Rahman M, Wingren G, Axelson O
Department of Occupational and Environmental Medicine University Hospital, Linköping, Sweden.
Scand J Work Environ Health. 1996 Apr;22(2):146-9. doi: 10.5271/sjweh.123.
The purpose of this study was to search for evidence of an association between occupational arsenic exposure and diabetes mellitus, as implied by the relation of this disease to arsenic in drinking water in a recent study from Taiwan.
A case-referent analysis on death records of 5498 individuals in the art glass producing part of southeastern Sweden was performed. Out of all the enrolled subjects, 888 were glass workers. According to occupational title, glassblowers, foundry workers, and unspecified workers were regarded as potentially exposed to arsenic. Persons with a diagnosis of diabetes mellitus either as an underlying or contributing cause of death were considered cases. Referents were decedents without any indication of cancer, cardiovascular disease, or diabetes.
A slightly elevated risk [Mantel-Haenszel odds ratio (MH-OR) 1.2, 95% confidence interval (95% CI) 0.82-1.8] was found for diabetes mellitus among the glassworks employees, especially in combination with cardiovascular disease (MH-OR 1.4, 95% CI 0.81-2.3). For the glassblowers, other foundry workers and unspecified glassworkers probably exposed to arsenic, the M-H odds ratio was 1.4 (95% CI 0.92-2.2). Unspecified glass workers, who probably included persons with high exposure, carried the higher risk (MH-OR 1.8, 95% CI 1.1-2.8).
The observations from this study provide limited support for the possibility that occupational arsenic exposure could play a role in the development of diabetes mellitus. Many other metallic compounds are also used in art glass production, however, and there is a possibility of confounding.
本研究旨在寻找职业性砷暴露与糖尿病之间存在关联的证据,台湾最近一项研究表明糖尿病与饮用水中的砷有关,由此推测两者可能存在关联。
对瑞典东南部艺术玻璃生产行业5498名个体的死亡记录进行病例对照分析。在所有登记的受试者中,888人为玻璃工人。根据职业头衔,吹玻璃工人、铸造工人和未明确工种的工人被视为可能接触砷的人群。将诊断为糖尿病且为潜在或主要死因的人视为病例。对照为未显示有癌症、心血管疾病或糖尿病迹象的死者。
玻璃厂员工患糖尿病的风险略有升高[曼特尔-亨塞尔优势比(MH-OR)为1.2,95%置信区间(95%CI)为0.82-1.8],尤其是合并心血管疾病时(MH-OR为1.4,95%CI为0.81-2.3)。对于吹玻璃工人、其他铸造工人以及可能接触砷的未明确工种的玻璃工人,M-H优势比为1.4(95%CI为0.92-2.2)。未明确工种的玻璃工人(可能包括高暴露人群)的风险更高(MH-OR为1.8,95%CI为1.1-2.8)。
本研究的观察结果为职业性砷暴露可能在糖尿病发病中起作用这一可能性提供了有限支持。然而,艺术玻璃生产中也使用了许多其他金属化合物,存在混杂因素的可能性。