锡矿作业工人粉尘接触和队列死因分析

[目的]评价混合性粉尘接触对锡矿作业工人健康的影响及累积粉尘接触与主要引起工人死亡疾病的关系。[方法]建立广西4个锡矿1972~1974年在册且工作一年以上工人的研究队列,以全国城市居民年龄别死亡率为参照,标化死亡比(SMR)作为统计指标。[结果]队列共计7837人,至1994年底,共计165156.7人年,死亡1094人。影响锡矿工人健康的主要疾病按累积死亡率从高到低排序分别是:肿瘤(5.3%)、脑血管疾病(2.4%)、心血管系统疾病(1.9%)和呼吸系统疾病(1.7%),这4种疾病引起的死亡占总数的80.7%,恶性肿瘤以肺癌和肝癌最多,分别占总死亡数的12.6%和10.9%。全死因标化死亡比(SMR=0.94)接近全国平均水平,而鼻咽癌、肝癌、肺癌、白血病、尘肺和脑血管疾病的SMR较高,分别为3.41、1.97、2.49、2.31、33.89和1.15。队列中接尘工人4629名,研究发现矿尘接触导致死亡率上升,与粉尘接触存在明确剂量反应关系的疾病主要是尘肺、肺癌和肺结核。[结论]混合性粉尘明显影响工人健康,累积粉尘接触与肺癌死亡存在剂量-反应关系,可能与粉尘中高含量的砷和游离二氧化硅有关。

Exposures to Silica Mixed Dust and Cohort Mortality Study in Tin Miners

[Objective] To evaluate health impacts of silica mixed dust in tin miners and investigate dose-response relationship between cumulative dust exposure and the mortality of lung cancer. [Methods] A cohort of 7 837 workers registered in the employment records in four tin mines between 1972 and 1974 was identified for this study. The mortality follow-up was traced through 1994. Standardized mortality ratios(SMRs)were calculated based on Chinese national mortality. [Results] The all-causes mortality in the four tin mines was nearly the same as the national mortality. Malignant neoplasm,cerebrovascular disease,cardiovascular disease and respiratory disease accounted for 80.7% of all death. Extraordinary SMRs of respiratory diseases and pneumoconiosis were observed from that of all malignant diseases. A does response relationship was established between dust exposure and lung cancer,pneumoconiosis and pulmonary tuberculosis. [Conclusion] The findings indicated the existence of a positive dose-response relationship between cumulative dust exposure and the mortality of lung cancer. High arsenic content in dust particles seemed to play an important role as well as crystalline silica in causing high mortality of lung cancer.