炼化企业作业职工恶性肿瘤流行病学调查研究

对锦州、抚顺、兰州、大连、锦西、南京、上海、大庆、独山子和茂名等十三个炼油厂做了癌症死亡率回顾性队列研究。队列成员５１８８９人，失访１７１７人（３．３１％）。结果表明：页岩型炼油厂队列成员肺癌的ＳＭＲ显著增高，肺癌与暴露程度间存在着剂量－反应关系。对于煤合成油厂的高暴露区（１９７１～１９８８年）的肺癌，通过Ｌｏｇｉｓｔｉｃ回归分析，调整其他环境混淆效应后，其ＯＲ值为９．２５。石油型炼厂队列成员全癌死亡率增高，在观察期内表现出上升趋势，胃癌、肝癌的ＳＭＲ分别为１．４３和１．５１，存在着明显的统计学意义。     

页岩型炼油厂作业职工恶性肿瘤流行病学调查

调查显示页岩型炼油厂在页岩干馏及其原油加工过程中，工人肺癌的ＳＭＲ明显增高；工人肺癌死亡与暴露程度存在着高度相关，提示两者可能存在剂量－效应关系。关于页岩型炼油厂的肝癌、食管癌、肺癌的ＳＭＲ增高的原因尚不清楚，需要进一步研究。     

煤合成油厂恶性肿瘤回顾性队列研究(1971～1981年)

本文对锦州煤合成油厂进行了恶性肿瘤死亡11年回顾性队列研究。结果表明:高暴露区肺癌的明显超出具有职业特征。中暴露区工人同时接触焦炉逸散物和放射性物质,放射性物质能致多种恶性肿瘤。该厂恶性肿瘤高发主要是肺癌,消化道癌。     

油毡工人癌症27年队列观察

本文对１２０名油毡工人癌症２７年队列观察，结果表明：接触组共死亡３８人，癌症死亡１１人，肺癌居全癌之首，与对照组和对照人群比较，肺癌均有明显超出量，ＳＭＲ分别为４．６３（Ｐ＜０．０１）和３．５１（Ｐ＜０．０５）。但按暴露至观察终点年数的肺癌ＳＭＲ随ｌａｔｅｎｃｙ增长的趋势不明显。肺癌死亡年龄较对照组提前６．８３年。吸烟对肺癌起协同作用，说明油毡工人肺癌无论与任何时期对照组和对照人群比较，均显示明显     

煤工尘肺死亡的回顾性队列研究

为探索煤工尘肺病人的主要死因以及煤工尘肺与恶性肿瘤死亡之间的关系，采用流行病学回顾性队列研究方法对开滦矿务局１９５２～１９９５年诊断的３２２８例煤工尘肺患者（全部为男性）的结局进行了调查。队列观察从１９７０年１月１日开始，至死亡病例的死亡日期或１９９５年１２月３１日终止，以全国男性人群为参照。用标化死亡比（ＳＭＲ）作为统计指标，并计算９５％可信区间（９５％ＣＩ）。结果：全死因ＳＭＲ较全国人群高１１％（ＳＭＲ＝１．１１，９５％ＣＩ：１．０４～１．１８）。其中肺心病死亡（ＳＭＲ＝５．９７，９５％ＣＩ：５．２３～６．７７）、肺结核死亡（ＳＭＲ＝３．６８，９５％ＣＩ：３．０１～４．４６）均高于全国人群。全癌死亡低于全国人群（ＳＭＲ＝０．８１，９５％ＣＩ：０．７１～０．９２），但肺癌死亡高于全国人群（ＳＭＲ＝１．３６，９５％ＣＩ：１．１０～１．６６）。按不同死亡年代及粉尘种类进一步分析，均发现肺癌高发。结果表明：煤工尘肺病人的全死因死亡比稍高于全国人群，其中，肺心病和肺结核有明显的超额死亡。煤工尘肺病人中肺癌死亡超高。提示：煤工尘肺与肺癌的发生有关。     

橡胶职业暴露与肺癌关系的前瞻性研究：I标化死亡率分析

目的 将橡胶职业暴露人群肺癌死亡率与普通人群比较，估计其肺癌危险度及肺癌在工种间的聚集性。方法 对某橡胶厂工人进行２３年（１９７３－１９９５年）随访，应用标化死亡率比（ＳＭＲ）分析。结果 男女性工人肺癌死亡率轻度增高，ＳＭＲ分别为１．２２（９５％ＣＩ：０．５８￣２．２４）和１．２６（９５％ＣＩ：０．９０￣１．７１）。肺癌死亡率在不同工种间差别有显著意义（一致性检验Ｐ＝０．００２），表现为硫化、胶鞋     

油毡工肺癌病因学研究

对全国１５个省市２０家油毡厂工人的肺癌发病作了连续１７例的队列研究。结果表明，男性油毡人工肺癌发病率超出对照人群和全国城市居民，ＳＭＲ分别为３３７和１８１。按工作场所沥青烟浓度平均为０．８８ｍｇ．ｍ＾３，９６ｎｇ／ｍ＾３，６．２８ｍｇ／ｍ＾３，分成低、中、高３层接触水平后，与对照人群肺癌相比的ＳＭＲ为１９９（Ｐ〉０．０５），３１９（Ｐ〈０．０１），４１５（Ｐ〈０．０１）；与全国城市居民相比的ＳＭＲ     

橡胶职业暴露与胃癌关系的病例-队列研究

为研究橡胶职业暴露与胃癌之间的关系，对某橡胶厂工人进行了２３年（１９７３～９５）的前瞻性研究，应用标化死亡率和病例－队列方法。结果表明，队列人群总的胃癌ＳＭＲ约为１，但男性工人炼胶，女性内胎等工种的胃癌危险度升高，准似然多因素分析表明，对非职业因素的混杂作用进行调整后，胃癌可能与橡胶粉尘，尤其是滑石粉尘有关     

耐火材料厂矽尘作业工人肺癌流行病学研究

本文对冶金系统十一个耐火材料厂的矽砖、粘土砖制造工人的肺癌进行了回顾性队列研究。队列由６２６６名男性工人组成，观察期为１９６３年１月１日至１９８５年１２月３１日，在此２３年期间共累积１３０７３０人年。以全国不同地区的十个大、中型钢铁企业的钢坯初轧厂１１４７０名男性职工在１９７１年至１９８５年间的年龄别、死因别死亡率为标准，计算各项死因的标化率比（ＳＭＲ）。矽尘作业人群的肺癌显示超量发生（ＳＲＲ为１     

橡胶职业暴露与胃癌关系的病例—队列研究

为研究橡胶职业暴露与胃癌之间的关系，对某橡胶厂工人进行了２３年（１９７３～９５）的前瞻性研究，应用标化死亡率和病例－队列方法，结果表明，队列人群总的胃癌ＳＭＲ约为１，但男性工人炼胶，女性内胎等工种的胃癌危险度升高，准似然多因素分析表明，对非职业因素的混杂作用进行调整后，胃癌可能与橡胶粉尘，尤其是滑石粉尘的有关。     

Epidemiologic study of cancer mortality among Israeli asphalt workers

BACKGROUND: We describe the results of a cancer mortality study among asphalt workers in Israel. METHODS: Personal identifiers and employment histories of 2,176 workers were extracted from company records. RESULTS: Mortality from all malignant neoplasms was significantly reduced in the whole cohort (SMR 0.68, 95% confidence interval (CI) 0.56-0.83). SMR for lung cancer was elevated in workers exposed to bitumen (SMR 1.05, 95% CI 0.62-1.66). No significant elevation or reduction in mortality was observed in relation to a specific site. SMRs for lung cancer was higher among ever exposed to bitumen than among unexposed. There was no association between lung cancer risk and estimated exposure to bitumen fume, and no dose-response was apparent. CONCLUSIONS: While the results of this cohort study indicate a slightly increased SMR for lung cancer, it did not produce evidence of a causal link between lung cancer and exposure to bitumen fume.     

Mortality experience of haematite mine workers in China

The mortality risk of iron ore (haematite) miners between 1970 and 1982 was investigated in a retrospective cohort study of workers from two mines, Longyan and Taochong, in China. The cohort was limited to men and consisted of 5406 underground miners and 1038 unexposed surface workers. Among the 490 underground miners who died, 205 (42%) died of silicosis and silicotuberculosis and 98 (20%) of cancer, including 29 cases (5.9%) of lung cancer. The study found an excess risk of non-malignant respiratory disease and of lung cancer among haematite miners. The standardised mortality ratio for lung cancer compared with nationwide male population rates was significantly raised (SMR = 3.7), especially for those miners who were first employed underground before mechanical ventilation and wet drilling were introduced (SMR = 4.8); with jobs involving heavy exposure to dust, radon, and radon daughters (SMR = 4.2); with a history of silicosis (SMR = 5.3); and with silicotuberculosis (SMR = 6.6). No excess risk of lung cancer was observed in unexposed workers (SMR = 1.2). Among current smokers, the risk of lung cancer increased with the level of exposure to dust. The mortality from all cancer, stomach, liver, and oesophageal cancer was not raised among underground miners. An excess risk of lung cancer among underground mine workers which could not be attributed solely to tobacco use was associated with working conditions underground, especially with exposure to dust and radon gas and with the presence of non-malignant respiratory disease. Because of an overlap of exposures to dust and radon daughters, the independent effects of these factors could not be evaluated.     

Mortality experience of haematite mine workers in China.

The mortality risk of iron ore (haematite) miners between 1970 and 1982 was investigated in a retrospective cohort study of workers from two mines, Longyan and Taochong, in China. The cohort was limited to men and consisted of 5406 underground miners and 1038 unexposed surface workers. Among the 490 underground miners who died, 205 (42%) died of silicosis and silicotuberculosis and 98 (20%) of cancer, including 29 cases (5.9%) of lung cancer. The study found an excess risk of non-malignant respiratory disease and of lung cancer among haematite miners. The standardised mortality ratio for lung cancer compared with nationwide male population rates was significantly raised (SMR = 3.7), especially for those miners who were first employed underground before mechanical ventilation and wet drilling were introduced (SMR = 4.8); with jobs involving heavy exposure to dust, radon, and radon daughters (SMR = 4.2); with a history of silicosis (SMR = 5.3); and with silicotuberculosis (SMR = 6.6). No excess risk of lung cancer was observed in unexposed workers (SMR = 1.2). Among current smokers, the risk of lung cancer increased with the level of exposure to dust. The mortality from all cancer, stomach, liver, and oesophageal cancer was not raised among underground miners. An excess risk of lung cancer among underground mine workers which could not be attributed solely to tobacco use was associated with working conditions underground, especially with exposure to dust and radon gas and with the presence of non-malignant respiratory disease. Because of an overlap of exposures to dust and radon daughters, the independent effects of these factors could not be evaluated.     

Mortalities of workers at the Nitro plant with exposure to 2-mercaptobenzothialzole

OBJECTIVES: An update of a study of workers exposed to 2- mercaptobenzothiazole (MBT) at a rubber chemicals plant in Nitro, West Virginia is reported. The earlier study found high rates of lung cancer, prostate cancer, and bladder cancer in these workers who also had potential exposure to 4-aminobiphenyl (PAB), a potent bladder carcinogen. METHODS: This cohort mortality study examines the mortalities of 1059 full time white male production workers employed at the plant from 1955 to 1977. A detailed exposure assessment was done on the 600 workers with exposure to MBT. Nine years of additional follow up to the previous study are added. RESULTS: It was found that MBT workers have expected rates of lung (standardised mortality ratio (SMR) = 1.0 95% confidence interval (95% CI) 0.7 to 1.5) and prostate (SMR = 0.9, 95% CI 0.2 to 2.3) cancer. There was an excess of bladder cancer among MBT workers who had definite exposure to PAB (SMR = 27.1, 95% CI 11.7 to 53.4), and MBT workers with potential exposure to PAB (SMR = 4.3, 95% CI 1.4 to 10.0). However, there were no deaths from bladder cancer among workers with no exposure to PAB (SMR = 0.0, 95% CI 0.0 to 24.7), although there were only 0.2 deaths expected. CONCLUSIONS: The potential confounding of exposure to an unknown portion of PAB in the MBT workers makes it impossible to evaluate risk of bladder cancer in this population at this time. However, exposure to MBT does not seem to increase the risk of most cancers including cancers of the lung and prostate.

 

     

温石棉与肺癌——二十七年追踪研究

目的 探讨单纯接触温石棉的工人恶性肿瘤,尤其肺癌是否超高。方法 采用固定队列研究方法。研究队列为515例男性石棉工人,人列条件为1972年1月1日工资在册,工龄满1年,没有明显心肺疾患者。对照队列为650例不接尘男性工人,其余条件同研究队。追踪27年（1972－1998）。结果 （1）研究队列全癌死亡50例（SMR＝144）,其中肺癌22例（SMR＝652）;．对照队列全癌死亡1例（SMR＝34）,肺癌3例（SMR＝89）。两队列间全癌和肺癌差异均有显著性（P＜0．05）。（2）不接触石棉的吸烟者肺癌RR为2．6,不吸烟的石棉接触者肺癌RR为12．2,而接触石棉的吸烟者RR高达32．1。吸烟和石棉暴露协同指数为2．2。（3）研究队列发生胸膜间皮瘤2例。结论 单纯暴露于温石棉的工人肺癌显著超高。     

上海某冶炼厂铅接触工人肿瘤死亡的回顾性队列研究

目的 了解职业铅接触工人肿瘤死亡情况,探讨职业铅接触与肿瘤的关系。方法 1985年1月1日前在本厂工人1年以上,且1985年1月1日仍存活的男性工人共6971名组成全队列,其中3344名在铅接触车间工作的工人组成的亚队列为接触队列。随访从1985年1月1日至1997年12月31日。以上海市人口的肿瘤死亡率作为标准对照,计算标化死亡比（SMR）;以本厂非接触人群作内对照计算相对危险度（RR）;估计累计接触剂量进行剂量－反应关系分析。结果 全队列6971人共观察87576人年,接触队列3344人共观察41505人年。全队列中,肺癌的SMR（95％CI）为128．0（101．1－159．7）。1965年后入厂的工人肺癌的SMR为463．7（P＜0．01）。有铅接触工作史且工龄超过20年的工人鼻咽癌的SMR＝408．0（P＜0．01）,肺癌的SMR＝156．6（P＜0．01）。肿瘤总计、恶性肿瘤总计、食管癌、胃癌、肝和胆道癌、肺癌和膀胱癌的RR（95％CI）分别为3．25（2．43－3．89）、3．28（2．54－4．32）、3．57（1．08－10．47）、2．93（1．15－4．87）、4．58（2．03－9．97）、8．58（4．82－15．11）、6．66（2．83－13．01）。将累计接触剂量分为高、中、低3个组,中、高组工人恶性肿瘤RR分别为1．62（P＜0．05）和1．70（P＜0．05）,且有随累计接触剂量增加危险性升高的趋势。中、高组工人的肺癌RR分别为2．55（P＜0．05）,和2．31（P＜0．05）。结论 工人肿瘤死亡危险性升高可能与铅接触有关,但还需要在控制其他职业有害因素接触和非职业性有害因素接触的情况下作进一步的研究。     

Cancer mortality of cadmium workers.

Several epidemiological studies of workers exposed to cadmium indicate an increased risk of lung and prostatic cancer. The increase is statistically significant in some of the studies but the SMR is greater than 100 in almost all. A cohort study of the mortality among 522 Swedish workers exposed to cadmium for at least one year in a nickel-cadmium battery plant support the earlier findings. The SMR for lung and prostatic cancer increased with increasing dose and latency but did not obtain statistical significance. A combination of all the available data from the most recent follow up of causes of death among cadmium workers in six different cohorts shows 28 cases of prostatic cancer (SMR = 162) and 195 cases of lung cancer (SMR = 121). This new analysis suggests that long term, high level exposure to cadmium is associated with an increased risk of cancer. The role of concomitant exposure to nickel needs further study.     

Cancer mortality of cadmium workers

Several epidemiological studies of workers exposed to cadmium indicate an increased risk of lung and prostatic cancer. The increase is statistically significant in some of the studies but the SMR is greater than 100 in almost all. A cohort study of the mortality among 522 Swedish workers exposed to cadmium for at least one year in a nickel-cadmium battery plant support the earlier findings. The SMR for lung and prostatic cancer increased with increasing dose and latency but did not obtain statistical significance. A combination of all the available data from the most recent follow up of causes of death among cadmium workers in six different cohorts shows 28 cases of prostatic cancer (SMR = 162) and 195 cases of lung cancer (SMR = 121). This new analysis suggests that long term, high level exposure to cadmium is associated with an increased risk of cancer. The role of concomitant exposure to nickel needs further study.     

Mortality and cancer incidence in Ontario glass fiber workers

BACKGROUND: In a previous cohort study of glass fiber manufacturing, we found a significant increase in lung cancer. This study extends the follow-up period. METHODS: We conducted a historical prospective study of 2557 men employed in producing glass wool. We obtained work histories, causes and dates of death, and date and site of cancer diagnoses. We computed standardized mortality and incidence ratios (SMR, SIR). RESULTS: The overall SMR for lung cancer was 163 (95% CI = 118-221). The SMR did not vary consistently by duration of employment and time since first employment. However, plant workers with >20 years' employment and >40 years since first exposure had an SMR for lung cancer of 282 (95% CI = 113-582). The SMR dropped with later date of first exposure, but the trend was non-significant. There was an unexpected overall increase in kidney cancer incidence. DISCUSSION: The increase in lung cancer is greater than in other cohorts of glass fiber workers. Since exposure data are lacking from the early years of the plant, we cannot state if the excess was due to glass fibers, other work exposures or other reasons.