Leon D A
Department of Epidemiology and Population Sciences, London School of Hygiene and Tropical Medicine.
Occup Environ Med. 1994 Feb;51(2):79-86. doi: 10.1136/oem.51.2.79.
A historical cohort study of the printing industry was established after an anecdotal report of a cluster of cases of bladder cancer in a newspaper factory in Manchester. The cohort comprised some 9500 men who were members of one or other of two trade unions (the NGA and NATSOPA) in the Manchester area between 1949 and 1963. During the follow up period (1949-83) 3482 deaths occurred among men born in 1890 or later; follow up was 97% complete. The results of the study do not support the hypothesis of an occupational risk of bladder cancer in the printing industry. The NGA have a standardised mortality ratio (SMR) of 63 (95% confidence interval (95% CI) 31-113) and NATSOPA an SMR of 113 (95% CI 67-178) based on 11 and 18 deaths from bladder cancer, respectively. Men involved in newspaper letterpress printing have a high mortality from lung cancer (SMR = 179, 95% CI 144-218) that is consistent with the findings of previous studies. Increased mortality from cancer of the buccal cavity and pharynx was found for NATSOPA workers in the newspaper industry; editorial workers had an SMR of 1053 (95% CI 128-3803) and clerical workers had an SMR of 638 (95% CI 132-1864). This is consistent with a review of published studies, which strongly suggest that workers in the printing industry have an increased risk of mortality from cancers of the buccal cavity and pharynx. Socioeconomic differences in union composition, rather than occupational factors, may account for the lower mortality in the NGA compared with NATSOPA. The NGA, a craft union, had an all causes SMR of 92 (95% CI 88-97), whereas NATSOPA covered a broader span of occupations and skill levels, and had an all causes SMR of 112 (95% CI 106-117); the NATSOPA and NGA all causes rate ratio was 1.21 (95% CI 1.13-1,29).
在曼彻斯特一家报社工厂出现一系列膀胱癌病例的轶事报道后，开展了一项印刷行业的历史性队列研究。该队列包括约9500名男性，他们在1949年至1963年间是曼彻斯特地区两个工会（全国图形协会和全国印刷、造纸及相关行业工会）之一的成员。在随访期（1949 - 1983年），1890年或之后出生的男性中有3482人死亡；随访完成率为97%。该研究结果不支持印刷行业存在膀胱癌职业风险这一假设。基于分别11例和18例膀胱癌死亡病例，全国图形协会的标准化死亡比（SMR）为63（95%置信区间（95%CI）31 - 113），全国印刷、造纸及相关行业工会的SMR为113（95%CI 67 - 178）。从事报纸凸版印刷的男性肺癌死亡率很高（SMR = 179，95%CI 144 - 218），这与先前研究结果一致。在报业中，发现全国印刷、造纸及相关行业工会的工人口腔和咽喉癌死亡率增加；编辑人员的SMR为1053（95%CI 128 - 3803），文职人员的SMR为638（95%CI 132 - 1864）。这与已发表研究的综述一致，该综述强烈表明印刷行业的工人患口腔和咽喉癌的死亡风险增加。工会构成方面的社会经济差异，而非职业因素，可能是全国图形协会死亡率低于全国印刷、造纸及相关行业工会的原因。全国图形协会是一个行业工会，全因SMR为92（95%CI 88 - 97），而全国印刷、造纸及相关行业工会涵盖更广泛的职业和技能水平范围，全因SMR为112（95%CI 106 - 117）；全国印刷、造纸及相关行业工会与全国图形协会的全因率比为1.21（95%CI 1.13 - 1.29）。
