Kogevinas M, Sala M, Boffetta P, Kazerouni N, Kromhout H, Hoar-Zahm S
Respiratory and Environmental Health Research Unit, Institut Municipal d'Investigació Mèdica, Barcelona, Spain.
Occup Environ Med. 1998 Jan;55(1):1-12. doi: 10.1136/oem.55.1.1.
To examine the recent epidemiological evidence on cancer risk among workers in the rubber industry.
Epidemiological studies published after the last detailed review by the International Agency for Research on Cancer (IARC) in 1982 were reviewed. 12 cohort studies in nine countries that examined distinct populations of workers in the rubber industry, seven industry based nested case-control studies, 48 community based case-control studies in 16 countries, and 23 studies based on administrative data that reported risks for employment in the rubber industry were identified.
Excess risks of bladder cancer, lung cancer, and leukaemia were found in most studies, with risks above 1.5 in about half of the studies. A moderate excess risk for laryngeal cancer was consistent across studies. Excess risks were found in a few studies for cancers of the oesophagus, stomach, colon, liver, pancreas, skin, prostate, kidney, brain, and thyroid, and for malignant lymphoma and multiple myeloma, but overall results were not consistent for these neoplasms.
Magnitude of the observed risks varied considerably between studies, but overall the findings indicate the presence of a widespread moderate increased cancer risk among rubber workers. The most consistent results were for bladder, laryngeal, and lung cancer and for leukaemia. Excess risks were also found for other neoplasms but an evaluation of the consistency of the findings is difficult because of the possible selective reporting of results. Recent studies do not provide information associating specific exposures with cancer risk. The preventive measures taken in the rubber industry in recent years may decrease risks, but this has not been documented yet in epidemiological studies.
研究橡胶行业工人癌症风险的近期流行病学证据。
对国际癌症研究机构(IARC)1982年上次详细审查之后发表的流行病学研究进行综述。确定了9个国家的12项队列研究,这些研究调查了橡胶行业不同的工人群体;7项基于行业的巢式病例对照研究;16个国家的48项基于社区的病例对照研究;以及23项基于行政数据的研究,这些研究报告了橡胶行业就业风险。
大多数研究发现膀胱癌、肺癌和白血病存在超额风险,约一半的研究中风险高于1.5。喉癌存在中度超额风险在各项研究中是一致的。少数研究发现食管癌、胃癌、结肠癌、肝癌、胰腺癌、皮肤癌、前列腺癌、肾癌、脑癌和甲状腺癌以及恶性淋巴瘤和多发性骨髓瘤存在超额风险,但这些肿瘤的总体结果并不一致。
不同研究中观察到的风险程度差异很大,但总体而言,研究结果表明橡胶工人中普遍存在中度癌症风险增加。最一致的结果是膀胱癌、喉癌、肺癌和白血病。其他肿瘤也发现了超额风险,但由于可能存在结果的选择性报告,很难对研究结果的一致性进行评估。近期研究未提供将特定暴露与癌症风险相关联的信息。近年来橡胶行业采取的预防措施可能会降低风险,但这在流行病学研究中尚未得到证实。