Tornling G, Gustavsson P, Hogstedt C
Department of Thoracic Medicine, Karolinska Hospital, Stockholm, Sweden.
Am J Ind Med. 1994 Feb;25(2):219-28. doi: 10.1002/ajim.4700250208.
Fire fighters are exposed to irritating, asphyxiating, and toxic gases and aerosols, to psychological stress, and to physically demanding work. Due to differences in fire fighting techniques, exposure conditions for fire fighters differ among different countries. The purpose of this investigation was to study cancer incidence and mortality in fire fighters who have been working with fire fighting methods used in Sweden from the beginning of this century onwards. All male fire fighters employed for at least 1 year in the City of Stockholm during 1931-1983 were traced, and an index of the number of fires fought was calculated for each individual. The mortality during 1951-1986 (among 1, 116 fire fighters) was lower than expected (SMR = 82; 95% confidence interval 72-91) compared with local mortality rates, with a low mortality in circulatory diseases, obstructive lung diseases, violent deaths, and suicides. The cancer incidence in 1958-1986 was equal to the expected (SMR = 100; 95% confidence interval 83-119). However, an excess of stomach cancer (18 observed vs. 9.37 expected; SMR = 192, 95% CI 114-304) was observed. There was also a tendency for higher incidence and mortality in stomach and brain cancer with increasing number of fires. There were four deaths from brain cancer compared to 0.8 expected (SMR = 496; 95% CI 135-1270) in the highest exposure category. Fire fighters are, however, not systematically exposed to known stomach or brain carcinogens, and the results need confirmation in further studies with extensive exposure evaluations.
消防员会接触到刺激性、窒息性和有毒气体及气溶胶，会承受心理压力，且工作对体力要求很高。由于灭火技术存在差异，不同国家消防员的接触条件也有所不同。本调查的目的是研究自本世纪初以来一直采用瑞典灭火方法工作的消防员的癌症发病率和死亡率。对1931年至1983年期间在斯德哥尔摩市工作至少1年的所有男性消防员进行了追踪，并为每个人计算了灭火次数指数。与当地死亡率相比，1951年至1986年期间（1116名消防员中）的死亡率低于预期（标准化死亡比=82；95%置信区间72-91），循环系统疾病、阻塞性肺病、暴力死亡和自杀的死亡率较低。1958年至1986年期间的癌症发病率与预期相等（标准化死亡比=100；95%置信区间83-119）。然而，观察到胃癌病例过多（观察到18例，预期9.37例；标准化死亡比=192，95%置信区间114-304）。随着灭火次数的增加，胃癌和脑癌的发病率和死亡率也有上升趋势。在最高暴露类别中，有4人死于脑癌，而预期为0.8例（标准化死亡比=496；95%置信区间135-1270）。然而，消防员并未系统地接触已知的胃癌或脑癌致癌物，这些结果需要在进一步的广泛暴露评估研究中得到证实。
