Fritschi L, Siemiatycki J
Epidemiology and Biostatistics Unit, Institut Armand-Frappier, Laval, Québec, Canada.
Occup Environ Med. 1996 Mar;53(3):168-73. doi: 10.1136/oem.53.3.168.
Associations between occupational exposures and the occurrence of cutaneous melanoma were examined as part of a large population based case-control study of 19 cancer sites.
Cases were men aged 35 to 70 years old, resident in Montreal, Canada, with a new histologically confirmed cutaneous melanoma (n = 103). There were two control groups, a randomly selected population control group (n = 533), and a cancer control group (n = 533) randomly selected from among subjects with other types of cancer in the large study. Odds ratios for the occurrence of melanoma were calculated for each exposure circumstance for which there were more than four exposed cases (85 substances, 13 occupations, and 20 industries) adjusting for age, ethnicity, and number of years of schooling.
Significantly increased risk of melanoma was found for exposure to four substances (fabric dust, plastic dust, trichloroethylene, and a group containing paints used on surfaces other than metal and varnishes used on surfaces other than wood), three occupations (warehouse clerks, salesmen, and miners and quarrymen), and two industries (clothing and non-metallic mineral products).
Most of the occupational circumstances examined were not associated with melanoma, nor is there any strong evidence from previous research that any of those are risk factors. For the few occupational circumstances which were associated in our data with melanoma, the statistical evidence was weak, and there is little or no supporting evidence in the scientific literature. On the whole, there is no persuasive evidence of occupational risk factors for melanoma, but the studies have been too small or have involved too much misclassification of exposure for this conclusion to be definitive.
作为一项针对19个癌症部位的大型人群病例对照研究的一部分,研究职业暴露与皮肤黑色素瘤发生之间的关联。
病例为年龄在35至70岁之间、居住在加拿大蒙特利尔的男性,经组织学确诊为新发皮肤黑色素瘤(n = 103)。有两个对照组,一个是随机选择的人群对照组(n = 533),另一个是从该大型研究中患有其他类型癌症的受试者中随机选择的癌症对照组(n = 533)。针对每种暴露情况(85种物质、13种职业和20个行业),在暴露病例超过4例时,计算黑色素瘤发生的比值比,并对年龄、种族和受教育年限进行调整。
发现接触四种物质(织物粉尘、塑料粉尘、三氯乙烯以及一组包含用于金属以外表面的涂料和用于木材以外表面的清漆)、三种职业(仓库职员、销售人员以及矿工和采石工人)和两个行业(服装业和非金属矿产品业)会显著增加患黑色素瘤的风险。
所研究的大多数职业情况与黑色素瘤无关,以前的研究也没有强有力的证据表明其中任何一种是危险因素。对于我们数据中与黑色素瘤相关的少数职业情况,统计证据薄弱,科学文献中几乎没有或没有支持性证据。总体而言,没有令人信服的证据表明存在黑色素瘤的职业危险因素,但这些研究规模太小或暴露分类错误过多,无法得出确定性结论。