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有机溶剂与癌症。

Organic solvents and cancer.

作者信息

Lynge E, Anttila A, Hemminki K

机构信息

Danish Cancer Society, København.

出版信息

Cancer Causes Control. 1997 May;8(3):406-19. doi: 10.1023/a:1018461406120.

Abstract

Epidemiologic evidence on the relationship between organic solvents and cancer is reviewed. In the 1980s, more than a million persons were potentially exposed to some specific solvents in the United States; in Canada, 40 percent of male cancer patients in Montreal had experienced exposure to solvents; in the Finnish population, one percent was regularly exposed. There is evidence for increased risks of cancer following exposure to: trichloroethylene (for the liver and biliary tract and for non-Hodgkin's lymphomas); tetrachloroethylene (for the esophagus and cervix--although confounding by smoking, alcohol, and sexual habits cannot be excluded--and non-Hodgkin's lymphoma); and carbon tetrachloride (lymphohematopoietic malignancies). An excess risk of liver and biliary tract cancers was suggested in the cohort with the high exposure to methylene chloride, but not found in the other cohorts where an excess risk of pancreatic cancer was suggested. 1,1,1-trichloroethane has been used widely, but only a few studies have been done suggesting a risk of multiple myeloma. A causal association between exposure to benzene and an increased risk of leukemia is well-established, as well as a suggested risk of lung and nasopharynx cancer in a Chinese cohort. Increased risks of various gastrointestinal cancers have been suggested following exposure to toluene. Two informative studies indicated an increased risk of lung cancer, not supported by other studies. Increased risks of lymphohematopoietic malignancies have been reported in some studies of persons exposed to toluene or xylene, but not in the two most informative studies on toluene. Occupation as a painter has consistently been associated with a 40 percent increased risk of lung cancer. (With the mixed exposures, however, it is not possible to identify the specific causative agent[s].) A large number of studies of workers exposed to styrene have evidenced no consistent excess risk of all lymphohematopoietic malignancies, although the most sensitive study suggested an excess risk of leukemia among workers with a high exposure.

摘要

本文综述了有机溶剂与癌症关系的流行病学证据。20世纪80年代,在美国有超过100万人可能接触过某些特定溶剂;在加拿大,蒙特利尔40%的男性癌症患者曾接触过溶剂;在芬兰人群中,1%的人经常接触溶剂。有证据表明,接触以下物质后癌症风险增加:三氯乙烯(导致肝脏和胆道以及非霍奇金淋巴瘤);四氯乙烯(导致食管癌和宫颈癌——尽管不能排除吸烟、饮酒和性行为的混杂因素——以及非霍奇金淋巴瘤);四氯化碳(淋巴造血系统恶性肿瘤)。高浓度接触二氯甲烷的队列中提示肝脏和胆道癌症风险增加,但在其他提示胰腺癌风险增加的队列中未发现。1,1,1 - 三氯乙烷已被广泛使用,但仅有少数研究提示有患多发性骨髓瘤的风险。接触苯与白血病风险增加之间的因果关系已得到充分证实,在中国的一个队列中也提示有患肺癌和鼻咽癌的风险。接触甲苯后提示患各种胃肠道癌症的风险增加。两项有参考价值的研究表明患肺癌风险增加,但未得到其他研究的支持。在一些接触甲苯或二甲苯的人群研究中报告了淋巴造血系统恶性肿瘤风险增加,但在关于甲苯的两项最具参考价值的研究中未发现。油漆工职业一直与患肺癌风险增加40%相关。(然而,由于接触情况复杂,无法确定具体的致病因素。)大量对接触苯乙烯工人的研究表明,并未发现所有淋巴造血系统恶性肿瘤都有一致的额外风险,尽管最敏感的研究提示高暴露工人中有患白血病的额外风险。

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