Kogevinas M, Becher H, Benn T, Bertazzi P A, Boffetta P, Bueno-de-Mesquita H B, Coggon D, Colin D, Flesch-Janys D, Fingerhut M, Green L, Kauppinen T, Littorin M, Lynge E, Mathews J D, Neuberger M, Pearce N, Saracci R
Unit of Environmental Cancer Epidemiology, International Agency for Research on Cancer, Lyon, France.
Am J Epidemiol. 1997 Jun 15;145(12):1061-75. doi: 10.1093/oxfordjournals.aje.a009069.
The authors examined cancer mortality in a historical cohort study of 21,863 male and female workers in 36 cohorts exposed to phenoxy herbicides, chlorophenols, and dioxins in 12 countries. Subjects in this updated and expanded multinational study coordinated by the International Agency for Research on Cancer were followed from 1939 to 1992. Exposure was reconstructed using job records, company exposure questionnaires, and serum and adipose tissue dioxin levels. Among workers exposed to phenoxy herbicides contaminated with 2,3,7,8-tetrachlorodibenzo-p-dioxin (TCDD) or higher chlorinated dioxins, mortality from soft-tissue sarcoma (6 deaths; standardized mortality ratio (SMR) = 2.03, 95% confidence interval (CI) 0.75-4.43) was higher than expected from national mortality rates. Mortality from all malignant neoplasms (710 deaths; SMR = 1.12, 95% CI 1.04-1.21), non-Hodgkin's lymphoma (24 deaths; SMR = 1.39, 95% CI 0.89-2.06), and lung cancer (225 deaths; SMR = 1.12, 95% CI 0.98-1.28) was slightly elevated. Risks for all neoplasms, for sarcomas, and for lymphomas increased with time since first exposure. In workers exposed to phenoxy herbicides with minimal or no contamination by TCDD and higher chlorinated dioxins, mortality from all neoplasms (398 deaths; SMR = 0.96, 95% CI 0.87-1.06), non-Hodgkin's lymphoma (9 deaths; SMR = 1.00), and lung cancer (148 deaths; SMR = 1.03) was similar to that expected, and mortality from soft-tissue sarcoma was slightly elevated (2 deaths; SMR = 1.35). In a Poisson regression analysis, workers exposed to TCDD or higher chlorinated dioxins had an increased risk for all neoplasms (rate ratio = 1.29, 95% CI 0.94-1.76) compared with workers from the same cohort exposed to phenoxy herbicides and chlorophenols but with minimal or no exposure to TCDD and higher chlorinated dioxins. These findings indicate that exposure to herbicides contaminated with TCDD and higher chlorinated dioxins may be associated with a small increase in overall cancer risk and in risk for specific cancers.
作者在一项历史性队列研究中，对12个国家36个队列中接触苯氧基除草剂、氯酚和二噁英的21863名男性和女性工人的癌症死亡率进行了研究。这项由国际癌症研究机构协调的最新且扩大的跨国研究中的受试者，从1939年至1992年进行了随访。利用工作记录、公司接触调查问卷以及血清和脂肪组织中的二噁英水平来重建接触情况。在接触被2,3,7,8 - 四氯二苯并 - p - 二噁英（TCDD）或更高氯代二噁英污染的苯氧基除草剂的工人中，软组织肉瘤的死亡率（6例死亡；标准化死亡比（SMR）= 2.03，95%置信区间（CI）0.75 - 4.43）高于根据国家死亡率预期的水平。所有恶性肿瘤的死亡率（710例死亡；SMR = 1.12，95% CI 1.04 - 1.21）、非霍奇金淋巴瘤的死亡率（24例死亡；SMR = 1.39，95% CI 0.89 - 2.06）以及肺癌的死亡率（225例死亡；SMR = 1.12，95% CI 0.98 - 1.28）略有升高。自首次接触以来，所有肿瘤、肉瘤和淋巴瘤的风险随时间增加。在接触TCDD和更高氯代二噁英污染极少或未受污染的苯氧基除草剂的工人中，所有肿瘤的死亡率（398例死亡；SMR = 0.96，95% CI 0.87 - 1.06）、非霍奇金淋巴瘤的死亡率（9例死亡；SMR = 1.00）以及肺癌的死亡率（148例死亡；SMR = 1.03）与预期相似，而软组织肉瘤的死亡率略有升高（2例死亡；SMR = 1.35）。在泊松回归分析中，与同一队列中接触苯氧基除草剂和氯酚但极少或未接触TCDD和更高氯代二噁英的工人相比，接触TCDD或更高氯代二噁英的工人所有肿瘤的风险增加（率比 = 1.29，95% CI 0.94 - 1.76）。这些发现表明，接触被TCDD和更高氯代二噁英污染的除草剂可能与总体癌症风险以及特定癌症风险的小幅增加有关。
