Pukkala E, Saarni H
Finnish Cancer Registry, Helsinki, Finland.
Cancer Causes Control. 1996 Mar;7(2):231-9. doi: 10.1007/BF00051299.
A cohort of 30,940 male and 11,529 female seafarers registered in the files of Seafarers' Pension Fund in Finland was followed up through the Finnish Cancer Registry for cancer in 1967-92. Among male seafarers, there were 1,199 cases of cancer, which corresponds to the average cancer incidence in Finnish men. There was a statistically significant excess of non-melanoma skin cancer (standardized incidence ratio [SIR] = 1.8, 95 percent confidence interval [CI] = 1.2-2.5) and mesothelioma (SIR = 2.9, CI = 1.2-5.6) in the follow-up category of 20 or more years since the first employment. Alcohol-related cancers were increased among seafarers (SIR for cancer of the mouth and pharynx = 1.5; esophagus = 1.4; and liver = 1.5; combined CI = 1.1-1.9). Deck crews had a significantly high risk of cancer of the pancreas (SIR = 2.0) and also prostate after 10 years since first employment (SIR = 1.6). Occupational asbestos exposure among seafarers is likely strong enough to cause excess cases of mesothelioma but not of lung cancer. Occupational exposures also may be associated with increased risk of cancers of the kidney, pancreas, prostate and old-age brain cancer in some of the main occupational categories. Cumulative ultraviolet radiation likely doubles the risk of non-melanoma skin cancer among older men and repeated sunburns that of skin melanoma in ages below 30 (SIR among deck and engine crew = 4.6, CI = 3.1-6.5). Female ship personnel had a significantly elevated total cancer risk (observed number of cases = 732) which increased over follow-up time (SIR in the category > or = 20 years since the first employment was 1.3, CI = 1.1-1.5). This excess was attributable primarily to lung cancer (SIR = 2.6, CI = 2.0-3.3). Also cancers of the cervix uteri, vulva, and vagina showed significant excess after 10 to 20 years since first employment aboard.
在芬兰海员养老基金档案中登记的30940名男性和11529名女性海员组成的队列,于1967年至1992年期间通过芬兰癌症登记处对癌症情况进行了随访。在男性海员中,有1199例癌症病例,这与芬兰男性的平均癌症发病率相当。自首次就业起20年或更长时间的随访类别中,非黑色素瘤皮肤癌(标准化发病比[SIR]=1.8,95%置信区间[CI]=1.2 - 2.5)和间皮瘤(SIR = 2.9,CI = 1.2 - 5.6)有统计学显著的超额发病情况。海员中与酒精相关的癌症有所增加(口腔和咽喉癌的SIR = 1.5;食道癌 = 1.4;肝癌 = 1.5;合并CI = 1.1 - 1.9)。甲板船员在首次就业10年后患胰腺癌(SIR = 2.0)以及前列腺癌(SIR = 1.6)的风险显著较高。海员中的职业性石棉暴露可能足以导致间皮瘤病例超额,但不会导致肺癌病例超额。职业暴露在一些主要职业类别中也可能与肾癌、胰腺癌、前列腺癌和老年脑癌的风险增加有关。累积紫外线辐射可能使老年男性患非黑色素瘤皮肤癌的风险加倍,而反复晒伤会使30岁以下人群患皮肤黑色素瘤的风险加倍(甲板和轮机船员中的SIR = 4.6,CI = 3.1 - 6.5)。女性船舶工作人员的总癌症风险显著升高(观察到的病例数 = 732),且随随访时间增加(自首次就业起≥20年类别中的SIR为1.3,CI = 1.1 - 1.5)。这种超额主要归因于肺癌(SIR = 2.6,CI = 2.0 - 3.3)。自首次登船就业10至20年后,子宫颈癌、外阴癌和阴道癌也显示出显著的超额发病情况。