橡胶制品工业恶性肿瘤死亡率流行病学调查

本文报告橡胶制品工业恶性肿瘤死亡率情况。采用回顾性队列流行病学研究方法,共调查3 573人,3 455人进入队列,失访率为3.3％,得67 693人年。1965～1984年间共死亡346人,其中恶性肿瘤占33.2％,为全部死因之首。全部职工和男性职工全癌死亡、肝癌死亡、膀胱癌死亡与当地居民比较相差具有显著意义。按工种分析,压胶工种恶性肿瘤SMR191,P<0.05。将全部职工分为直接接触组和间接接触组分析比较,直接接触组肝癌和膀胱癌的死亡率高于间接接触组。     

广西锡矿工人恶性肿瘤死亡率研究

对大厂和栗木锡矿1972～1974年的在册职工7849人进行了历史前瞻性队列研究;并通过多种监测手段对环境有害因子进行了监测。结果表明,锡矿全死因死亡率为632.7/10万,与全国居民死亡率计算的期望数比较,SMR=1.11(95％CI为1.03～1.19),恶性肿瘤死亡为全死因之首(占39.3％),其次是脑血管疾病和心脏病。恶性肿瘤死亡明显超高(SMR=1.56),且主要集中在肺癌、肝癌和鼻咽癌,其中肺癌占首位(32.1％),SMR为1.98,肝癌和鼻咽癌的SMR为1.79和3.71。监测结果进一步表明,大厂矿肺癌超高与接尘水平及其可吸入砷浓度的高低有明显的联系。     

汽车铸造作业工人队列死因研究

目的 分析危害汽车铸造作业工人健康的主要疾病,探讨铸造作业有害因素对工人寿命的影响.方法 采用流行病学队列研究方法,以某汽车铸造厂1980年在册的3529名职工为研究对象,从1980年随访至2005年底,以全国城市居民年龄别死亡率均值为参照,用标化死亡比(SMR)作为统计指标,并计算95%可信区间.结果 随访至2005年底,共计84 999人年,共死亡265人,死亡率3.12‰,累积死亡率为7.51%.铸工队列全死因SMR为0.96(95%CI:0.85～1.08)与全国平均水平持平,随着年龄增长,全死因SMR呈现升高趋势,50岁以上组工人的SMR均大于1.影响铸造工人寿命的主要疾病按累积死亡率从高到低排序分别是:恶性肿瘤(3.43%)、意外伤害(1.16%)、脑血管疾病(1.08%)、心血管疾病(0.79%).恶性肿瘤占总死亡原因的45.7%.铸造工人中死亡率明显升高的疾病有恶性肿瘤(SMR=7.87)、意外伤害(SMR=2.70)、心血管疾病(SMR=2.68)、消化系统疾病(SMR=2.79).一线作业工人恶性肿瘤死亡是辅助丁人的1.95倍(RR=1.95,P<0.05).结论 铸造作业中粉尘等职业危害因素明显影响工人的健康,恶性肿瘤死亡明显增加,应加强防护.     

镉作业工人恶性肿瘤的回顾性队列调查

用回顾性队列调查方法,调查柳州锌品厂职工14年间发生的恶性肿瘤,发现镉作业工人恶性肿瘤死亡超高。全癌、肺癌和肝癌的SMR分别为141、278和360,其中肝癌的死亡超高在统计学上有显著性意义。     

某有色金属冶炼厂恶性肿瘤死亡流行病学调查

本文对某有色金属冶炼厂工人14年恶性肿瘤死亡情况,采用流行病学回顾性队列分析方法,进行了调查。结果表明,恶性肿瘤占全死因第1位,全肿瘤、肺癌、肝癌及其它癌的SRR、SMR和SPMR均显著高于当地居民;癌症死亡年龄较当地居民提前约6岁;肿癌死亡率随工龄增加而增高,而且不同工种间有显著差异。表明该冶炼厂癌症发生除受本地区因素影响外,尚受职业因素影响,并且不能排除多种毒物联合致癌作用。     

接触滑石粉尘的陶瓷工人死因随访调查

本文对七个瓷厂1972—1974年间在厂工作一年以上的全部在册职工12218人进行了有关滑石和粉尘接触者死亡的队列研究。结果表明:全队列共死亡1256人,全死因与全国中小城市居民死亡率比较,呈轻度增高,SMR为1.18,P<0.01。主要表现在非恶性呼吸性疾病死亡增高。队列中全癌及肺癌死亡SMR分别为0.97和0.94,略低于全国居民死亡率。但接滑石人群肺癌死亡率则明显超高(SMR=2.62),提示滑石暴露与肺癌之间有联系,但例数较少,尚需进一步研究。     

某珠宝玉器厂职工恶性肿瘤死亡状况队列调查

本文报告了某珠宝玉器厂职工恶性肿瘤死亡的历史性列队调研,对象为1958.7.1建厂时起至1973.6.30止,工龄满一年的工人;观察期为1958.7.1～1983.6.30共25年。共214人;3879人年。死亡52人,肿瘤死亡21例。用上海市区居民肿瘤死亡专率作参照,该厂男职工全肿瘤SMR=167,P<0.05;食管癌SMR=407,P<0.001。用该市手工业系统职工恶性肿瘤死亡资料作参照,该厂男职工全肿瘤SMR=200,P<0.05;食管癌SMR=566,P<0.001。因该厂工人籍贯为江苏者较多,作籍贯SMR分析,提示江苏籍贯职工食管癌死亡水平高于江苏省一般人群(SMR=280,P<0.05)。接触水平分析,直接接触组职工食管癌死亡有显著意义(SMR=350,P<0.01,间接接触组无显著意义;接触工龄≥30年,SMR=600,P<0.001)。比例死亡比(PMR)分析,亦同样显示食管癌有极其显著意义(PMR=355,P<0.01)。该厂生产原料中无明显致癌物质,车间空气中的粉尘浓度亦较低,食管癌显著超高是否与职业接触有关,尚待进一步研究。     

木材综合厂恶性肿瘤死亡调查

本文回顾调查了某木材综合厂在23年中恶性肿瘤死亡情况。共追访1417人,其中男1043、女374人。全死因死亡73人,男女SMR均低于1,恶性肿瘤死亡36人,男性癌死亡率及SMR均显著高于当地居民(p<0.01)。女性无显著性差异。男性消化系肿瘤占全肿瘤的78.13%多。木材接触组与对照组比较,全死因、恶性肿瘤RR均大于2(p<0.001),平均死亡年龄亦均低于对照组。     

石棉矿工人和煤矿工人两个队列恶性肿瘤15年追踪研究

本文调查了两个队列(石棉矿工人和煤矿工人)男性共3035人,计58188人年的恶性肿瘤死亡率,追踪15年(1972.1.1～1987.1.1),结果表明石棉矿工人恶性肿瘤死亡率显著高于煤矿工人(SMR 1.43.P<0.05),肺癌SMR 5.72(P<0.01),肝癌、SMR2.39(P<0.05),消化道癌两队列未见差异SMR0.73,(P>0.05),不同年龄组比较显示40～50岁组石棉矿工人死亡率和恶性肿瘤死亡率均显著高于煤矿工人(P<0.05),且恶性肿瘤高发年龄在40～60岁组,其发病年龄较煤矿工人为早。此外,两队列的第一位死因均为呼吸道疾患,恶性肿瘤为第二位,可见加强防尘,防毒和鼓励戒炳等措施仍是矿山卫生工作的主要任务。石棉是多致癌物质,国外已早有报导,国内的调查资料未证实石棉的多致癌作用,但确认石棉工人肺癌高发,消化道癌未见增高。Jacobsen(1982)对煤矿工人死亡率追踪调查26年,死因分析表明消化道癌占第二位,国内王绵珍等(1986)报道煤矿工人恶性肿瘤居死因第二位,为了比较石棉矿工人和煤矿工人的恶性肿瘤,尤其是消化道癌的发病情况,作者对1472例石棉工人和2593例煤矿工人两个队列进行了15年追踪研究,结果报导如下。     

浙江省1995—1996年居民恶性肿瘤死亡分析

我省1995～1996年疾病监测点居民死亡监测结果,居民恶性肿瘤死亡率131.49/10万,占死亡总数的19.25％,居于死因顺位第二位.其中城市点恶性肿瘤死亡率151.54/10万,前三位死因是肺癌、肝癌和胃癌;农村点恶性肿瘤死亡率125/10万,前三位是死因胃癌、肝癌和肺癌.男性恶性肿瘤死亡率169.81/10万,居于男性全死因顺位第一位,恶性肿瘤死因顺位依次为肝癌、胃癌和肺癌;女性恶性肿瘤死亡率90.91/10万,死因顺位依次为胃癌、肝癌和肺癌.恶性肿瘤是中年期的首位死因(死亡率121.40/10万),是小儿期(死亡率5.69/10万)、青年期(死亡率14.95/10万)和老年期(死亡率711.12/10万)的第二位死因,去恶性肿瘤后,平均期望寿命可增加2.91岁.     

某化工厂恶性肿瘤死亡的回顾性队列研究

目的：了解职业因素对化工厂工人恶性肿瘤死亡的影响。方法：采用流行病学队列研究方法对该厂接触毒物工人疾病死亡原因进行29年回顾性分析。结果：硫酸、磷肥两车间肝癌死亡明显高于对照组（P＜0．05或0．01）;磷肥车间全癌死亡也明显高于对照组（P＜0．05）。此外,磷肥车间累计接毒工龄15－20年（或年龄40－50岁）全癌死亡、累计接毒工龄20年以上（或年龄50岁以上）肝癌死亡标化相对危险度（SRR）明显高于对照组（P＜0．05或0．01）;硫酸车间累计接毒工龄20年以上（或年龄50岁以上）肝癌死亡SRR也明显高于对照组（P＜0．05或0．01）。结论：本研究表明,某化工厂癌症发生可能与其生产环境中存在的铁金属矿尘、磷矿石粉尘以及氟化物等职业危害因素的综合作用有关。     

广州某染织厂职工死亡情况调查

目的调查染织工死亡情况,探讨染织工健康监护工作。方法逐年登记1990～1997年某染织厂职工死亡情况、原从事工作岗位和吸烟与否等,并统计分析不同死因的职工标准化死亡比例比(SPMR)。结果①织布车间噪声强度范围为87．8～102．7dB(A),超过90dB(A)占57．1％(4/7);棉尘浓度范围0．67～1．59mg/m3;②主要死因为肿瘤29人(43．3％),其次是心血管疾病22人(32．8％);③SPMR值提示染织工死于恶性肿瘤和心血管疾病的人数比广州一般人群死亡数高,以男肝癌和女乳腺癌为主,其中男泳染工死于肝癌的SPMR为655．74％,女织布工死于乳腺癌的SPMR为869．57％,均非常显著高于广州一般人群相同性别相应癌的死亡构成(P＜0．01)。结论染织厂染料及其中间产物的致癌性不能排除;织布女工乳腺癌高发值得进一步探讨;在染织工中很有必要提倡不吸烟或戒烟,并将其作为厂规之一加以限制。     

氯乙烯作业工人恶性肿瘤流行病学调查研究

目的 为了解氯乙烯作业工人恶性肿瘤发病情况。方法 采用回顾前瞻性观察法,对921名氯乙烯作业工人进行了40年死因流行病学调查。结果 男性接触组肝癌死亡率明显高于对照组。RR为2．16（P＜0．05）;接触组恶性肿瘤、肝癌的死亡也显著高于1994年全国城市居民恶性肿瘤的死亡率及1995年全国城市居民肝癌的死亡水平。SMR分别为1．8、29（P＜0．05）。在恶性肿瘤分类构成中,接触组肝癌居首位。结论 氯乙烯作业工人肝癌高发具有职业性特征。     

Mortality among aircraft manufacturing workers

OBJECTIVES: To evaluate the risk of cancer and other diseases among workers engaged in aircraft manufacturing and potentially exposed to compounds containing chromate, trichloroethylene (TCE), perchloroethylene (PCE), and mixed solvents. METHODS: A retrospective cohort mortality study was conducted of workers employed for at least 1 year at a large aircraft manufacturing facility in California on or after 1 January 1960. The mortality experience of these workers was determined by examination of national, state, and company records to the end of 1996. Standardised mortality ratios (SMRs) were evaluated comparing the observed numbers of deaths among workers with those expected in the general population adjusting for age, sex, race, and calendar year. The SMRs for 40 cause of death categories were computed for the total cohort and for subgroups defined by sex, race, position in the factory, work duration, year of first employment, latency, and broad occupational groups. Factory job titles were classified as to likely use of chemicals, and internal Poisson regression analyses were used to compute mortality risk ratios for categories of years of exposure to chromate, TCE, PCE, and mixed solvents, with unexposed factory workers serving as referents. RESULTS: The study cohort comprised 77,965 workers who accrued nearly 1.9 million person-years of follow up (mean 24.2 years). Mortality follow up, estimated as 99% complete, showed that 20,236 workers had died by 31 December 1996, with cause of death obtained for 98%. Workers experienced low overall mortality (all causes of death SMR 0.83) and low cancer mortality (SMR 0.90). No significant increases in risk were found for any of the 40 specific cause of death categories, whereas for several causes the numbers of deaths were significantly below expectation. Analyses by occupational group and specific job titles showed no remarkable mortality patterns. Factory workers estimated to have been routinely exposed to chromate were not at increased risk of total cancer (SMR 0.93) or of lung cancer (SMR 1.02). Workers routinely exposed to TCE, PCE, or a mixture of solvents also were not at increased risk of total cancer (SMRs 0.86, 1.07, and 0.89, respectively), and the numbers of deaths for specific cancer sites were close to expected values. Slight to moderately increased rates of non-Hodgkin''s lymphoma were found among workers exposed to TCE or PCE, but none was significant. A significant increase in testicular cancer was found among those with exposure to mixed solvents, but the excess was based on only six deaths and could not be linked to any particular solvent or job activity. Internal cohort analyses showed no significant trends of increased risk for any cancer with increasing years of exposure to chromate or solvents. CONCLUSIONS: The results from this large scale cohort study of workers followed up for over 3 decades provide no clear evidence that occupational exposures at the aircraft manufacturing factory resulted in increases in the risk of death from cancer or other diseases. Our findings support previous studies of aircraft workers in which cancer risks were generally at or below expected levels.       

A mortality study of a research, engineering, and metal fabrication facility in western New York State

The mortality experience of 8,146 male employees of a research, engineering, and metal fabrication facility in Tonawanda, New York state was examined from 1946 to 1981. Potential workplace exposures included welding fumes, cutting oils, asbestos, organic solvents, and environmental ionizing radiation, as the result of disposal of wastes during the Manhattan Project of World War II. External comparisons with the US male population were supplemented by regional comparisons. For the total cohort, deficits were observed for all causes of death (standardized mortality ratio (SMR) = 87) and most non-cancer causes. The observed number of cancer deaths was close to expected (SMR = 99). There was an excess of connective and soft tissue cancer deaths, most notably in hourly employees hired prior to 1946. Among all hourly employees, there was an excess of respiratory cancer, which did not appear to be associated with length of employment. Mesothelioma was recorded as the cause of death for three decedents, two of whom were hourly employees who worked in production areas with high potential for asbestos exposure. The standardized mortality ratio for cirrhosis of the liver was elevated among long-term hourly employees hired prior to 1946. The roles of carbon tetrachloride exposure in the 1940s and alcohol consumption are discussed as possible contributory risk factors for the cirrhosis findings. The data do not provide evidence of radiation-induced cancers within this employee population.     

Mortality among residents of Uravan, Colorado who lived near a uranium mill, 1936-84.

A cohort mortality study was conducted of all adult residents who ever lived in Uravan, Colorado, a company town built around a uranium mill. Vital status was determined through 2004 and standardised mortality analyses conducted for 1905 men and women alive after 1978 who lived for at least 6 months between 1936 and 1984 in Uravan. Overall, mortality from all causes (standardised mortality ratio (SMR) 0.90) and all cancers (SMR 1.00) was less than or as expected based on US mortality rates. Among the 459 residents who had worked in underground uranium mines, a significant increase in lung cancer was found (SMR 2.00; 95% CI 1.39-2.78). No significant elevation in lung cancer was seen among the 767 female residents of Uravan or the 622 uranium mill workers. No cause of death of a priori interest was significantly increased in any group, i.e. cancers of the kidney, liver, breast, lymphoma or leukaemia or non-malignant respiratory disease, renal disease or liver disease. This community cohort study revealed a significant excess of lung cancer among males who had been employed as underground miners. We attribute this excess to the historically high levels of radon in uranium mines of the Colorado Plateau, coupled with the heavy use of tobacco products. There was no evidence that environmental radiation exposures above natural background associated with the uranium mill operations increased the risk of cancer. Although the population studied was relatively small, the follow-up was long, extending up to 65 years after first residence in Uravan, and nearly half of the study subjects had died.     

Mortality in a cohort of pentachlorophenol manufacturing workers, 1940–1989

Mortality in a cohort of 770 workers with potential pentachlorophenol (PCP) exposure was evaluated from 1940 through 1989. The study cohort is a subset of a larger cohort of workers with potential exposure to higher chlorinated dioxins. Total mortality and cancer mortality, in the PCP cohort were slightly lower than expected in comparison to the U.S. white male population. There were 229 total deaths with 242.5 expected (SMR = 94, 95% confidence interval 83–108), and 50 cancer deaths with 52.6 expected (SMR = 95, 95% confidence interval 71–125). In comparison with unexposed employees, the risk ratio for total mortality was 1.03 (95% confidence internal 0.90–1.17), and the risk ratio for all cancer mortality was 0.95 (95% confidence interval 0.71–1.26). In most cause of death categories of a priori interest no deaths were observed in the cohort. A small excess of other and unspecified lymphopoietic cancer deaths was observed but did not appear to be related to exposure. Excesses of deaths due to cancer of the kidney, gastric and duodenal ulcer, cirrhosis of the liver, and all accidents were observed in comparison with the U.S. white male population and with unexposed employees. These were associated with increasing estimated cumulative PCP exposure after lagging exposures by 5 and 15 years. Despite the limited size and the generally favorable total mortality experience of the cohort, it was concluded that cohort members may have incurred increased risk of death due to some specific causes. The risks could not, however, be attributed conclusively to PCP exposure and may have been associated with other occupational and nonoccupational factors. Additional mortality surveillance of this cohort will be performed. © 1996 Wiley-Liss, Inc.     

Cohorte des travailleurs du nucléaire à Électricité de France : mortalité des agents statutaires sur la période 1968–2003

BackgroundWe conducted a mortality study on a cohort of French nuclear workers employed at Électricité de France (EDF). A first cancer mortality analysis had covered the period 1968–1994. This paper presents results from a mortality analysis including nine additional years of follow-up to cover workers employed from 1968 to 2003.MethodsThe cohort includes 22 393 workers, 97% of whom are males. Employment data were updated using the EDF personnel file. Vital status was ascertained using the French National Registry of Population, and further completed using EDF personnel and pension files. Causes of death were obtained from the National registry of causes of death. Standardised Mortality Ratios (SMR) were computed using national rates as references. Variations of all causes and all cancers SMRs were studied according to demographic and occupational characteristics.ResultsAt the study end point (31/12/2003), 74% of workers are still in active employment. Only 0.3% of workers are lost to follow-up. The median duration of follow-up is 20 years. Causes are ascertained for 96% of deaths. The total number of deaths is 874, 307 of which are cancer deaths. SMRs for all causes and cancers show a significant deficit compared to the French national mortality. No significant excess was observed for any of the cancer sites studied. Non-significant excesses are observed for pancreatic, pleural, kidney and brain cancer. Significant variations of all causes SMRs according to age at study entry and attained age are observed. Significant variations of all causes and all cancers SMRs according to diploma at employment are observed, with a reduced SMR for a higher level of diploma.ConclusionThere is a significant deficit of mortality compared to the general population, reflecting a strong Healthy Worker Effect. Although nine years of follow-up were added, this cohort is made up of young workers, most of whom are still in active service. Regular updating of the follow up of this cohort is planned, aiming for an occupational health surveillance of workers occupationally exposed to ionizing radiation in France.