Sathiakumar N, Delzell E, Hovinga M, Macaluso M, Julian J A, Larson R, Cole P, Muir D C
Department of Epidemiology, School of Public Health, University of Alabama at Birmingham, USA.
Occup Environ Med. 1998 Apr;55(4):230-5. doi: 10.1136/oem.55.4.230.
This study evaluated the mortality experience of workers from the styrene-butadiene rubber industry. Concerns about a possible association of 1,3-butadiene and styrene with lymphohaematopoietic, gastrointestinal, and lung cancers prompted the investigation.
A retrospective follow up study was conducted of 15,649 men employed for at least one year at any of eight North American styrene-butadiene rubber plants. Analyses used standardised mortality ratios (SMRs) to compare styrene-butadiene rubber workers' cause specific mortalities (1943-91) with those of the United States and Ontario general populations.
On average, there were 25 years of follow up per subject. The standardised mortality ratio (SMR) was 87 (95% confidence interval (95% CI) 85 to 90) for all causes of death combined and was 93 (95% CI 87 to 99) for all cancers. There was an excess of leukaemia (SMR 131, 95% CI 97 to 174), restricted to hourly workers (SMR 143, 95% CI 104 to 191). For causes of death other than leukaemia, SMRs were close to or below the null value of 100. Results by work area (process group) were unremarkable for non-Hodgkin's lymphoma, multiple myeloma, and stomach cancer. Maintenance workers had a slight increase in deaths from lung cancer, and certain subgroups of workers had more than expected deaths from cancer of the large intestine and the larynx.
This study found an excess of leukaemia that is likely to be due to exposure to butadiene or to butadiene plus other chemicals. Deaths from non-Hodgkin's lymphoma, multiple myeloma, and stomach cancer did not seem to be related to occupational exposure. The excess deaths from lung cancer among maintenance workers may be due in part to confounding by smoking, which was not controlled for, and in part to an unidentified occupational exposure other than butadiene or styrene. Increases in cancer of the large intestine and larynx were based on small numbers, did not seem to be due to exposure to butadiene or styrene, and may be chance observations.
本研究评估了丁苯橡胶行业工人的死亡情况。由于担心1,3 - 丁二烯和苯乙烯可能与淋巴造血系统、胃肠道及肺癌存在关联，故而开展此项调查。
对北美8家丁苯橡胶工厂中至少工作1年的15649名男性进行了一项回顾性随访研究。分析采用标准化死亡比（SMR），将丁苯橡胶工人特定病因死亡率（1943 - 1991年）与美国及安大略省普通人群的死亡率进行比较。
每位受试者平均随访25年。所有死因合并的标准化死亡比（SMR）为87（95%置信区间（95%CI）85至90），所有癌症的标准化死亡比为93（95%CI 87至99）。白血病死亡人数过多（SMR 131，95%CI 97至174），且仅限于小时工（SMR 143，95%CI 104至191）。对于白血病以外的死因，SMR接近或低于100的零值。按工作区域（工艺组）划分，非霍奇金淋巴瘤、多发性骨髓瘤和胃癌的结果无明显差异。维修工人肺癌死亡人数略有增加，某些工人群体的大肠癌和喉癌死亡人数高于预期。
本研究发现白血病死亡人数过多，可能是由于接触丁二烯或丁二烯与其他化学物质共同作用所致。非霍奇金淋巴瘤、多发性骨髓瘤和胃癌的死亡似乎与职业接触无关。维修工人肺癌死亡人数过多，部分原因可能是未控制的吸烟因素造成的混杂，部分原因可能是丁二烯或苯乙烯以外的未明确职业接触。大肠癌和喉癌的增加基于少量病例，似乎并非由接触丁二烯或苯乙烯所致，可能是偶然观察结果。
