Blair A, Zahm S H
Occupational Studies Section, National Cancer Institute, Bethesda, Maryland, USA.
Environ Health Perspect. 1995 Nov;103 Suppl 8(Suppl 8):205-8. doi: 10.1289/ehp.95103s8205.
The purpose of this report is to review the literature on cancer among persons employed in agriculture, to characterize the value of this line of research, and to recommend future directions. Farmers, despite a generally favorable mortality, appear to experience elevated rates for several cancers, including leukemia, non-Hodgkin's lymphoma, multiple myeloma, soft-tissue sarcoma, and cancers of the skin, lip, stomach, brain, and prostate. The rates for several of these tumors (i.e., non-Hodgkin's lymphoma, multiple myeloma, skin, brain, and prostate) appear to be increasing in the general population. No set of established etiologic factors explains all the cancer excesses observed among farmers, although several are associated with naturally occurring or medically induced immunodeficiencies. This suggests that there may be factors in the agricultural environment that introduce immune system deficiencies. Farmers are exposed to a variety of substances that could operate through this mechanism, including pesticides, engine exhausts, solvents, dusts, and zoonotic microbes. Studies to further characterize the cancer risk among farmers, their dependents, and farm laborers, and to identify the exposures that may be involved would not only be useful in providing a safe work environment in agriculture but may furnish considerable insight into the causes for a number of tumors that are rising in incidence in the general population.
本报告旨在回顾农业从业者癌症方面的文献，阐述这一研究领域的价值，并推荐未来的研究方向。农民尽管总体死亡率较低，但似乎有几种癌症的发病率较高，包括白血病、非霍奇金淋巴瘤、多发性骨髓瘤、软组织肉瘤以及皮肤癌、唇癌、胃癌、脑癌和前列腺癌。其中几种肿瘤（即非霍奇金淋巴瘤、多发性骨髓瘤、皮肤癌、脑癌和前列腺癌）在普通人群中的发病率似乎在上升。虽然有几种病因与自然发生或医学诱导的免疫缺陷有关，但没有一组既定的病因能解释农民中观察到的所有癌症超额发病情况。这表明农业环境中可能存在导致免疫系统缺陷的因素。农民接触到多种可能通过这种机制起作用的物质，包括农药、发动机尾气、溶剂、粉尘和人畜共患微生物。进一步明确农民、其家属和农场工人的癌症风险，并确定可能涉及的暴露因素的研究，不仅有助于提供安全的农业工作环境，还可能为深入了解普通人群中发病率不断上升的多种肿瘤的病因提供相当多的见解。
