Mastrangelo G, Marzia V, Paruzzolo P, Saia B
Istituto di Medicina del Lavoro, Università di Padova.
G Ital Med Lav Ergon. 1997 Jan-Mar;19(1):33-5.
An epidemiological study of mortality was carried out in the Province of Padua in a cohort of family farmers. The subjects, identified from the SCAU files, were enrolled in the cohort if informations were available on complete registry data, date of beginning and of termination of farm work, size of farm, and number of dairy cattle. The 2,415 farmers selected were followed-up for mortality through the registry offices of their Communes of residence. The cause of death was obtained for the 541 decedents. The standardised mortality ratio (SMR) was the ratio between observed and expected mortality, calculated on the basis of the mortality rates in the regional general population. The lung cancer SMR was 0.54 (0.36-0.79; observed = 27) among the 1641 dairy farmers, and 0.78 (0.46-1.25; observed = 17) among the 774 arable farmers. Among dairy farmers, moreover, lung cancer SMRs showed a significant trend across the quartiles of length of work, number of cattle, area of farm, age at beginning farm work, and age at work termination. Dairy farmers are known to be exposed to higher airborne endotoxin concentrations, and it is reasonable to assume that this cumulative exposure further increases with years of work, number of cattle, and area of farm. Microbial endotoxin might have protected dairy farmers against lung cancer through a host factor, the Tumor Necrosis Factor, produced by alveolar macrophages.
在帕多瓦省对一群家庭农场主进行了死亡率的流行病学研究。从农业社会保险机构（SCAU）档案中识别出研究对象，若能获取完整登记数据、农事工作开始和结束日期、农场规模以及奶牛数量等信息，这些对象就被纳入该队列。选取的2415名农场主通过其居住社区的登记办公室进行死亡率随访。获取了541名死者的死因。标准化死亡率（SMR）是观察到的死亡率与预期死亡率之比，根据该地区普通人群的死亡率计算得出。在1641名奶农中，肺癌标准化死亡率为0.54（0.36 - 0.79；观察到的病例数 = 27），在774名从事耕地作业的农民中，肺癌标准化死亡率为0.78（0.46 - 1.25；观察到的病例数 = 17）。此外，在奶农中，肺癌标准化死亡率在工作时长、奶牛数量、农场面积、开始从事农事工作的年龄以及工作结束时的年龄等四分位数区间呈现出显著趋势。已知奶农接触到的空气中内毒素浓度较高，合理推测这种累积接触会随着工作年限、奶牛数量和农场面积的增加而进一步上升。微生物内毒素可能通过肺泡巨噬细胞产生的一种宿主因子——肿瘤坏死因子，保护奶农预防肺癌。
