van Loon A J, Kant I J, Swaen G M, Goldbohm R A, Kremer A M, van den Brandt P A
University of Limburg, Department of Epidemiology, Maastricht, The Netherlands.
Occup Environ Med. 1997 Nov;54(11):817-24. doi: 10.1136/oem.54.11.817.
To investigate risk of lung cancers associated with common established carcinogenic occupational exposures (asbestos, paint dust, polycyclic aromatic hydrocarbons, and welding fumes) in a prospective cohort study among the general population, and to estimate the proportion of lung cancer cases attributable to these occupational exposures.
A prospective cohort study on diet, other lifestyle factors, job history, and cancer risk that started in 1986 in The Netherlands on 58,279 men, aged 55-69 years. Based on information about job history obtained from a self-administered questionnaire, case by case expert assessment was carried out to assign to each study subject a cumulative probability of occupational exposure for each carcinogenic exposure. For analysis, a case-cohort approach was used, in which the person-years at risk were estimated from a randomly selected subcohort (n = 1688). After 4.3 years of follow up, 524 lung cancer cases with complete job history were available.
After adjustment for age, each of the other occupational exposures, and for smoking habits and intake of vitamin C, beta-carotene, and retinol, significant associations were found between risk of lung cancer and cumulative probability of occupational exposure to asbestos (relative risk (RR) highest/no exposure = 3.49, 95% confidence interval (95% CI) 1.69 to 7.18, trend P < 0.01 or paint dust (RR highest/no exposure = 2.48, 95% CI 0.88 to 6.97, trend P < 0.01). The population attributable risks (PARs) for the four exposures based on the multivariately adjusted RRs for ever exposed versus never exposed workers were calculated. The PAR of lifetime occupational exposure to asbestos was calculated to be 11.6%.
This prospective cohort study among the general population showed that occupational exposure to asbestos or paint dust is associated with higher RRs for lung cancer. This study shows that after adjustment for smoking and diet about 11.6% of the cases of lung cancer in men is attributable to lifetime occupational exposure to asbestos.
在一项针对普通人群的前瞻性队列研究中，调查与常见的已确定致癌职业暴露（石棉、油漆粉尘、多环芳烃和焊接烟尘）相关的肺癌风险，并估计可归因于这些职业暴露的肺癌病例比例。
1986年在荷兰对58279名年龄在55 - 69岁的男性开展了一项关于饮食、其他生活方式因素、工作史和癌症风险的前瞻性队列研究。根据通过自填问卷获得的工作史信息，逐例进行专家评估，为每个研究对象确定每种致癌暴露的职业暴露累积概率。分析采用病例 - 队列方法，其中风险人年数是从随机选择的一个亚队列（n = 1688）中估计得出。经过4.3年的随访，获得了524例有完整工作史的肺癌病例。
在对年龄、其他职业暴露、吸烟习惯以及维生素C、β - 胡萝卜素和视黄醇的摄入量进行调整后，发现肺癌风险与职业暴露于石棉的累积概率之间存在显著关联（相对风险（RR）最高暴露组/无暴露组 = 3.49，95%置信区间（95%CI）为1.69至7.18，趋势P < 0.01），或与油漆粉尘之间存在显著关联（RR最高暴露组/无暴露组 = 2.48，95%CI为0.88至6.97，趋势P < 0.01）。根据曾暴露与未暴露工人的多变量调整RR计算了这四种暴露的人群归因风险（PARs）。终生职业暴露于石棉的PAR计算为11.6%。
这项针对普通人群的前瞻性队列研究表明，职业暴露于石棉或油漆粉尘与肺癌的较高RR相关。该研究表明，在对吸烟和饮食进行调整后，男性肺癌病例中约11.6%可归因于终生职业暴露于石棉。
