Blair A, Kazerouni N
Occupational Studies Section at the National Cancer Institute, Rockville, MD 20892-7364, USA.
Cancer Causes Control. 1997 May;8(3):473-90. doi: 10.1023/a:1018417623867.
Epidemiologic evidence on the relation between reactive chemicals and cancer is reviewed. These highly reactive chemicals (acrylonitrile; bis[chloromethyl]ether and chloromethyl methyl ether; 1,3-butadiene, ethylene oxide; formaldehyde; mustard gas; sulfuric acid; and vinyl chloride) vary in use and exposure. All are animal carcinogens that also have received considerable epidemiologic attention. Acrylonitrile is a chemical of current economic importance. The epidemiologic evidence is quite weak, but the available studies were very small. Epidemiologic studies clearly demonstrate that bis (chloromethyl) ether and chloromethyl methyl ether cause lung cancer. Continued follow-up of exposed workers is encouraged to provide information on risks for other cancers. Results from epidemiologic studies of butadiene-exposed workers are somewhat inconsistent, but the largest study with the best exposure assessment found the largest relative risk for leukemia. The failure of several larger studies to replicate the early Swedish findings of a very strong association between leukemia and ethylene oxide has not been adequately explained. Epidemiologic studies of formaldehyde provide limited evidence for an association with cancer of the nasopharynx and possibly with nasal cancer. These very rare tumors, however, are difficult to study epidemiologically. Mustard gas is a well-established lung carcinogen, but a recent follow-up of the English cohort suggests that other sites also may be affected. Sulfuric acid appears to cause laryngeal cancer. A suggested relationship with lung cancer in a few studies is of concern because of the widespread opportunity for exposure from ambient air pollution. Vinyl chloride causes angiosarcoma of the liver, but a large, multi-country study provided no clear evidence that other sites are affected.
本文综述了关于活性化学物质与癌症之间关系的流行病学证据。这些高活性化学物质（丙烯腈；双（氯甲基）醚和氯甲基甲醚；1,3 - 丁二烯、环氧乙烷；甲醛；芥子气；硫酸；以及氯乙烯）在用途和暴露情况方面各不相同。它们均为动物致癌物，也受到了相当多的流行病学关注。丙烯腈是一种具有当前经济重要性的化学物质。流行病学证据相当薄弱，但现有研究规模非常小。流行病学研究清楚地表明，双（氯甲基）醚和氯甲基甲醚会导致肺癌。鼓励对接触这些物质的工人进行持续随访，以获取关于其他癌症风险的信息。对接触丁二烯工人的流行病学研究结果有些不一致，但规模最大且暴露评估最佳的研究发现白血病的相对风险最高。几项较大规模的研究未能重现瑞典早期关于白血病与环氧乙烷之间极强关联的发现，这一点尚未得到充分解释。甲醛的流行病学研究为其与鼻咽癌以及可能与鼻腔癌的关联提供了有限的证据。然而，这些极为罕见的肿瘤在流行病学上难以研究。芥子气是一种公认的肺癌致癌物，但最近对英国队列的随访表明其他部位也可能受到影响。硫酸似乎会导致喉癌。一些研究中提出的与肺癌的关系令人担忧，因为从环境空气污染中接触硫酸的机会广泛。氯乙烯会导致肝血管肉瘤，但一项大型多国研究未提供其他部位受影响的明确证据。
