Straif K, Weiland S K, Werner B, Chambless L, Mundt K A, Keil U
Institute of Epidemiology and Social Medicine, University of Münster, Germany.
Occup Environ Med. 1998 May;55(5):325-32. doi: 10.1136/oem.55.5.325.
To determine the mortality from non-respiratory cancers by work area among active and retired male workers of the German rubber industry.
A cohort of 11,633 male German workers was followed up for mortality from 1 January 1981 to 31 December 1991. Cohort members were active (n = 7536) or retired (n = 4127) on 1 January 1981 and had been employed for at least one year in one of five study plants producing tyres or technical rubber goods. Work histories were reconstructed from routinely documented "cost centre codes" and classified into six categories: I preparation of materials; II production of technical rubber goods; III production of tyres; IV storage and dispatch; V general service; VI others. Standardised mortality ratios (SMRs) and 95% confidence intervals (95% CIs), controlling for age and calendar year and stratified by work area (employment in respective work area for at least one year) and time related variables (year of hire, lagged years of employment in work area) were calculated from national mortality rates as the reference.
Significant increases in mortality were found for pharyngeal cancer in work area IV (three deaths, SMR 486, 95% CI 101 to 1419), oesophageal cancer in work area III (11 deaths, SMR 227, 95% CI 114 to 407), and leukaemia in work areas I (11 deaths, SMR 216; 95% CI 108 to 387) and II (14 deaths, SMR 187; 95% CI 102 to 213). Furthermore, increased SMRs were found for stomach cancer in work area I (22 deaths, SMR 134; 95% CI 84 to 203), colon cancer in work area II (27 deaths, SMR 131, 95% CI 86 to 191), prostatic cancer in work area V (27 deaths, SMR 152, 95% CI 99 to 221), and bladder cancer in work areas IV (six deaths, SMR 253; 95% CI 93 to 551) and V (12 deaths, SMR 159, 95% CI 82 to 279). Mortality from cancer of the liver or gall bladder, pancreas and kidney, and from lymphomas was not substantially increased in any of the work areas.
Mortality from cancer of several sites was associated with specific work areas. Some of these associations have been reported previously. Future analyses of our study will have to determine the role of specific exposures in the aetiology of these cancers.
确定德国橡胶行业在职和退休男性工人按工作区域划分的非呼吸道癌症死亡率。
对11633名德国男性工人队列进行随访，观察其1981年1月1日至1991年12月31日期间的死亡率。队列成员在1981年1月1日时在职（n = 7536）或退休（n = 4127），且曾在五家生产轮胎或工业橡胶制品的研究工厂中至少工作过一年。工作经历根据常规记录的“成本中心代码”进行重建，并分为六类：I材料准备；II工业橡胶制品生产；III轮胎生产；IV储存与发货；V一般服务；VI其他。以国家死亡率为参照，计算标准化死亡比（SMR）和95%置信区间（95%CI），控制年龄和日历年份，并按工作区域（在相应工作区域至少工作一年）和时间相关变量（入职年份、在工作区域的滞后工作年限）进行分层。
在工作区域IV，发现咽癌死亡率显著增加（3例死亡，SMR 486，95%CI 101至1419）；在工作区域III，食管癌死亡率显著增加（11例死亡，SMR 227，95%CI 114至407）；在工作区域I（11例死亡，SMR 216；95%CI 108至387）和II（14例死亡，SMR 187；95%CI 102至213），白血病死亡率显著增加。此外，在工作区域I，胃癌死亡率的SMR升高（22例死亡，SMR 134；95%CI 84至203）；在工作区域II，结肠癌死亡率的SMR升高（27例死亡，SMR 131，95%CI 86至191）；在工作区域V，前列腺癌死亡率的SMR升高（27例死亡，SMR 152，95%CI 99至221）；在工作区域IV（6例死亡，SMR 253；95%CI 93至551）和V（12例死亡，SMR 159，95%CI 82至279），膀胱癌死亡率的SMR升高。在任何工作区域，肝癌或胆囊癌、胰腺癌、肾癌以及淋巴瘤的死亡率均未显著增加。
多个部位癌症的死亡率与特定工作区域有关。其中一些关联此前已有报道。对本研究的后续分析将必须确定特定暴露因素在这些癌症病因中的作用。
