某热电回顾性队列死亡调查—10年随访

虽然有许多文章评价火力发电厂对周围环境的危害，但是很少关于直接接触粉尘、高温、噪声、毒物等有害因素对电厂职工健康影响的报道，为了查明这些因素对电厂职工死率和肿瘤死亡率有没有影响，我们对某热电厂进行了１０年回顾性队列调查研究，结果１６２４人组成的队列，１０年提供１５４１３．７３人年，死亡５２人，其中１６人死于恶性肿瘤，队列全死因死记稍低于本市居民人口（ＳＭＲ＝０．７８，９５％可信限０．５６－０．９９     

乌鲁木齐市居民1991～1992年恶性肿瘤职业人群分布

目的：了解乌鲁木齐市不同职业人群中恶性肿瘤的分布特征，为进一步探讨某些职业环境与恶性肿瘤的关系收集基础资料。方法：收集本市居民当中１９９１～１９９２年恶性肿瘤死亡资料，按国家统计局规定的职业人群分类标准，将人群分组，用标化死亡比（ＳＭＲ）指标评价各职业人群恶性肿瘤死亡率水平。结果：国家机关企事业负责人及办事员、建筑工人、驾驶员、采矿工人、化学工人、橡胶塑料工人、皮革皮毛及玻璃陶瓷工人肺癌ＳＭＲ分别为１．５６、５．９６、１．８６、４．９０、９．０９、１４．９３、２０．４１、１８．８７，并都具有统计学显著性差异（Ｐ＜０．０５）。建筑工人、采矿工人及电气安装工人胃癌ＳＭＲ分别为３．７２、４．６９和３．３６，也具有显著的统计学意义（Ｐ＜０．０５）。而专业技术人员中肺癌、肝癌及胃癌的ＳＭＲ分别只是０．１２、０．２１及０．３０（Ｐ＜０．０５）。结论：肺癌在国家机关、企事业负责人及办事员、建筑工人、驾驶员、采矿工人、化学工人、橡胶塑料工人、皮革皮毛工人和玻璃陶瓷工人中明显高于一般人群。胃癌在建筑工人、采矿工人及电气安装工人中多见。各类专业技术人员中肺癌、肝癌及胃癌死亡率明显低于一般人群。     

1975～1995年乌鲁木齐石油化工厂职工恶性肿瘤死亡状况分析

目的：调查和分析从事石油化工作业职工恶性肿瘤死亡状况。方法：资料由石油化工厂人事部门提供，死因按ＩＣＤ－９分类，标化死亡率按１９６４年第二次全国人口普查资料计算，病例均为一、二级诊断。结果：该厂２１年间各种死因的年平均死亡率为１５６．５８／１０万，其中恶性肿瘤在全死因位次占第一位，恶性肿瘤死亡率随年龄而上升，不同民族恶性肿瘤死亡率不同（χ２＝６．６７，Ｐ＜０．０５）。结论：石油化工厂职工白血病死亡率超过参照人群，其ＳＭＲ＝１５１，Ｐ＜０．０１，表明该厂职工患白血病的危险性增高。     

热电厂工人接尘剂量与尘肺发病关系的探讨

为研究热电厂接尘工人接尘剂量与尘肺发病的关系，根据某热电厂接尘工人接尘时间、肺总通气量及车间的粉尘浓度和游离ＳｉＯ２含量，计算职工肺内石英负荷量，然后采用累积剂量患病率寿命表法研究尘肺患病率与粉尘剂量反应关系，推算该类粉尘的容许浓度。结果：接尘剂量与尘肺患病率呈显著正相关关系（ｒ＝０．９２３，Ｐ＜０．００５），并推算出其直线回归方程为Ｙ＝－４５．４０４４＋１１．０１０１２Ｘ。提示：如果要求每人平均工作３０ａ，且尘肺患病率低于０５％，则接触煤粉（ｃｏａｌｄｕｓｔ）者和接触灰粉（ｆｌｙａｓｈ）者作业场所平均粉尘浓度分别应控制在１０００ｍｇ／ｍ３和３２５ｍｇ／ｍ３以下。     

鸿化总厂1980—1993年职工死亡死因探讨

本文用回顾性研究方法，对３４９例职工死亡死因进行了分析，并与当地居民死亡水平作对照，结果表明，全死因前三位是循环系统疾病，恶性肿瘤，呼吸系统疾病，与本市居民死因顺位不同，男性高于女性（Ｐ〈０．０１），癌症死亡的前三位为肺癌，肝癌，胃癌，男民生高于女性（Ｐ〈０．０１），与对照资料比较，恶性肿瘤的标比死亡比（ＳＭＲ）差异高度显著，肺癌，肝癌，鼻咽癌的标化死亡比（ＳＭＲ）差异高度显著。生产车间，辅助车间     

化肥行业肝癌流行病学调查研究

对某化肥厂３４３名职工肝癌发病情况进行了回顾性队列调查，结果表明，该厂男性肝癌的标化死亡率为１３４．４１／１０＾５，ＳＭＲ＝６．７２（Ｐ〈０．０１），非常显著，高于我省肝癌死亡率，但女性死亡率未见增加。接触氟化氢等工业毒物的两组职工与非接毒组的职工患肝癌的相对危险度ＳＲＲ〈１，因此认为厂肝癌高发与该行业ＨＦ等毒物接触缺乏明显的联系，本文还该对厂职工乙肝感染，饮酒习惯等地肝癌影响作了探讨。     

乌鲁木齐市2000年恶性肿瘤死亡率预测

目的：通过对乌鲁木齐市居民２０００年恶性肿瘤死亡率的预测，为恶性肿瘤的预防和控制策略与措施的研究提供科学依据。方法：系统收集乌鲁木齐市居民恶性肿瘤死亡资料，用灰色系统理论，对本市２０００年恶性肿瘤死亡率进行短期预测。结果：到２０００年，乌鲁木齐市居民恶性肿瘤死亡率由１９９３年的５９．０／１０万上升为９１．３／１０万。其中男性肿瘤死亡率由１９９３年的７６．３／１０万上升为１２４．２／１０万，女性肿瘤死亡率由４１．０／１０万上升为５８．０／１０万。肺癌死亡率由１９９３年的１４．３／１０万到２０００年时上升为２７．０／１０万，是上升速度最快而且幅度最大的肿瘤。结论：预测结果说明乌鲁木齐市居民恶性肿瘤死亡率将继续上升；肺癌、胃癌及食道癌仍将是危害人民群众身心健康的主要恶性肿瘤     

1975—1995年乌鲁木齐石油化工厂职工恶性肿瘤死亡状况分析

目的：调查和分析从事化工作业职工恶性肿瘤死亡状况。方法：资料由石油化工厂人事部门提供，死因按ＩＣＤ－９分类，标化死亡率按１９６４年第二次全国人口普查资料计算，病例均业、二级诊断。结果：该厂２１年间各处死因的年平均死记良为１５６．５８／１０万，其中恶生肿瘤在全死因位次占第一位，恶性肿瘤死亡率随年龄而上升，不同民族恶性肿瘤死亡率不同。结论：石油化工厂职工白血病死亡率超过参照人群其中ＳＭＲ＝１５１，Ｐ〉     

阿斯匹林预防老年缺血性脑血管病（584例病人1—5年的随访研究）

５８４例轻型缺血性卒中（ＭＩＳ）或（ＴＩＡ）病人随机分为阿斯匹林（ＡＳＡ）组３０１例与对照组２８３例，随访１２－６０（平均３０．２）月的结果发现：ＡＳＡ组卒中与死亡率（１４．０％）明显低于对照组（２０．５％）（Ｐ〈０．０５）。ＡＳＡ组卒中与死亡危险性较对照组降低３２％（相对危险性（ＲＲ）为０．６８，９５％可信区间为０．４６－１．０１）；ＡＳＡ组卒中、血管性死亡及心肌梗塞发生率（２０．６％）显著低于     

口腔颌面部亚性肿瘤尿激主其受体的基因表达和临床意义

目的：探讨ＵＰＡ及ＵＰＡＲ与口腔颌面部亚性肿瘤浸润、转移的关系。方法；应用ＣＤＮＡ＝ＭＲＮＡ交技术定量检测口腔颌面部恶性肿瘤ＵＰＡ和ＵＰＡＲＭＴＲＡＮ表达水平。结果：癌组织ＵＰＡ和ＵＰＡＲＭＲＮＡ含量高上应正常组织（Ｐ〈０．０１），伴有淋巴结转移癌组织ＵＰＡ和ＵＰＡＲ高于淋巴结转移者（Ｐ〈０．０１，Ｐ〈０．０５），ＵＰＡ、ＵＰＡＲ表达水平与淋巴关系密切（Ｒ＝０．４１Ｐ〈０．０１，Ｒ＝０．３１，Ｐ〈     

Cohort Mortality Study in Three Ceramic Factories in Jingdezhen in China

To investigate the health impacts of crystalline silica mixed dust and other potential occupational hazards on workers in ceramic factories, a cohort study of 4851 workers registered in the employment records in 3 ceramic factories in Jingdezhen city of China between 1972 and 1974 was identified. The cohort mortality was traced throughout 2003 with an accumulation of 128970.2 person-years, revealed 1542 deaths. Standardized mortality ratios （SMRs） were calculated for the main causes of death by using Chinese national mortality rates as reference. The mortality from all causes in three ceramic factories was 12.0‰ and the cumulative mortality was 31.8%. Malignant neoplasm, cardiovascular diseases, respiratory diseases, infectious diseases were the first four illnesses that threaten workers’ life, and they accounted for 73.2% of all deaths. The results of this study showed that the standardized mortality ratio for all subjects was 1.02, which is very close to that expected on the basis of the China national mortality rates. Statistically significant mortality excesses for respiratory disease （SMR=1.36）, pneumoconiosis （SMR=37.34）, infectious disease （SMR=5.70） and pul- monary tuberculosis （SMR=3.88） were observed. The mortality of 2938 dust-exposed workers was higher than that of 1913 non dust-exposed workers. Except for pneumoconiosis, the mortality from lung cancer, non-malignant respiratory diseases and pulmonary tuberculosis in dust-exposed workers were significantly increased as compared with that in non-exposed workers, and the relative risks （RRs） were 1.86 （1.16–2.99）, 2.50 （1.84–3.40）, 1.81 （1.34–2.45）. The exposure-response relationships between cumulative dust exposure level and mortality from all causes, colorectal cancer, lung cancer, respiratory diseases, and pulmonary tuberculosis were also identified. The findings indicated that silica mixed dust in ceramic factories has harmful impact on the workers’ health and life span in ceramic factory.     

建筑工人死因分析

对某建筑公司进行了15年死因回顾性调查,共观察23419人年,死亡65人。恶性肿瘤居死因之首,脑部疾患与胃癌死亡率显著高于当地人群,标化死亡比(SMR)分别为2.50,2.74,其中建筑工全死因、全癌、脑、肺疾患及胃癌的SMR分别为2.00、2.31、5.43、4.22、4.49;其他操作工全死因、全癌及肝癌的SMR分别为2.05、3.03、6.25,均显著高于当地人群。     

Analysis of mortality in chrysotile asbestos miners in China

In order to investigate the mortality of a cohort of chrysotile asbestos miners in China and evaluate its association with exposure to chrysotile,a fixed cohort of 1932 workers in chrysotile asbes-tos mine was established in 1981 and followed till June 1,2010.Information on vital status,cause of death and smoking habits was collected.The workers were divided into two groups according to their exposure status.The exposed group was composed of frontline workers who worked directly on mining or processing asbestos products.The control group consisted of those who were not directly exposed to asbestos in their work.Standardized mortality ratio (SMR) was calculated according to Chinese national death rates.Cox proportional hazards model was applied to estimate the adjusted relative risks of deaths from major causes in exposed and control groups.The results of this study showed that main causes of mortality were malignant neoplasm,cardiovascular disease,cerebrovascular disease and respiratory disease for chrysotile miners.The mortality rate was 939.20 per 100 000 person-years for workers.The SMR for all causes of death was 1.46 in the cohort.Statistically significant mortality excesses were found for lung cancer (SMR=1.51),pulmonary heart disease (SMR=2.70),respiratory disease (SMR=1.93),asbestosis (SMR=9.62),and accident (SMR=1.59).The mortalities from malignant neo-plasm,lung cancer,cerebrovascular disease and digestive disease in the exposed group were signifi-cantly higher than those in the control group.The findings indicate that chrysotile exposure is a risk factor for lung cancer,respiratory disease,cerebrovascular disease and digestive disease.     

ACEI/ARB治疗左室射血分数正常性心力衰竭的系统评价

目的系统评价ACEI或ARB对射血分数正常性心力衰竭(HFNEF)的治疗是否有益。方法检索2001年11月—2011年11月Cochrane Central Register of Controlled Trails、MEDLINE、EMBASE和万方数据库中关于ACEI或ARB和安慰剂的随机对照试验(RCT),计算出优势比(OR)和OR的95%可信区间。对符合质量标准的RCT进行Meta分析。结果共4个RCT符合条件纳入Meta分析。ACEI或ARB组与安慰剂组总病死率的OR值为0.99,95%可信区间为(0.87～1.14),2组差异无统计学意义(P>0.05);ACEI或ARB组与安慰剂组治疗心脏原因死亡的OR值为1.02,95%可信区间为(0.87～1.20),2组差异无统计学意义(P>0.05);ACEI或ARB组与安慰剂组住院率OR值为0.97,95%可信区间为(0.88～1.07),2组差异无统计学意义(P>0.05);ACEI或ARB组与安慰剂组心力衰竭恶化的OR值为1.03,95%可信区间为(0.80～1.32),2组差异无统计学意义(P>0.05)。结论 ACEI或ARB组与对照组间在降低HFNEF的总病死率、心脏原因病死率、住院率和心力衰竭恶化方面没有统计学差异。     

石棉工人的肺癌调查

作者调查了省内两个石棉矿和一个石棉厂共2383例工人的恶性肿瘤,尤其是肺癌的发生率。采用回顾性队列调查法,追踪10年。结果肺癌标化死亡比(SMR)为2.66(P<0.05),相对危险度(RR)10.36(P<0.01),均有显著性差异。肺癌的潜伏期平均23.8年,主要发生在高石棉粉尘浓度的工种,表明肺癌的发生与接触石棉密切相关。     

锦州陶瓷厂矽肺患病率预测预报的研究

本文对锦州陶瓷厂1960—1981年在岗接尘工人1066人进行矽肺发展情况调查,收集了矽肺发展和粉尘浓度资料,并计算了接尘的各工种工作时间(以年为单位)和该工种工作地点粉尘浓度(mg/m~3)的积之和的累积接尘量。单位为毫克年,应用工龄累积患病率寿命表,相关回归法,探讨陶瓷作业接尘工人接尘量与矽肺发病的关系。由统计可见工龄与接尘量,工龄与患病率以及接尘量与患病率之间均呈正相关,并用寿命表法预测矽肺的发展趋势。现工龄为1—2年的一批接尘工人预期再接尘20.87年,其患病概率为238‰,这对于评价车间劳动卫生措施的效果,降低车间的粉尘浓度,控制矽肺的发展,保护工人健康具有一定实际意义。     

Radiographic abnormalities and the risk of lung cancer among workers exposed to silica dust in Ontario.

OBJECTIVE: To determine whether workers in Ontario who had been exposed to silica dust and who have radiographic abnormalities are at increased risk of lung cancer. DESIGN: Cohort and case-control studies of rates of death from lung cancer and cancer incidence rates; data were obtained from the Ontario Silicosis Surveillance Registry. Follow-up was through linkage to the Ontario mortality and cancer registries. SETTING: Ontario. PARTICIPANTS: A total of 523 workers with radiographic abnormalities and 1568 control subjects with normal radiographic findings who had been exposed to silica dust. Matching criteria were year of birth and the requirement that the control subject have a normal radiographic finding either later than or in the same year that the radiographic abnormality was identified in the silicosis subject. OUTCOME MEASURES: Standardized mortality ratios (SMRs), standardized incidence ratios (SIRs) and odds ratios for lung cancer. RESULTS: In the cohort analysis, with the Ontario population rates as reference, the all-cause SMR was 0.96 among the workers with radiographic abnormalities and 0.51 among the control subjects. The corresponding SIRs for lung cancer were 2.49 and 0.87 (p < 0.001). In the case-control analysis the workers with silicosis were more likely than the control subjects to have been smokers, but this difference likely accounted for only a small part of the difference in the incidence of lung cancer. The relative risk of lung cancer was elevated among the workers with silicosis from the foundry, mining and nonmetallic-minerals industries; however, the number of subjects was too small for a significant difference to be detected. Among the miners exposure to radon daughters did not affect the risk of lung cancer attributable to radiographic abnormalities. CONCLUSIONS: Radiographic abnormalities suggestive of exposure to silica dust are markers for increased risk of lung cancer. Physicians might thus wish to warn their patients with silica-associated radiographic abnormalities about the increased risk and to counsel those who smoke to stop.     

Mortality of employees of the United Kingdom Atomic Energy Authority, 1946-1979

An analysis was conducted of 3373 deaths among 39 546 people employed by the United Kingdom Atomic Energy Authority between 1946 and 1979, the population having been followed up for an average of 16 years. Overall the death rates were below those prevailing in England and Wales but consistent with those expected in a normal workforce. At ages 15-74 years the standardised mortality ratios (SMRs) were 74 for deaths from all causes and 79 for deaths from all cancers. Mortality from only four causes was above the national average--namely, testicular cancer (SMR 153; 10 deaths), leukaemia (SMR 123; 35 deaths), thyroid cancer (SMR 122; three deaths), non-Hodgkin's lymphoma (SMR 107; 20 deaths)--but in none was the increase significant at the 5% level. Half of the authority's employees were recorded as having been monitored for exposure to radiation, their collective recorded exposure being 660 Sv (65 954 rem). Among these prostatic cancer was the only condition with a clearly increased mortality in relation to exposure. Of the 19 men who had a radiation record and died from prostatic cancer at ages 15-74 years, nine had been monitored for several different sources of exposure to radiation. The standardised mortality ratios were 889 (six deaths) in employees monitored for contamination by tritium, 254 (nine deaths) in those monitored for contamination by other radionuclides, and 385 (nine deaths) in those with dosimeter readings totalling more than 50 mSv (5 rem); but the same nine subjects tended to account for each of these significantly raised ratios. Because multiple exposures were common and other relevant information was not available the reason for the increased mortality from prostatic cancer in this population could not be determined and requires further investigation. Excess mortality rates of 2.2 and 12.5 deaths per million person years per 10 mSv (1 rem) were estimated for leukaemia and all cancers, respectively. The confidence limits around these estimates were wide, included zero, and made it unlikely that the International Commission on Radiological Protection's cancer risk coefficients were underestimated by more than 15-fold. Thus despite this being the largest British workforce whose mortality has been reported in relation to low level ionising radiation exposure, even larger populations will need to be followed up over longer periods before narrower ranges of risk estimates can be derived.     

Mortality of workers at the Sellafield plant of British Nuclear Fuels

The mortality of all 14,327 people who were known to have been employed at the Sellafield plant of British Nuclear Fuels at any time between the opening of the site in 1947 and 31 December 1975 was studied up to the end of 1983. The vital state of 96% of the workers was traced satisfactorily and 2277 were found to have died, 572 (25%) from cancer. On average the workers suffered a mortality from all causes that was 2% less than that of the general population of England and Wales and 9% less than that of the population of Cumberland (the area in which the plant is sited). Their mortality from cancers of all kinds was 5% less than that of England and Wales and 3% less than that of Cumberland. In the five years after their first employment Sellafield workers had an overall mortality that was 70% of that of England and Wales, probably due to healthier members of the population being selected for employment. Raised death rates from cancers of several specific sites were found, but only for those of ill defined and secondary sites was the excess statistically significant (30 observed, 19.7 expected). For cancers of the liver and gall bladder there was a significant deficit of deaths (four observed, 10.5 expected). Workers in areas of the plant where radiation exposure was likely were issued with dosimeters to measure their external exposure to ionising radiations. Personal dose records were maintained for workers who entered such areas other than infrequently. Workers with personal dose records ("radiation" workers) had lower death rates from all causes combined than other workers but the death rates from cancer in the two groups were similar. Compared with the general population radiation workers had statistically significant deficits of liver and gall bladder cancer, lung cancer, and Hodgkin's disease. There were excesses of deaths from myeloma (seven observed, 4.2 expected) and prostatic cancer (19 observed, 15.8 expected) but these were not significant and there was no evidence of an excess of leukaemia (10 deaths observed, 12.2 expected) or cancer of the pancreas (15 observed, 17.8 expected). Non-radiation workers had a significant deficit of leukaemia (one death observed, 5.1 expected) and a significant excess of cancers of ill defined and secondary sites (13 deaths observed, 5.8 expected). For no type of cancer was the ratio of observed to expected deaths significantly different between radiation and non-radiation workers.(ABSTRACT TRUNCATED AT 400 WORDS)