Rosenman K D, Stanbury M
Department of Medicine, Michigan State University, East Lansing 48824-1316, USA.
Am J Ind Med. 1996 May;29(5):491-500. doi: 10.1002/(SICI)1097-0274(199605)29:5<491::AID-AJIM7>3.0.CO;2-P.
Hexavalent chromium is a known carcinogen. Previous epidemiologic studies in the 1950s of United States workers from seven facilities producing chromium compounds from chromite ore have reported a markedly increased risk for dying from lung cancer. As part of a high risk notification project of workers from four of these facilities, a mortality study was performed. The cohort was assembled in 1990-1991 from the Social Security records of four former chromate producing facilities in northern New Jersey. The study subjects were known to have worked at these facilities some time between 1937 and 1971. Proportionate mortality and proportionate cancer mortality ratios (PCMR) were calculated. The overall risk for lung cancer was a PCMR of 1.51 (confidence limits [CL] 1.29-1.74) for white men and 1.34 (CL 1.00-1.75) for black men. These risks increased with increasing duration of employment and latency since time of first employment. The PCMR for greater than 20 years duration of work and more than 20 years since first exposure was 1.94 (CL 1.15-3.06) for white men and 3.08 (CL 1.13-6.71) for black men. The risk for lung cancer for white men remains elevated more than 20 years after exposure has ceased (PCMR, 1.29; CL 1.03-1.60). The PCMR for nasal cavity/sinus cancer was also found to be a significantly increased, 5.18 (CL 2.37-11.30). A cluster of bladder cancer was seen among black workers from one facility, (PCMR, 3.30; CL 1.42-6.51). Despite the cessation of exposure, former chromium workers remain at significantly increased risk of lung cancer. Although there have been case reports of nasal cavity/ sinus cancer in association with chromium exposure, this is the first epidemiologic study to report a significant increase in these cancers. Limitations in this study include lack of exposure data and lack of information on smoking habits. The lack of increase in other smoking-related diseases besides lung cancer indicates that the increase in lung cancer cannot be attributed to cigarette smoking. The ongoing elevated risk of lung cancer after cessation of exposure emphasizes the need for developing early detection texts for lung cancer.
六价铬是一种已知的致癌物。20世纪50年代，针对美国7家从铬铁矿生产铬化合物的工厂工人开展的流行病学研究报告称，肺癌死亡风险显著增加。作为其中4家工厂工人高风险通知项目的一部分，开展了一项死亡率研究。该队列于1990 - 1991年从新泽西州北部4家 former chromate producing facilities 的社会保障记录中组建。已知研究对象在1937年至1971年期间的某个时间在这些工厂工作过。计算了比例死亡率和比例癌症死亡率（PCMR）。白人男性肺癌的总体风险为PCMR 1.51（置信区间[CL] 1.29 - 1.74），黑人男性为1.34（CL 1.00 - 1.75）。这些风险随着就业时长和首次就业后潜伏期的增加而增加。工作时长超过20年且首次接触后超过20年的白人男性PCMR为1.94（CL 1.15 - 3.06），黑人男性为3.08（CL 1.13 - 6.71）。接触停止20多年后，白人男性肺癌风险仍处于升高水平（PCMR，1.29；CL 1.03 - 1.60）。鼻腔/鼻窦癌的PCMR也被发现显著升高，为5.18（CL 2.37 - 11.30）。在一家工厂的黑人工人中发现了膀胱癌聚集现象（PCMR，3.30；CL 1.42 - 6.51）。尽管接触已停止，但 former chromium workers 患肺癌的风险仍显著增加。虽然有与铬接触相关的鼻腔/鼻窦癌病例报告，但这是第一项报告这些癌症显著增加的流行病学研究。本研究的局限性包括缺乏接触数据和吸烟习惯信息。除肺癌外，其他与吸烟相关疾病未增加表明肺癌增加不能归因于吸烟。接触停止后肺癌风险持续升高凸显了开发肺癌早期检测方法的必要性。
