Tomásek L, Darby S C, Fearn T, Swerdlow A J, Placek V, Kunz E
National Institute of Public Health, Prague, Czech Republic.
Radiat Res. 1994 Feb;137(2):251-61.
Lung cancer mortality in a cohort of 4320 miners first employed during 1948-1959 at the Jáchymov and Horní Slavkov uranium mines in West Bohemia and followed until 1 January 1991 has been studied to gain a greater understanding of the consequences of exposure to radon and its progeny. Among men whose exposure rates never exceeded 10 working levels, excess relative risks per unit exposure were greater in younger men, and exposures received in the periods 15-24, 25-34 and 35+ years previously were found to have 47, 24 and 0% of the effect of exposures 5-14 years previously. Within this low-exposure-rate group excess relative risk increased linearly with time-weighted cumulative exposure and did not depend on exposure rate or duration of exposure. For men who spent less than 20% of their employment at the Jáchymov mine the excess relative risk per working level month was 1.36% (95% confidence interval 0.52-3.54) in the baseline category (age group 55+ and exposure received 5-14 years previously). For men who spent more than 20% of their employment at Jáchymov, the corresponding excess relative risk per working level month was higher by a factor of 1.80 (95% confidence interval 1.27-2.97). The difference may be due to the fact that men who spent more than 20% of their employment at Jáchymov were exposed to the much higher levels of arsenic in the dust at the Jáchymov mine than at other mines. When men with exposure rates above 10 working levels were included in the analysis, patterns of risk were complex and depended on both exposure rate and duration of exposure in addition to the factors mentioned above. If these findings are confirmed elsewhere, calculation of risk estimates for extrapolation to modern occupational or environmental exposures should be based on miners with exposure rates below about 10 working levels. Further investigation is desirable of the influence of dusts containing arsenic on lung cancer risk in miners exposed to radon.
对一组4320名矿工的肺癌死亡率进行了研究，这些矿工于1948年至1959年首次受雇于西波希米亚的雅希莫夫和霍尔尼斯拉夫科夫铀矿，并一直跟踪到1991年1月1日，目的是更深入地了解接触氡及其子体的后果。在接触率从未超过10工作水平的男性中，每单位接触的超额相对风险在较年轻男性中更高，并且发现15 - 24年、25 - 34年和35年以上以前接受的接触分别具有5 - 14年以前接触效果的47%、24%和0%。在这个低接触率组中，超额相对风险随时间加权累积接触呈线性增加，且不依赖于接触率或接触持续时间。对于在雅希莫夫矿工作时间少于其总工作时间20%的男性，在基线类别（年龄组55岁及以上且5 - 14年以前接受接触）中，每工作水平月的超额相对风险为1.36%（95%置信区间0.52 - 3.54）。对于在雅希莫夫矿工作时间超过其总工作时间20%的男性，每工作水平月相应的超额相对风险高出1.80倍（95%置信区间1.27 - 2.97）。这种差异可能是由于在雅希莫夫矿工作时间超过其总工作时间20%的男性，接触雅希莫夫矿粉尘中砷的水平比其他矿高得多。当将接触率高于10工作水平的男性纳入分析时，风险模式很复杂，除上述因素外，还取决于接触率和接触持续时间。如果这些发现在其他地方得到证实，用于外推到现代职业或环境接触的风险估计计算应基于接触率低于约10工作水平的矿工。需要进一步研究含砷粉尘对接触氡的矿工肺癌风险的影响。
