Blair A, Stewart P A, Zaebst D D, Pottern L, Zey J N, Bloom T F, Miller B, Ward E, Lubin J
Occupational Epidemiology Branch, National Cancer Institute, Bethesda, Maryland 20892, United States.
Scand J Work Environ Health. 1998;24 Suppl 2:25-41.
This study was designed to evaluate the relationship between occupational exposure to acrylonitrile and cancer mortality.
Workers (18079 white men, 4293 white women, 2191 nonwhite men, and 897 nonwhite women) employed in acrylonitrile production or use in the 1950s through 1983 were followed through 1989 for vital status and cause of death. Exposure-response relationships were evaluated from quantitative estimates of historical exposures. Tobacco use was determined for a sample of workers to assess potential confounding. Mortality rates between the exposed and unexposed workers in the cohort were compared using the Poisson regression.
Analyses by cumulative, average, peak, intensity, duration, and lagged exposure revealed no elevated risk of cancers of the stomach, brain, breast, prostate or lymphatic and hematopoietic systems. Mortality from lung cancer was elevated for the highest quintile of cumulative exposure. When the decile categories were used, the relative risk did not continue to increase at higher levels. Adjustment for cigarette use reduced the risk for lung cancer only slightly. Separate analyses for wage and salaried workers, long-term and short-term workers, fiber and nonfiber plants, and individual plants revealed no clear exposure-response patterns.
The results indicate that exposure to acrylonitrile at the levels studied is not associated with an increased relative risk for most cancers of a priori interest. The excess of lung cancer in the highest quintile of cumulative exposure may indicate carcinogenic activity at the highest levels of exposure, but analyses of exposure-response do not provide strong or consistent evidence for a causal association.
本研究旨在评估职业性接触丙烯腈与癌症死亡率之间的关系。
对20世纪50年代至1983年期间受雇于丙烯腈生产或使用行业的工人（18079名白人男性、4293名白人女性、2191名非白人男性和897名非白人女性）进行随访，直至1989年，以了解其生命状况和死亡原因。通过对历史接触情况的定量估计来评估接触-反应关系。对一部分工人的烟草使用情况进行了测定，以评估潜在的混杂因素。使用泊松回归比较队列中接触组和非接触组工人的死亡率。
通过累积、平均、峰值、强度、持续时间和滞后接触分析发现，胃癌、脑癌、乳腺癌、前列腺癌或淋巴及造血系统癌症的风险并未升高。累积接触最高五分位数的工人肺癌死亡率有所升高。当使用十分位数分类时，相对风险在较高水平并未继续增加。对吸烟情况进行调整后，肺癌风险仅略有降低。对工资和薪金工人、长期和短期工人、纤维和非纤维工厂以及个别工厂进行的单独分析未发现明确的接触-反应模式。
结果表明，在所研究的接触水平下，丙烯腈接触与大多数预先关注的癌症相对风险增加无关。累积接触最高五分位数的工人中肺癌超额可能表明在最高接触水平存在致癌活性，但接触-反应分析并未为因果关联提供有力或一致的证据。
