Mellemgaard A, Engholm G, McLaughlin J K, Olsen J H
Danish Cancer Registry, Institute of Cancer Epidemiology, Copenhagen.
Scand J Work Environ Health. 1994 Jun;20(3):160-5. doi: 10.5271/sjweh.1413.
Risk factors for renal-cell carcinoma, the most frequent type of kidney cancer, remains enigmatic. Time trends in incidence and changes in the regional distribution of this cancer are suggestive of environmental risk factors. This study reports on occupational risk factors for renal-cell carcinoma in Denmark.
In a population-based study, 365 persons with histologically verified renal-cell carcinoma and 396 referents were interviewed. Information was collected on occupation, education, and occupational exposure to a number of suspected substances, including hydrocarbons, asbestos, and radiation.
Risk of renal-cell carcinoma was found to be associated with employment as a truck driver, exposure to gasoline, other hydrocarbons, and insecticides and herbicides. The risk of renal-cell carcinoma was higher in the lower socioeconomic strata for both the men and the women. Nonsignificantly elevated risks were observed for employment in oil refineries, gasoline stations, and the iron and steel industry. No association was found for exposure to radiation or for employment in industries such as leather manufacturing and health care, which have previously been linked to an increased risk of renal-cell carcinoma.
The risk of renal-cell carcinoma is increased in lower socioeconomic strata, and previously identified or suspected risk factors do not explain the excess in risk. This study adds additional support to the hypothesis of a link between renal-cell carcinoma and hydrocarbons and also demonstrates the need for further studies on occupational risk factors for renal-cell carcinoma.
肾细胞癌是最常见的肾癌类型，其危险因素仍不明确。该癌症发病率的时间趋势以及区域分布变化提示存在环境危险因素。本研究报告丹麦肾细胞癌的职业危险因素。
在一项基于人群的研究中，对365例经组织学证实的肾细胞癌患者和396名对照者进行了访谈。收集了有关职业、教育以及职业接触多种可疑物质的信息，这些物质包括碳氢化合物、石棉和辐射。
发现肾细胞癌风险与卡车司机职业、接触汽油、其他碳氢化合物以及杀虫剂和除草剂有关。男性和女性中，社会经济地位较低阶层的肾细胞癌风险更高。在炼油厂、加油站和钢铁行业就业的风险虽有升高但无统计学意义。未发现辐射暴露或皮革制造及医疗保健等行业就业与肾细胞癌风险增加有关，此前曾认为这些行业与肾细胞癌风险增加有关。
社会经济地位较低阶层的肾细胞癌风险增加，先前确定或怀疑的危险因素无法解释这种风险过高现象。本研究进一步支持了肾细胞癌与碳氢化合物之间存在关联的假说，也表明需要对肾细胞癌的职业危险因素进行进一步研究。
