Jöckel K H, Ahrens W, Bolm-Audorff U
Bremen Institute for Prevention Research and Social Medicine, Germany.
Am J Ind Med. 1994 Jun;25(6):805-12. doi: 10.1002/ajim.4700250605.
In a hospital-based case-control study, 391 male cases or primary lung cancer and the same number of controls--matched by sex, age, and region--were personally interviewed for their job and smoking histories. The data reported reflect the midpoint of a study aiming at a total of 1,000 cases. One objective of the study was to assess confounding by asbestos exposure in what was thought to be a welding-associated risk. While the odds ratios (OR) increased steeply with cumulative exposure to tobacco smoke and were raised also for lifelong asbestos exposure of over 4,100 working hours (OR = 1.91), the effect of welding exposure was reduced after adjustment for smoking and exposure to asbestos. Furthermore, no consistent dose-response relationship could be shown in relation to welding hours. Therefore the present study supports the hypothesis that some, if not all, of the excess risk of welders observed in the literature may be due to the exposure to asbestos. The finding that the subgroup of employees in the aircraft industry showed an increased odds ratio of 2.14 after adjustment for smoking and exposure to asbestos deserves further attention. This suggests the need for further research on the role of berryllium-containing alloys, which has been suggested by other authors.
在一项基于医院的病例对照研究中，391例男性原发性肺癌患者以及相同数量的对照者（按性别、年龄和地区匹配）接受了关于其工作和吸烟史的个人访谈。报告的数据反映了一项旨在纳入总计1000例病例的研究的中期情况。该研究的一个目标是评估在被认为与焊接相关的风险中石棉暴露的混杂作用。虽然比值比（OR）随着累积接触烟草烟雾而急剧增加，并且终身接触石棉超过4100工时的情况下比值比也有所升高（OR = 1.91），但在对吸烟和石棉暴露进行调整后，焊接暴露的影响有所降低。此外，关于焊接工时并未显示出一致的剂量反应关系。因此，本研究支持这样一种假设，即文献中观察到的焊工的部分（如果不是全部）额外风险可能归因于石棉暴露。在对吸烟和石棉暴露进行调整后，航空业员工亚组的比值比增加到2.14这一发现值得进一步关注。这表明需要进一步研究含铍合金的作用，其他作者也已提出这一点。
