Finkelstein M M
Family Medicine Centre, Mt. Sinai Hospital, Toronto, Ontario, Canada.
Am J Ind Med. 1998 Sep;34(3):244-51. doi: 10.1002/(sici)1097-0274(199809)34:3<244::aid-ajim6>3.0.co;2-v.
A case-control study, nested in a cohort of workers under surveillance for silicosis in 1979 or later, was undertaken to assess lung cancer risk in relation to the ILO coding scheme for the pneumoconioses. The subjects of this study are from the 41 matched quarters, consisting of one workers with silicosis and three age-matched controls, in which a lung cancer case was diagnosed. The odds ratio for lung cancer among subjects with ILO classification 1/0 or more, in comparison to subjects with category < or = 0/1, was 3.27 (95% CI =1.32-8.2). Adjustment of the radiographic risk for the effect of cumulative radon exposure had the effect of increasing the odds ratio for the association between ILO category > or = 1/0 and lung cancer. Although small smoking differences could account for the increased lung cancer odds ratio among workers with silicosis, the empirical evidence suggests that these smoking differences do not exist. It is concluded on the basis of two North American studies of silica exposed workers that radiographic silicosis is a marker for an increased risk of lung cancer.
一项病例对照研究嵌套于1979年及以后接受矽肺监测的工人群体中，旨在评估与国际劳工组织（ILO）尘肺病编码方案相关的肺癌风险。本研究的对象来自41个匹配组，每组由一名矽肺患者和三名年龄匹配的对照组成，其中有一例被诊断为肺癌。与国际劳工组织分类<或=0/1的受试者相比，国际劳工组织分类为1/0或更高的受试者患肺癌的比值比为3.27（95%可信区间=1.32 - 8.2）。对累积氡暴露影响的放射学风险进行调整后，国际劳工组织分类>或=1/0与肺癌之间关联的比值比有所增加。尽管矽肺患者中肺癌比值比的增加可能与吸烟差异较小有关，但实证证据表明这些吸烟差异并不存在。基于两项对接触二氧化硅工人的北美研究得出结论，放射学矽肺是肺癌风险增加的一个标志。
