Andersson E, Nilsson T, Persson B, Wingren G, Torén K
Department of Occupational Medicine, Sahlgrenska University Hospital, Göteborg, Sweden.
Scand J Work Environ Health. 1998 Feb;24(1):12-7. doi: 10.5271/sjweh.273.
The aims of the present case-referent study were to investigate whether sulfite workers show increased mortality from asthma, chronic obstructive pulmonary disease or certain malignancies of interest in relation to sulfite mill work. The main exposure from the pulping processes is from sulfur dioxide, wood dust and terpenes.
The subjects of the study were all the men who died between 1960 and 1989 and who were aged 40 to 75 years at death (N = 780) in the parishes surrounding 3 sulfite mills. The men who died from asthma (N = 13), COPD (N = 20), lung cancer (N = 33), stomach cancer (N = 35), or brain tumor (N = 10) formed the case group. All the subjects, except the cases in question, were used as referents. As a proxy variable of exposure, job titles from the registers of deaths and burials were used, and 24% of the subjects were classified as exposed.
There was an increased mortality from asthma [odds ratio(OR) 2.8, 90% confidence interval (90% CI) 1.1-6.8] and brain tumors (OR 3.3, 90% CI 1.2-8.9) among the sulfite workers. The mortality due to lung cancer was not significantly increased (OR 1.4, 90% CI 0.7-2.6), and there was a reduced mortality from stomach cancer (OR 0.4, 90% CI 0.2-0.9).
The increased asthma mortality may be due to accidental exposure to irritating gases, such as sulfur dioxide. The increased risk for brain tumors has no obvious explanation.
本病例对照研究的目的是调查亚硫酸盐工人相对于亚硫酸盐制浆厂工作，是否显示出哮喘、慢性阻塞性肺疾病或某些相关恶性肿瘤的死亡率增加。制浆过程中的主要暴露源是二氧化硫、木屑和萜烯。
研究对象为1960年至1989年间死亡、死亡时年龄在40至75岁之间（N = 780）的3家亚硫酸盐制浆厂周边教区的所有男性。死于哮喘（N = 13）、慢性阻塞性肺疾病（N = 20）、肺癌（N = 33）、胃癌（N = 35）或脑肿瘤（N = 10）的男性组成病例组。除上述病例外，所有研究对象均作为对照。作为暴露的替代变量，使用死亡和埋葬登记册中的职位头衔，24%的研究对象被归类为暴露组。
亚硫酸盐工人中哮喘死亡率增加[比值比（OR）2.8，90%置信区间（90%CI）1.1 - 6.8]，脑肿瘤死亡率增加（OR 3.3，90%CI 1.2 - 8.9）。肺癌死亡率没有显著增加（OR 1.4，90%CI 0.7 - 2.6），胃癌死亡率降低（OR 0.4，90%CI 0.2 - 0.9）。
哮喘死亡率增加可能是由于意外接触刺激性气体，如二氧化硫。脑肿瘤风险增加尚无明显解释。
