Szeszenia-Dabrowska N, Wilczyńska U, Szymczak W, Laskowicz K
Department of Occupational and Environmental Epidemiology, Nofer Institute of Occupational Medicine, Lódź, Poland.
Int J Occup Med Environ Health. 1998;11(2):171-7.
The paper presents data on cancer risk, especially pleural mesothelioma and lung cancer, among the workers of asbestos cement plant who living in the vicinity of the plant, were also environmentally exposed to asbestos. In 1959 an asbestos cement factory was founded in the rural area of south-eastern Poland. Apart from chrysotile asbestos, crocidolite was used till 1985 chiefly for the manufacture of pressure pipes. The blue asbestos made up 15% of the mean annual tonnage of the processed asbestos. It was found that soon after asbestos production had started the process wastes were made available to local community, particularly to the workers of that factory. For over twenty years asbestos wastes of all kinds, both wet (process sludge) and dry (from pipe and sheet grinding) were exploited for the hardening of roads, paths, farmyards and sports fields and as construction material components. For the evaluation of cancer risk due to occupational exposure to asbestos a cohort of 1,526 workers employed in this factory was observed till the end of 1996. The cohort availability was 95.6%. Standardized mortality ratio (SMR) was calculated using the man-years method. The reference population was the general population of Poland. The results of the study demonstrated a statistically significant increase in the risk of a) pleural mesothelioma--over an 80-fold excess among males and over a 200-fold one among females; b) lung cancer in females--over a 6-fold excess; c) colon cancer in males--over a 3-fold excess. In the 1990 ten new cases of pleural mesothelioma in the cohort were reported. As compared to other asbestos-cement cohorts in Poland, observed at the same time, this cohort presented a very high risk of pleural mesothelioma. The analysis of 16 cases of pleural mesothelioma found in the cohort from 1987 to 1997 revealed 4 cases with very short employment period (3.5 months-5 years) including two cases with relatively short latency period (11-12 years). In order to find explanation of these findings, additional investigations were made. The epidemiological study indicated that all these persons were at the same time subject to non-occupational exposure associated with massive utilization of commonly available asbestos-cement wastes as road surface material.
本文介绍了居住在石棉水泥厂附近且在环境中接触石棉的该厂工人的癌症风险数据，尤其是胸膜间皮瘤和肺癌风险。1959年，一家石棉水泥厂在波兰东南部农村地区建成。除温石棉外，直至1985年，青石棉主要用于制造压力管道。蓝石棉占加工石棉年均吨数的15%。研究发现，石棉生产开始后不久，生产废料就提供给了当地社区，尤其是该厂工人。二十多年来，各类石棉废料，包括湿的（生产污泥）和干的（管道和板材研磨产生的），都被用于道路、小径、农场和运动场的硬化以及作为建筑材料成分。为评估职业接触石棉导致的癌症风险，对该厂雇佣的1526名工人组成的队列进行了观察，直至1996年底。队列可获得率为9５.6%。采用人年法计算标准化死亡比（SMR）。参照人群为波兰总人口。研究结果表明，以下癌症风险有统计学显著增加：a）胸膜间皮瘤——男性超过80倍，女性超过200倍；b）女性肺癌——超过6倍；c）男性结肠癌——超过3倍。1990年，该队列报告了10例新的胸膜间皮瘤病例。与波兰同期观察到的其他石棉水泥工人队列相比，该队列胸膜间皮瘤风险非常高。对该队列1987年至1997年发现的16例胸膜间皮瘤病例分析显示，4例就业期很短（3.5个月至5年），其中2例潜伏期相对较短（11至12年）。为解释这些发现，进行了额外调查。流行病学研究表明，所有这些人同时还受到与大量使用普通可得的石棉水泥废料作为路面材料相关的非职业性接触。
