Band P R, Le N D, Fang R, Deschamps M, Coldman A J, Gallagher R P, Moody J
Division of Epidemiology and Cancer Prevention, BC Cancer Agency, Vancouver, Canada.
Am J Epidemiol. 1996 Jan 15;143(2):137-43. doi: 10.1093/oxfordjournals.aje.a008722.
Despite the special working environment and exposures of airline pilots, data on risk of death and cancer incidence in this occupational group are limited. The authors investigated a cohort of 2,740 Air Canada pilots who contributed 62,449 person-years of observation. All male pilots employed for at least 1 year on and since January 1, 1950, were studied. The cutoff date for outcome information was December 31, 1992. Standardized mortality ratio (SMR) and standardized incidence ratio (SIR) were used to compare mortality rates and cancer incidence rates of the cohort with the respective Canadian population rates. Ninety percent confidence intervals of the SMR and SIR were calculated. Statistically significant decreased mortality was observed for all causes (SMR = 0.63, 90% confidence interval (CI) 0.56-0.70), for all cancers (SMR = 0.61, 90% CI 0.48-0.76), and for all noncancer diseases (SMR = 0.53, 90% CI 0.45-0.62). Mortality from aircraft accidents was significantly raised (SMR = 26.57, 90% CI 19.3-35.9). Significantly decreased cancer incidence was observed for all cancers (SIR = 0.71, 90% CI 0.61-0.82), rectal cancer (SIR = 0.42, 90% CI 0.14-0.96), lung cancer (SIR = 0.28, 90% CI 0.16-0.46), and bladder cancer (SIR = 0.36, 90% CI 0.12-0.82). Prostate cancer (SIR = 1.87, 90% CI 1.38-2.49) and acute myeloid leukemia (SIR = 4.72, 90% CI 2.05-9.31) were significantly increased. The preferred relative risk model for radiation-induced nonchronic lymphoid leukemia (Beir V report) was applied to the cohort by using published estimates of in-flight radiation exposures. The estimated relative risk ranged from 1.001 to 1.06 and did not differ significantly from the observed SIR (SIR = 1.88, 90% CI 0.80-3.53). However, the incidence rate of acute myeloid leukemia was significantly increased. Monitoring of in-flight radiation exposure and long-term follow-up of civil aviation crew members is needed to further assess cancer incidence and leukemia risk in this special occupational group.
尽管航空公司飞行员有着特殊的工作环境和接触因素，但关于这一职业群体的死亡风险和癌症发病率的数据有限。作者调查了2740名加拿大航空公司飞行员组成的队列，这些飞行员贡献了62449人年的观察数据。研究对象为1950年1月1日及以后受雇至少1年的所有男性飞行员。结局信息的截止日期为1992年12月31日。使用标准化死亡率（SMR）和标准化发病率（SIR）将该队列的死亡率和癌症发病率与加拿大相应人群的发病率进行比较。计算了SMR和SIR的90%置信区间。观察到所有原因导致的死亡率显著降低（SMR = 0.63，90%置信区间（CI）0.56 - 0.70），所有癌症导致的死亡率显著降低（SMR = 0.61，90% CI 0.48 - 0.76），以及所有非癌症疾病导致的死亡率显著降低（SMR = 0.53，90% CI 0.45 - 0.62）。飞机事故导致的死亡率显著升高（SMR = 26.57，90% CI 19.3 - 35.9）。观察到所有癌症的发病率显著降低（SIR = 0.71，90% CI 0.61 - 0.82），直肠癌（SIR = 0.42，90% CI 0.14 - 0.96）、肺癌（SIR = 0.28，90% CI 0.16 - 0.46）和膀胱癌（SIR = 0.36，90% CI 0.12 - 0.82）的发病率也显著降低。前列腺癌（SIR = 1.87，90% CI 1.38 - 2.49）和急性髓系白血病（SIR = 4.72，90% CI 2.05 - 9.31）的发病率显著升高。通过使用已发表的飞行中辐射暴露估计值，将辐射诱发的非慢性淋巴细胞白血病的首选相对风险模型（贝鲁特V报告）应用于该队列。估计的相对风险范围为1.001至1.06，与观察到的SIR（SIR = 1.88，90% CI 0.80 - 3.53）无显著差异。然而，急性髓系白血病的发病率显著升高。需要对飞行中辐射暴露进行监测，并对民航机组人员进行长期随访，以进一步评估这一特殊职业群体的癌症发病率和白血病风险。
