癌和咽癌的高发病率可能是高酒精摄入量的结果。