Poole C, Dreyer N A, Satterfield M H, Levin L, Rothman K J
Epidemiology Resources Inc., Newton Lower Falls, MA 02162.
Environ Health Perspect. 1993 Dec;101 Suppl 6(Suppl 6):53-62. doi: 10.1289/ehp.93101s653.
To evaluate the hypothesis of increased kidney cancer risk after exposure to hydrocarbons, especially those present in gasoline, we conducted a case-control study in a cohort of approximately 100,000 male refinery workers from five petroleum companies. A review of 18,323 death certificates identified 102 kidney cancer cases, to each of whom four controls were matched by refinery location and decade of birth. Work histories, containing an average of 15.7 job assignments per subject, were found for 98% of the cases and 94% of the controls. To each job, industrial hygienists assigned semiquantitative ratings for the intensity and frequency of exposures to three hydrocarbon categories: nonaromatic liquid gasoline distillates, aromatic hydrocarbons, and the more volatile hydrocarbons. Ratings of "present" or "absent" were assigned for seven additional exposures: higher boiling hydrocarbons, polynuclear aromatic hydrocarbons, asbestos, chlorinated solvents, ionizing radiation, and lead. Each exposure had either no association or a weak association with kidney cancer. For the hydrocarbon category of principal a priori interest, the nonaromatic liquid gasoline distillates, the estimated relative risk (RR) for any exposure above refinery background was 1.0 (95% confidence interval [CI] 0.5-1.9). Analyses of cumulative exposures and of exposures in varying time periods before kidney cancer occurrence also produced null or near-null results. In an analysis of the longest job held by each subject (average duration 9.2 years or 40% of the refinery work history), three groups appeared to be at increased risk: laborers (RR = 1.9, 95% CI 1.0-3.9); workers in receipt, storage, and movements (RR = 2.5, 95% CI 0.9-6.6); and unit cleaners (RR = 2.3, 95% CI 0.5-9.9).
为了评估接触碳氢化合物尤其是汽油中所含碳氢化合物后肾癌风险增加的假设，我们在来自五家石油公司的约100,000名男性炼油厂工人队列中开展了一项病例对照研究。对18,323份死亡证明进行审查后确定了102例肾癌病例，按照炼油厂地点和出生年代为每个病例匹配了4名对照。在98%的病例和94%的对照中获取到了工作经历，每个对象平均有15.7份工作任务记录。对于每份工作，工业卫生学家针对接触三类碳氢化合物的强度和频率给出了半定量评级：非芳香族液态汽油馏分、芳香烃以及挥发性更强的碳氢化合物。针对另外七种接触情况给出了“有”或“无”的评级：高沸点碳氢化合物、多环芳烃、石棉、氯化溶剂、电离辐射和铅。每种接触与肾癌要么无关联，要么关联较弱。对于主要的先验关注碳氢化合物类别，即非芳香族液态汽油馏分，高于炼油厂背景水平的任何接触的估计相对风险（RR）为1.0（95%置信区间[CI] 0.5 - 1.9）。对累积接触情况以及肾癌发生前不同时间段的接触情况进行分析，也得出了无效或接近无效的结果。在对每个对象从事时间最长的工作（平均时长9.2年或占炼油厂工作经历的40%）进行分析时，有三组人员的风险似乎有所增加：体力劳动者（RR = 1.9，95% CI 1.0 - 3.9）；收货、储存和搬运工人（RR = 2.5，95% CI 0.9 - 6.6）；以及装置清洁工（RR = 2.3，95% CI 0.5 - 9.9）。
