Leon D A, Thomas P, Hutchings S
Department of Epidemiology and Population Sciences, London School of Hygiene and Tropical Medicine.
Occup Environ Med. 1994 Feb;51(2):87-94. doi: 10.1136/oem.51.2.87.
A nested case-control study of lung cancer among men exposed to ink mist in newspaper production with rotary letterpress technology is presented. It is based within a historical cohort of 9232 printing workers in Manchester (1949-63). Men who operated newspaper rotary letterpress machines had a lung cancer standardised mortality ratio (SMR) of 179 (95% confidence interval (95% CI) 144-218) when compared with rates for England and Wales for the follow up period 1950-83. When adjustment was made for the higher rates in the local area, the SMR was reduced to 122 (95% CI 98-148). The nested case control study was based on 110 lung cancer cases (1949-86) and 316 matched controls. Duration of work in a rotary letterpress machine room was positively associated with risk of lung cancer (chi 2 linear trend = 3.30, p = 0.07); mean with 30 or more years duration of exposure had a risk of 1.73 (95% CI 0.94-3.17), relative to those with less than 20 years of exposure. Adjustment for period of first exposure in a machine room reduced the strength of the positive duration effect. The magnitude of the SMRs found in the cohort study could be explained by confounding with smoking. The duration effect seen in the case-control study, however, suggests that there may be a real effect of exposure to letterpress ink mists. This is biologically plausible, as benzo[a]pyrene, a known human carcinogen, has been found in appreciable concentrations in the atmosphere of rotary letterpress machine rooms.
本文介绍了一项针对采用轮转凸版印刷技术的报纸生产中接触油墨雾气的男性肺癌患者进行的巢式病例对照研究。该研究基于曼彻斯特9232名印刷工人的历史队列（1949 - 1963年）。与1950 - 1983年随访期间英格兰和威尔士的发病率相比，操作报纸轮转凸版印刷机的男性肺癌标准化死亡比（SMR）为179（95%置信区间（95%CI）144 - 218）。对当地较高发病率进行调整后，SMR降至122（95%CI 98 - 148）。巢式病例对照研究基于110例肺癌病例（1949 - 1986年）和316例匹配对照。在轮转凸版印刷机房的工作时长与肺癌风险呈正相关（卡方线性趋势 = 3.30，p = 0.07）；暴露时长平均达30年或更长时间的人群，相对于暴露时长少于20年的人群，风险为1.73（95%CI 0.94 - 3.17）。对首次在机房暴露的时间段进行调整后，正性时长效应的强度降低。队列研究中发现的SMR大小可通过与吸烟的混杂作用来解释。然而，病例对照研究中观察到的时长效应表明，接触凸版印刷油墨雾气可能存在真实影响。这在生物学上是合理的，因为在轮转凸版印刷机房的空气中已发现浓度可观的已知人类致癌物苯并[a]芘。
