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[波兰石棉水泥行业工人的癌症风险]

[Cancer risk in asbestos-cement industry workers in Poland].

作者信息

Szeszenia-Dabrowska N, Wilczyńska U, Szymczak W

机构信息

Zakładu Epidemiologii Srodowiskowej, Instytutu Medycyny Pracy, Lodzi.

出版信息

Med Pr. 1997;48(5):473-83.

PMID:9501330
Abstract

A cohort study was carried out in order to evaluate the cancer risk in the asbestos-cement industry workers. The cohort consisted of workers employed in four asbestos-cement plants. One of those plants was established in 1924, the other three in the 1960s and 1970s. Currently only two of these plants continue their production. The plants used mainly chrysotile asbestos as well as crocidolite and amosite. Amphibolite asbestos was used before the mid-nineteen eighties in production of pressure pipes utilising about 15% of the total quantity of asbestos used. The measurements of the asbestos fibre concentration at work-sites have been taken occasionally since the mid 1980s, thus, the determination of a cumulative dose for individual persons in the cohort and the evaluation of the dose-effect relationship were not feasible. It could only be supposed that the concentrations at the preparatory work-site during first years of the plants' operation accounted for several tens fibres/cm3 in the production that employed the dry method. The cohort consisted of workers employed in the plant for at least three months between beginning of the plant during the post-war period, and 1980, that is during the period when amphibolite asbestos was in use. The retrospective observation was completed on 31 December 1991. The analysis of the death risk by causes was based on a standardized mortality ratios (SMRs) calculated using the person-years method. Statistical significance of SMRs was assessed by means of Poisson distribution one-sided test. The general population of Poland was used as the reference population to estimate the death risk. The cohort comprised 4,712 persons (3,563 males and 1,149 females). Of this number 4,500 persons (3,405 males and 1,095 females) were followed. The cohort availability were 95.5%. Male mortality, both total (473 deaths; SMR = 83) and due to malignant neoplasms (108 deaths; SMR = 86) was lower than in the general population. An excess of deaths from neoplasm of the pleura was by about 23 times higher (5 deaths; SMR = 2,288) and from neoplasm of the large intestine by two times higher (7 deaths; SMR = 214). Among females (41 deaths; SMR = 50) death risk was lower than in the reference population. At a low level of total mortality from neoplasms (13 deaths; SMR = 52) a statistically significant excess of deaths from neoplasm of the pleura (2 deaths; SMR = 2,112) was observed. In the plants investigated the analysis revealed a considerably diversified mortality from asbestos-related neoplasms. The incidence of pleura mesothelioma should be attributed to the use of considerable quantities of crocidolite asbestos and high concentrations of fibres in the air in plants II and IV, particularly during the first years after their establishment. In view of a long period of latency the excess of this neoplasm can be expected till 2020.

摘要

为评估石棉水泥行业工人的癌症风险,开展了一项队列研究。该队列由四家石棉水泥厂的工人组成。其中一家工厂建于1924年,另外三家建于20世纪60年代和70年代。目前只有两家工厂仍在生产。这些工厂主要使用温石棉,以及青石棉和铁石棉。20世纪80年代中期以前,在压力管生产中使用了闪石类石棉,约占石棉总用量的15%。自20世纪80年代中期以来,偶尔会对工作场所的石棉纤维浓度进行测量,因此,确定队列中个体的累积剂量以及评估剂量-效应关系并不可行。只能推测,在工厂运营的头几年,干法生产车间的浓度为每立方厘米几十根纤维。该队列由战后工厂开工至1980年(即闪石类石棉使用期间)在工厂工作至少三个月的工人组成。回顾性观察于1991年12月31日完成。死因死亡风险分析基于用人年法计算的标准化死亡比(SMR)。通过泊松分布单侧检验评估SMR的统计学显著性。以波兰总人口作为参考人群来估计死亡风险。该队列包括4712人(男性3563人,女性1149人)。其中4500人(男性3405人,女性1095人)被随访。队列可及率为95.5%。男性总死亡率(473例死亡;SMR = 83)和恶性肿瘤死亡率(108例死亡;SMR = 86)均低于一般人群。胸膜肿瘤死亡人数超过一般人群约23倍(5例死亡;SMR = 2288),大肠肿瘤死亡人数超过两倍(7例死亡;SMR = 214)。女性(41例死亡;SMR = 50)的死亡风险低于参考人群。在肿瘤总死亡率较低水平(13例死亡;SMR = 52)时,观察到胸膜肿瘤死亡人数有统计学显著性增加(2例死亡;SMR = 2112)。在所调查的工厂中,分析显示与石棉相关肿瘤的死亡率差异很大。胸膜间皮瘤发病率应归因于工厂II和IV中大量使用青石棉以及空气中纤维浓度高,尤其是在工厂建成后的头几年。鉴于潜伏期较长,预计到2020年该肿瘤的超额发病情况仍会存在。

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