Karjalainen A, Anttila S, Vanhala E, Vainio H
Finnish Institute of Occupational Health, Helsinki.
Scand J Work Environ Health. 1994 Aug;20(4):243-50. doi: 10.5271/sjweh.1401.
The aim of the study was to investigate the asbestos-associated risk of lung cancer according to histological type of cancer, lobe of origin, pulmonary concentration, and type of amphibole fibers and also to estimate the etiologic fraction of asbestos for lung cancer.
The pulmonary concentration of asbestos fibers in 113 surgically treated male lung cancer patients and 297 autopsy cases among men serving as referents was determined by scanning electron microscopy. The age- and smoking-adjusted odds ratios of lung cancer were calculated according to pulmonary fiber concentration for all lung cancer types, squamous-cell carcinoma, and adenocarcinoma and for the lower-lobe and the upper- and middle-lobe cancers.
The risk of lung cancer was increased according to the pulmonary concentration of asbestos fibers (f) of 1.0 to 4.99 x 10(6) f.g-1 [odds ratio (OR) 1.7] and > or = 5.0 x 10(6) f.g-1 (OR 5.3). The odds ratios associated with fiber concentrations of > or = 1.0 x 10(6) f.g-1 were higher for adenocarcinoma (OR 4.0) than for squamous-cell carcinoma (OR 1.6). The asbestos-associated risk was higher for lower lobe tumors than for upper lobe tumors. The risk estimates for anthophyllite and crocidolite-amosite fibers were similar, except for the risk of squamous-cell carcinoma. An etiologic fraction of 19% was calculated for asbestos among male surgical lung cancer patients in the greater Helsinki area.
Past exposure to asbestos is a significant factor in the etiology of lung cancer in southern Finland. The asbestos-associated risk seems to be higher for pulmonary adenocarcinoma and lower-lobe tumors than for squamous-cell carcinoma and upper-lobe tumors.
本研究旨在根据癌症的组织学类型、起源肺叶、肺部浓度以及闪石纤维类型，调查与石棉相关的肺癌风险，并估计石棉在肺癌病因中所占的比例。
通过扫描电子显微镜测定了113例接受手术治疗的男性肺癌患者以及297例作为对照的男性尸检病例肺部的石棉纤维浓度。根据所有肺癌类型、鳞状细胞癌、腺癌以及下叶癌和上叶及中叶癌的肺部纤维浓度，计算了年龄和吸烟调整后的肺癌优势比。
肺癌风险随着肺部石棉纤维浓度（f）在1.0至4.99×10⁶ f.g⁻¹之间（优势比[OR] 1.7）以及≥5.0×10⁶ f.g⁻¹（OR 5.3）而增加。纤维浓度≥1.0×10⁶ f.g⁻¹时，腺癌的优势比（OR 4.0）高于鳞状细胞癌（OR 1.6）。下叶肿瘤的石棉相关风险高于上叶肿瘤。直闪石和青石棉纤维的风险估计相似，但鳞状细胞癌的风险除外。在大赫尔辛基地区的男性手术肺癌患者中，计算出石棉的病因比例为19%。
过去接触石棉是芬兰南部肺癌病因中的一个重要因素。石棉相关风险在肺腺癌和下叶肿瘤中似乎高于鳞状细胞癌和上叶肿瘤。
