Schneider J, Rödelsperger K, Pohlabeln H, Woitowitz H J
Institut und Poliklinik für Arbeits- und Sozialmedizin, Justus-Liebig-Universität Giessen.
Zentralbl Hyg Umweltmed. 1996 Nov;199(1):1-23.
In an interdisciplinary, multicentre case control study of the causal factors of the diffuse malignant mesothelioma (DMM) standardised histories where taken from n = 324 Patients suffering from DMM, n = 315 hospital control patients (KK) and n = 182 population controls (PK). For 66 DMM, 149 KK and 107 PK a risk from asbestos fibre dust at the workplace was not detectable. For latter persons indoor and outdoor asbestos exposure outside of the workplace were investigated. The following factors were examined: neighbourhood exposure from companies using asbestos, living in big cities and nearby main traffic roads, building materials containing asbestos, electric storage heaters and household contacts. For using electric storage heaters a statistically significant increased odds ratio (OR) was observed for DMM as well in comparison with KK (OR = 2.42; 95%-CI: 1.01-5.72) and in comparison for PK (OR = 2.91; 95%-CI: 1.08-7.80). Only outside of Hamburg an increased OR compared to KK was observed for people living in the neighbourhood of asbestos factories (OR = 16.3; 95%-CI: 1.35-196.8) and also, but only in Hamburg, compared to PK living nearby main traffic roads. There is only a trend for a mesothelioma-risk for household-contacts based on a few cases. In one DMM-patient without an occupational asbestos exposure the lung dust fibre analysis yielded 2.912 FB and 1.459 x 10(3) crocydolithe fibres per gram dried lung tissue. As a child he lived in the immediate vicinity of the blue asbestos mine in Wittenoom, Australia. Therefore in special cases a para-occupational asbestos or a neighbourhood asbestos exposure can be demonstrated as a risk factor of diffuse malignant mesothelioma.
在一项关于弥漫性恶性间皮瘤（DMM）病因的多中心跨学科病例对照研究中，对n = 324例DMM患者、n = 315例医院对照患者（KK）和n = 182例人群对照患者（PK）采用了标准化病史。在66例DMM患者、149例KK对照患者和107例PK对照患者中，未检测到工作场所石棉纤维粉尘的风险。对于后一组人员，调查了工作场所以外的室内和室外石棉暴露情况。研究了以下因素：使用石棉的公司造成的邻里暴露、居住在大城市和主要交通道路附近、含石棉的建筑材料、蓄热器以及家庭接触情况。与KK相比（比值比（OR）= 2.42；95%可信区间：1.01 - 5.72）以及与PK相比（OR = 2.91；95%可信区间：1.08 - 7.80），DMM患者使用蓄热器的OR值在统计学上均显著升高。仅在汉堡以外地区，居住在石棉工厂附近的人群与KK相比OR值升高（OR = 16.3；95%可信区间：1.35 - 196.8），同样仅在汉堡，居住在主要交通道路附近的人群与PK相比OR值升高。基于少数病例，家庭接触仅呈现出间皮瘤风险的一种趋势。在一名无职业性石棉暴露的DMM患者中，肺粉尘纤维分析显示每克干肺组织中有2.912根纤维和1.459×10³根青石棉纤维。他小时候住在澳大利亚维特努姆蓝石棉矿的紧邻地区。因此，在特殊情况下，可证明准职业性石棉暴露或邻里石棉暴露是弥漫性恶性间皮瘤的危险因素。
