英国肝脏血管肉瘤与氯乙烯生产场地的关系。
Angiosarcoma of the liver in Great Britain in proximity to vinyl chloride sites.
作者信息
Elliott P, Kleinschmidt I
机构信息
Department of Epidemiology and Public Health, Imperial College School of Medicine at St Mary's, London.
出版信息
Occup Environ Med. 1997 Jan;54(1):14-8. doi: 10.1136/oem.54.1.14.
OBJECTIVES
To study the incidence of angiosarcoma of the liver in England and Wales 1979-86 and Scotland 1975-87. To investigate whether any non-occupational neighbourhood cases occurred near a vinyl chloride site.
METHODS
This is a geographical study of incident cases among the general population of Great Britain. Diagnosis of angiosarcoma of the liver was based mainly on the national cancer registry, the world register of cases among vinyl chloride workers, and the register of cases (including histological review) maintained by the Health and Safety Executive. Proximity (< 10 km) of residence to a vinyl chloride site was based on postcode of address at the time of diagnosis.
RESULTS
55 cases were ascribed to angiosarcoma of the liver in England and Wales with a further six cases in Scotland (annual incidence in Great Britain from all sources of around 1.4 cases per 10 million population). There were two cases with documented exposure to Thorotrast, and 10 cases among vinyl chloride workers. There were no vinyl chloride sites in Scotland. Among the 25 cases in England and Wales with histological diagnosis after review by a panel of pathologists, only 15 were confirmed as angiosarcoma, and one of the two Scottish cases after histological review was also confirmed. Overall, 11 cases ascribed to angiosarcoma were resident within 10 km of a vinyl chloride site; nine were vinyl chloride workers, one further case on histological review was not considered to have been correctly diagnosed as angiosarcoma, and the remaining case, confirmed as angiosarcoma, was employed at a vinyl chloride factory during the late 1950s, although not as a vinyl chloride worker.
CONCLUSION
The incidence of angiosarcoma of the liver in Great Britain remains extremely rare. The one confirmed case in a non-vinyl chloride worker within 10 km of a site must nevertheless be presumed to have been exposed to vinyl chloride in the workplace. In the period of study, there were no confirmed non-occupationally exposed cases of angiosarcoma among residents living near a vinyl chloride site in Great Britain.
目的
研究1979 - 1986年英格兰和威尔士以及1975 - 1987年苏格兰肝脏血管肉瘤的发病率。调查在氯乙烯工厂附近是否出现过非职业性的邻里病例。
方法
这是一项针对英国普通人群中发病病例的地理学研究。肝脏血管肉瘤的诊断主要基于国家癌症登记处、氯乙烯工人病例世界登记处以及健康与安全执行局维护的病例登记处（包括组织学复查）。根据诊断时的住址邮政编码确定居住地与氯乙烯工厂的距离（<10公里）。
结果
英格兰和威尔士有55例被归因于肝脏血管肉瘤，苏格兰另有6例（英国所有来源的年发病率约为每1000万人口1.4例）。有2例有钍造影剂暴露记录，10例发生在氯乙烯工人中。苏格兰没有氯乙烯工厂。在英格兰和威尔士经一组病理学家复查后进行组织学诊断的25例中，只有15例被确认为血管肉瘤，苏格兰的2例经组织学复查后有1例也被确认。总体而言，11例归因于血管肉瘤的病例居住在距离氯乙烯工厂10公里范围内；9例是氯乙烯工人，经组织学复查后另有1例不被认为被正确诊断为血管肉瘤，其余1例被确认为血管肉瘤，该病例在20世纪50年代后期受雇于一家氯乙烯工厂，不过并非氯乙烯工人。
结论
英国肝脏血管肉瘤的发病率仍然极其罕见。然而，必须假定在距离工厂10公里范围内的1例确诊非氯乙烯工人病例在工作场所接触过氯乙烯。在研究期间，英国居住在氯乙烯工厂附近的居民中没有确诊的非职业性暴露血管肉瘤病例。
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