Hobbesland A, Kjuus H, Thelle D S
Department of Occupational and Environmental Medicine, Telemark Central Hospital, Skien, Norway.
Occup Environ Med. 1996 Aug;53(8):540-6. doi: 10.1136/oem.53.8.540.
Concern about the health hazards of exposure to workers in the ferroalloy industry has initiated this historical cohort study. The aim was to examine the mortality pattern among male employees in 12 Norwegian ferroalloy plants.
All men employed for at least six months who started their first employment during 1933-91 were eligible for the cohort. Deaths observed during 1962-90 were compared with expected figures calculated from national mortalities. Internal comparisons of rates were performed by Poisson regression analysis. The final cohort comprised 14,730 male employees who were observed for 288,886 person-years.
Mortality from all causes of death was slightly increased (3390 deaths, standardised mortality ratio (SMR) 1.08, 95% confidence interval (95% CI) 1.04-1.11). Regression analysis of total mortality showed a significant negative trend for the rate ratios with increasing duration of employment. An increased mortality was found among employees in urban plants compared with employees in rural plants (rate ratio (RR) 1.21, 95% CI 1.13-1.29). Excess deaths from cancer (SMR 1.11) and sudden death (SMR 1.47) were found among employees with at least three years of employment. Mortality from accidents, poisonings, and violence was increased among all employees (SMR 1.28). Excess deaths from this cause were however only found for the time after the end of employment in this industry and not during employment (SMR 0.90).
The increased mortality from cancer and sudden death could be related to work exposures, at least in subgroups, and these results warrant further studies. The excess deaths from accidents, poisonings, and violence were probably not related to work exposures. The mortality results for short term workers and other information indicate that systematic errors contribute to the increased overall mortality.
对铁合金行业工人接触危害健康因素的担忧引发了这项历史性队列研究。目的是调查挪威12家铁合金厂男性员工的死亡率模式。
所有在1933年至1991年期间开始首次工作且受雇至少六个月的男性都符合该队列研究的条件。将1962年至1990年期间观察到的死亡人数与根据全国死亡率计算出的预期数字进行比较。通过泊松回归分析进行死亡率的内部比较。最终队列包括14730名男性员工,观察时间为288886人年。
所有死因的死亡率略有上升(3390例死亡,标准化死亡率(SMR)为1.08,95%置信区间(95%CI)为1.04 - 1.11)。总死亡率的回归分析显示,随着就业时间的延长,比率呈显著负趋势。与农村工厂的员工相比,城市工厂的员工死亡率有所上升(比率比(RR)为1.21,95%CI为1.13 - 1.29)。在至少工作三年的员工中发现癌症(SMR为1.11)和猝死(SMR为1.47)导致的超额死亡。所有员工中事故、中毒和暴力导致的死亡率有所上升(SMR为1.28)。然而,仅在该行业就业结束后而非就业期间发现了这一原因导致的超额死亡(SMR为0.90)。
癌症和猝死导致的死亡率上升可能与工作接触有关,至少在某些亚组中如此,这些结果值得进一步研究。事故、中毒和暴力导致的超额死亡可能与工作接触无关。短期工人的死亡率结果和其他信息表明,系统误差导致了总体死亡率的上升。