Tsai S P, Gilstrap E L, Cowles S R, Snyder P J, Ross C E
Corporate Medical Department, Shell Oil Company, Houston, TX 77252-2463.
J Occup Med. 1993 Apr;35(4):415-21.
This study examined the 1973 to 1989 mortality experience of Shell's two California manufacturing locations' employees who worked more than 6 months before December 31, 1989 and pensioners who were alive as of January 1, 1973. Vital status of each employee as of December 31, 1989 was determined from various sources including company records, the National Death Index, and the Social Security Administration's Master Beneficiary Record file. The study included many long-term employees, with more than half (57%) of the total population working 20 years or longer. The total population exhibited 11% lower all causes mortality and 20% lower cancer mortality, as compared with the California general population. There were no significant excesses of any cause-specific mortality including cancer. Among total employees, mortality for several cancer sites showed a statistically nonsignificant increase, for example, cancer of the kidney (8 observed deaths and 6.02 expected), cancer of the bladder (11 observed deaths and 9.17 expected), and Hodgkin's disease (2 observed deaths and 1.01 expected). A review of these work histories revealed no predominant work area or job assignment. In contrast to the ecologic studies based on local county rates, lung cancer mortality in this study was significantly lower (Standardized Mortality ratio [SMR] = 0.73). In addition, statistically significant deficits in mortality were found for cirrhosis of the liver (SMR = 0.63) and all external causes of death (SMR = 0.74). This study also failed to show an increased mortality rate for cancers of the brain, stomach, and prostate--causes which have been reported to be elevated in other refinery and petrochemical employee studies.
本研究调查了壳牌公司位于加利福尼亚州的两个生产基地的员工在1973年至1989年期间的死亡情况,这些员工在1989年12月31日前工作超过6个月,以及截至1973年1月1日仍在世的退休人员。截至1989年12月31日,每位员工的生命状态是通过多种来源确定的,包括公司记录、国家死亡索引以及社会保障管理局的主要受益人记录文件。该研究纳入了许多长期员工,总人数的一半以上(57%)工作了20年或更长时间。与加利福尼亚州普通人群相比,总人群的全因死亡率低11%,癌症死亡率低20%。没有任何特定病因死亡率出现显著过高的情况,包括癌症。在全体员工中,几个癌症部位的死亡率有统计学上无显著意义的上升,例如肾癌(观察到8例死亡,预期6.02例)、膀胱癌(观察到11例死亡,预期9.17例)和霍奇金病(观察到2例死亡,预期1.01例)。对这些工作经历的审查未发现主要的工作领域或工作任务。与基于当地县发病率的生态学研究相反,本研究中的肺癌死亡率显著较低(标准化死亡率[SMR]=0.73)。此外,还发现肝硬化(SMR=0.63)和所有外部死因(SMR=0.74)的死亡率有统计学上的显著不足。本研究也未显示脑癌、胃癌和前列腺癌的死亡率上升,而在其他炼油厂和石化员工研究中曾报告这些癌症的死亡率有所升高。