Stellman S D, Demers P A, Colin D, Boffetta P
Division of Epidemiology, American Health Foundation, New York, New York 10017, USA.
Am J Ind Med. 1998 Sep;34(3):229-37. doi: 10.1002/(sici)1097-0274(199809)34:3<229::aid-ajim4>3.0.co;2-q.
In 1994, the International Agency for Research on Cancer (IARC) classified wood duct as a human carcinogen, based on very strong evidence of a carcinogenic risk of sino-nasal cancer. Excesses of other cancers, including lung and stomach, have been reported among persons employed in wood industries or occupationally exposed to wood dust, but not as consistently. We investigated such possible associations using the mortality experience of 362,823 men enrolled in the American Cancer Society's Cancer Prevention Study-II in 1982 and followed up for 6 years. Within this group, 45,399 men (12.5%) reported either employment in a wood-related occupation or exposure to wood dust or both. Among woodworkers, a small but significant excess risk was found for all cases of death (RR 1.17 (95% CI 1.11-1.24)) and for total malignancies (RR 1.17 (1.05-1.30)). Among men who reported exposure to wood dust, there was an elevated risk of total mortality (Rr 1.07 (1.03-1.11)), total malignancies (RR 1.08 (1.01-1.15)), and lung cancer (RR 1.17 (1.04-1.31)). Among woodworkers, a significant trend (P = 0.02) of increasing risk of lung cancer with increasing duration of exposure was observed. An unexpected, significantly increased mortality from prostate cancer was observed in both wood-employed and wood-exposed, and a twofold increased risk of fatal brain cancer was seen among the former. Lung cancer mortality was especially high among woodworkers who also reported exposure to asbestos or formaldehyde, and it appears that exposure to these known carcinogens may partly explain the observed increased risks. Excess sino-nasal cancer was not observed, but the number of cases was small.
1994年,国际癌症研究机构(IARC)将木尘归类为人类致癌物,这是基于确凿证据表明其存在导致鼻窦癌的致癌风险。在木材行业工作或职业性接触木尘的人群中,也有报告称其他癌症(包括肺癌和胃癌)出现超额发病情况,但并不一致。我们利用1982年美国癌症协会癌症预防研究-II中登记的362,823名男性的死亡情况进行了调查,并随访了6年。在这个群体中,45,399名男性(12.5%)报告曾从事与木材相关的职业、接触过木尘或两者皆有。在木工中,发现所有死亡病例(相对危险度RR 1.17(95%可信区间1.11 - 1.24))和全部恶性肿瘤(RR 1.17(1.05 - 1.30))存在虽小但显著的超额风险。在报告接触过木尘的男性中,总死亡率(RR 1.07(1.03 - 1.11))、全部恶性肿瘤(RR 1.08(1.01 - 1.15))和肺癌(RR 1.17(1.04 - 1.31))的风险有所升高。在木工中,观察到肺癌风险随接触时间延长而增加的显著趋势(P = 0.02)。在从事木材行业工作和接触木尘的人群中,均观察到前列腺癌死亡率意外显著升高,而在前者中致命性脑癌风险增加了两倍。在同时报告接触过石棉或甲醛的木工中,肺癌死亡率尤其高,看来接触这些已知致癌物可能部分解释了所观察到的风险增加情况。未观察到鼻窦癌超额发病情况,但病例数较少。