Cancer mortality among atomic bomb survivors exposed as children

Objectives

To compare cancer mortality among A-bomb survivors exposed as children with cancer mortality among an unexposed control group (the entire population of Japan, JPCG).

Methods

The subjects were the Hiroshima and Nagasaki A-bomb survivor groups (0–14 years of age in 1945) reported in life span study report 12 (follow-up years were from 1950 to 1990), and a control group consisting of the JPCG. We estimated the expected number of deaths due to all causes and cancers of various causes among the exposed survivors who died in the follow-up interval, if they had died with the same mortality as the JPCG (0–14 years of age in 1945). We calculated the standardized mortality ratio (SMR) of A-bomb survivors in comparison with the JPCG.

Results

SMRs were significantly higher in exposed boys overall for all deaths, all cancers, leukemia, and liver cancer, and for exposed girls overall for all cancers, solid cancers, liver cancer, and breast cancer. In boys, SMRs were significantly higher for all deaths and liver cancer even in those exposed to very low doses, and for all cancers, solid cancers, and liver cancer in those exposed to low doses. In girls, SMRs were significantly higher for liver cancer and uterine cancer in those exposed to low doses, and for leukemia, solid cancers, stomach cancer, and breast cancer in those exposed to high doses.

Conclusions

We calculated the SMRs for the A-bomb survivors versus JPCG in childhood and compared them with a true non-exposed group. A notable result was that SMRs in boys exposed to low doses were significantly higher for solid cancer.     

Effects of screening on cervical cancer incidence and mortality in New South Wales implied by influences of period of diagnosis and birth cohort

STUDY OBJECTIVES: Cervical cancer incidence and mortality in NSW during 1972-1996 is examined under counterfactual assumptions to estimate the number of new cervical cancer cases averted and deaths avoided, with projections to 2006. SETTING: Cervical cancer incident cases and deaths in NSW for 1972-96 were obtained from the NSW Central Cancer Registry, Sydney, Australia. DESIGN: Data were analysed by age-period-cohort (APC) modelling, using Poisson regression. Projection of incidence to 2006 was based on a linear trend for period effects. A counterfactual scenario was constructed assuming stable period effects (1972-74), but modelled cohort effects. Modelled rates were converted to cases and deaths (using mortality:incidence ratios for cervical cancer), and compared with actual data to estimate cancers prevented and deaths averted due to screening. RESULTS: Rising cohort effects with recency of birth were found after controlling for age and period of diagnosis, and declining period effects were identified after controlling for age and birth cohort. The estimated cumulated number of new cases of cervical cancer prevented during 1972-1996 was 3440. The cumulated number of averted deaths over 1972-1996, derived from incident cases, was estimated to be 1610 (including actual declines in the M/I ratio). With no change in the M/I ratio from 1972, estimated cumulated mortality averted due to cervical cancer for 1972-1996 was 1210 deaths. CONCLUSIONS: Cervical screening has prevented a substantial number of new cases of cervical cancer and deaths. In addition, secondary prevention and improved treatment has contributed further to cervical cancer deaths averted.     

Mortality and cancer incidence among tire manufacturing workers hired in or after 1962

OBJECTIVE: This study evaluated mortality during 1962 through 2003 and cancer incidence during 1995 through 2003 at a tire manufacturing plant. METHODS: The mortality study included 3425 men and women, employed for at least one year. Of these, 3069 were eligible for the cancer incidence study. RESULTS: Employees experienced 390 deaths compared with 608 expected (standardized mortality ratio (SMR)=64; 95% confidence interval (CI)=58-71). Total cancer mortality (123 observed, SMR=75, CI=62-89) and lung cancer mortality (47 observed, SMR=72, CI=53-96) were lower than expected. Hourly white men had small increases in stomach cancer, bladder cancer, and leukemia deaths. During 1995 through 2003, 169 incident cancers were observed compared with 197 expected (SIR=86, 95% CI=74-100). Three mesothelioma cases occurred among hourly white men (SIR=653, CI=135-1907); all were exposed potentially to asbestos before starting at the rubber plant. CONCLUSIONS: Small numbers and limited information on jobs, occupational agents, and lifestyle preclude attribution of observed increases to workplace exposures.     

2016年珠海市恶性肿瘤发病和死亡分析

目的 分析2016年珠海市恶性肿瘤发病和死亡情况。 方法 根据2016年珠海市恶性肿瘤发病和死亡资料,分析其发病与死亡率、顺位和构成比等指标,并利用Joinpoint软件分析2010—2016年恶性肿瘤发病率和死亡率变化趋势。 结果 2016年珠海市恶性肿瘤粗发病率为286.41/10万,中标发病率为222.69/10万,主要恶性肿瘤发病顺位依次为女性乳腺癌、肺癌、结直肠癌、肝癌、宫颈癌,前10位恶性肿瘤占全部恶性肿瘤发病72.75%。恶性肿瘤粗死亡率为116.16/10万,中标死亡率为88.83/10万,主要恶性肿瘤死亡顺位依次为肺癌、肝癌、结直肠癌、女性乳腺癌、胃癌,前10位恶性肿瘤占全部恶性肿瘤死亡80.27%。2010—2016年珠海市恶性肿瘤发病与死亡均呈显著上升趋势,发病率APC为3.27%（P<0.05）,死亡率APC为3.03%（P<0.01）。 结论 珠海市恶性肿瘤发病与死亡呈上升趋势,女性乳腺癌、肺癌、结直肠癌、肝癌和宫颈癌是珠海市需重点防治的癌症。     

Occupational exposure to phenoxy herbicides and chlorophenols and cancer mortality in the Netherlands

As part of the “IARC International Register of Persons Exposed to Phenoxy Herbicides and Contaminants,” a cohort of workers who manufacture and prepare chlorophenoxy herbicides was recruited in The Netherlands. The cohort comprised 2,310 workers from two plants, operated by different companies, who were followed during the periods 1955–1985 and 1965–1986, respectively. In 1963, there had been an industrial accident in one factory with concomitant release of dioxin into the environment. Loss to followup was 3%. Mortality data on 963 exposed and 1,111 nonexposed men were evaluated by external and internal comparison. Compared with national rates, total mortality (94 deaths, standardized mortality ratio [SMR] + 101; 95% confidence interval [CI], 82–124) and cancer mortality (31 deaths, SMR + 107; 95% CI, 73–152) for exposed workers were not significantly increased. A statistically insignificant increase was observed for non-Hodgkin's lymphoma (2 deaths, SMR + 299; 95% CI, 36–1,078). No cases of soft-tissue sarcoma were encountered. There was no increase in either total mortality (25 deaths, SMR + 111; 95% CI, 72–163) or cancer mortality (10 deaths, SMR + 137; 95% CI, 66–252) among the 139 workers probably exposed to dioxins during the 2,4,5-trichlorophenol production accident or the subsequent clean-up operations. Compared with nonexposed workers, exposed workers did not exhibit a higher total mortality (rate ratio [RR] + 1.28; 95% CI, 0.89–1.82). Mortality due to all cancers (RR + 1.7; 95% CI, 0.9–3.4) and respiratory cancer (RR + 1.7; 95% CI, 0.5–6.3) was insignificantly elevated. These findings suggest that the increases in cancer mortality among workers exposed to phenoxy herbicides and chlorophenols may be attributable to chance. Lack of power prevented evaluation with respect to specific cancers. © 1993 Wiley-Liss, Inc.     

四川省肿瘤登记地区肿瘤发病和死亡资料分析

目的了解2009年四川省肿瘤登记覆盖地区恶性肿瘤发病与死亡情况。方法对四川省5个肿瘤登记点上报2009年肿瘤登记资料进行审核与评价,选取肿瘤登记数据质量达标的3个登记点,收集肿瘤登记数据,计算肿瘤发病（死亡）率、年龄别发病（死亡）率等指标。结果纳人分析的3个肿瘤登记点2009年报告肿瘤新发病例4667例,死亡3192例。恶性肿瘤发病率310．6／10万（男性377．9／10万,女性239．3／10万）,城市地区发病率263．4／10万,农村地区379．8／10万。发病率35岁“年龄组开始快速升高,80岁～时处于最高水平。恶性肿瘤死亡率212．5／10万（男性270．2／10万,女性151．2／10万）,城市地区死亡率150．4／10万,农村地区303．2／10万。死亡率35岁～年龄组开始较为快速升高,70岁一开始迅速升高并无下降趋势。全省肿瘤登记地区恶性肿瘤发病率居前几位的是胃癌、肺癌、食管癌、肝癌、直肠癌、乳腺癌,发病前10位的恶性肿瘤占全部恶性肿瘤发病的79．12％。死亡率居前几位的是胃癌、肺癌、食管癌、肝癌、直肠癌,死亡居前10位的恶性肿瘤占全部恶性肿瘤死亡的85．09％。结论胃癌、肺癌、食管癌、直肠癌、肝癌、乳腺癌是威胁我省肿瘤登记地区居民健康的主恶性肿瘤,应作为防控重点。     

Mental health in F-111 maintenance workers: the study of Health Outcomes in Aircraft Maintenance Personnel (SHOAMP) general health and medical study

OBJECTIVE: We sought to contrast mood disorder symptoms in F-111 aircraft Deseal/Reseal maintenance personnel with appropriate comparisons. METHODS: Participants completed a comprehensive health assessment, including measures of mood disorder, self-reported mood symptom questionnaire items, and review of anxiolytic and depression medication. Multiple logistic regression was conducted for each outcome using exposure group and potential confounders as explanatory variables. RESULTS: There was high agreement between self-reported mood disturbance and objective tests. The exposed group was more likely to self-report previous diagnoses of depression/anxiety, had higher use of antidepressant medications, and had increased risk of diagnosis of depression/anxiety. Results were consistently strong against both comparison groups, with the exposed more likely to have mental distress and social dysfunction when compared with the Australian population. CONCLUSIONS: There is robust evidence for an association between F-111 Deseal/Reseal exposure and impaired mental health.     

Mortality and cancer incidence in Swedish battery workers exposed to cadmium and nickel

OBJECTIVE: To follow up cancer incidence and mortality in a group of Swedish battery workers exposed to nickel hydroxide and cadmium oxide. METHODS: 869 workers, employed at least one year between the years 1940 and 1980 were followed up until 1992. Vital status and causes of death were obtained from the Swedish cause of death registry. Cancer morbidity was retrieved from the Swedish cancer registry. Regional reference rates were used to compute the expected numbers of deaths and cancers. RESULTS: Up to 31 December, 1992, a total of 315 deaths (292 in men and 23 in women) had occurred in the cohort. For men, the overall standardised mortality ratio (SMR) was 106 (95% confidence interval (95% CI) 93.7 to 118) and for women 83.8 (95% CI 53.1 to 126). The SMRs for total cancer mortality were 125 (95% CI 98.2 to 157) for men and 69.5 (95% CI 25.5 to 151) for women. The SMR for lung cancer in men was 176 (95% CI 101 to 287). No lung cancers were found among female workers. Up to 31 December, 1991, a total of 118 cancers had occurred in the cohort. A significantly increased standardised incidence ratio (SIR) was found for cancer of the nose and nasal sinuses in men, three cases v 0.36 expected, yielding an SIR of 832 (95% CI 172 to 2430). Applying a 10 year latency period in cohort members exposed to > or = 1000 micrograms cadmium/m3, the SIR was 1107 (95% CI 134 to 4000). Similarly, for cohort members exposed to 2000 micrograms nickel/m3, the SIR was 1080 (95% CI 131 to 3900). CONCLUSION: There was an increased overall risk for lung cancer, but no exposure-response relation between cumulative exposure to cadmium or nickel and risk of lung cancer. There was a highly significant increased risk of cancer of the nose and nasal sinuses, which may be caused by exposure to nickel or cadmium or a combination of both exposures.

 

     

Cancer incidence and mortality around the Pan Britannica Industries pesticide factory, Waltham Abbey.

OBJECTIVES: To examine the incidence and mortality of cancer near the Pan Britannica Industries factory, Waltham Abbey, after reports of a possible cluster of all cancers and brain cancer in the vicinity. METHOD: Small area study of cancer incidence 1977-89, and mortality 1981-92, within a 7.5 km radius of the factory site. Postcoded cancer registrations and deaths in the study area were extracted from national data sets held by the Small Area Health Statistics Unit and compared with expected numbers computed by applying national rates stratified for age, sex, and deprivation to the local population (1981 and 1991 censuses). Observed/ expected (O/E) ratios were examined from 0-1 km and 0-7.5 km of the plant, and tests applied for a decline in relative risk with distance up to 7.5 km. RESULTS: There were 12,859 incidence cancers (1977-89) from 0-7.5 km (O/E ratio 1.04; 95% confidence interval (95% CI) 1.02 to 1.06) and 385 from 0-1 km (O/E 1.10; 1.00 to 1.22). There was an excess of skin melanoma from 0-1 km based on 11 cases (O/E 2.13; 1.06 to 3.80), and an excess from 0-7.5 km of cancer of the lung, stomach and pancreas combined, and prostate (O/Es ranged from 1.09 to 1.13). Only the findings from lung cancer were suggestive of a decline in risk with distance, especially in the later period (1982-9). There were 9196 cancer deaths (1981-92) from 0-7.5 km (O/E 1.04; 95% CI 1.02 to 1.06) and 308 from 0-1 km (O/E 1.24; 1.11 to 1.39); and 25507 non-cancer deaths (O/E 1.02; 1.01 to 1.04) from 0-7.5 km and 745 (O/E 1.14; 1.06 to 1.22) from 0-1 km. There was evidence of a decline in mortality with distance for all cancers combined, lung cancer (P = 0.001 for each), and colorectal cancer (P < 0.05), and also for non-cancers (P = 0.001). Proportional mortality analyses suggested a decline in risk with distance for lung cancer (P = 0.003) but not for all cancers or the site specific cancers examined. There was no evidence of an excess in the incidence or mortality from brain cancer. For cancer mortality in the inner-most wards, the findings were, for the most part, well within the range of variation across the region as a whole. CONCLUSIONS: The study provides limited and inconsistent evidence for a localised excess of cancer in the vicinity of the PBI plant. At present, further investigation does not seem warranted other than continued surveillance of mortality and cancer incidence in the locality.     

Cosmic radiation and mortality from cancer among male German airline pilots: extended cohort follow-up

Commercial airline pilots are exposed to cosmic radiation and other specific occupational factors, potentially leading to increased cancer mortality. This was analysed in a cohort of 6,000 German cockpit crew members. A mortality follow-up for the years 1960-2004 was performed and occupational and dosimetry data were collected for this period. 405 deaths, including 127 cancer deaths, occurred in the cohort. The mortality from all causes and all cancers was significantly lower than in the German population. Total mortality decreased with increasing radiation doses (rate ratio (RR) per 10 mSv: 0.85, 95 % CI: 0.79, 0.93), contrasting with a non-significant increase of cancer mortality (RR per 10 mSv: 1.05, 95 % CI: 0.91, 1.20), which was restricted to the group of cancers not categorized as radiogenic in categorical analyses. While the total and cancer mortality of cockpit crew is low, a positive trend of all cancer with radiation dose is observed. Incomplete adjustment for age, other exposures correlated with duration of employment and a healthy worker survivor effect may contribute to this finding. More information is expected from a pooled analysis of updated international aircrew studies.     

Fifteen years after the Gozan-Dong glass fiber outbreak, Incheon in 1995

Objectives

In 1995, an outbreak survey in Gozan-dong concluded that an association between fiberglass exposure in drinking water and cancer outbreak cannot be established. This study follows the subjects from a study in 1995 using a data linkage method to examine whether an association existed. The authors will address the potential benefits and methodological issues following outbreak surveys using data linkage, particularly when informed consent is absent.

Methods

This is a follow-up study of 697 (30 exposed) individuals out of the original 888 (31 exposed) participants (78.5%) from 1995 to 2007 assessing the cancer outcomes and deaths of these individuals. The National Cancer Registry (KNCR) and death certificate data were linked using the ID numbers of the participants. The standardized incidence ratio (SIR) and standardized mortality ratio (SMR) from cancers were calculated by the KNCR.

Results

The SIR values for all cancer or gastrointestinal cancer (GI) occurrences were the lowest in the exposed group (SIR, 0.73; 95% CI, 0.10 to 5.21; 0.00 for GI), while the two control groups (control 1: external, control 2: internal) showed slight increases in their SIR values (SIR, 1.18 and 1.27 for all cancers; 1.62 and 1.46 for GI). All lacked statistical significance. All-cause mortality levels for the three groups showed the same pattern (SMR 0.37, 1.29, and 1.11).

Conclusions

This study did not refute a finding of non-association with a 13-year follow-up. Considering that many outbreak surveys are associated with a small sample size and a cross-sectional design, follow-up studies that utilize data linkage should become standard procedure.     

Screening methodology application to evaluate cancer mortality in selected cities in the State of Minas Gerais, Brazil

An epidemiological investigation was launched in several cities in southern Minas Gerais State, Brazil, considering the possibility of increased cancer incidence due to high exposure to natural radiation. First, the cancer mortality patterns were assessed to determine whether there was an increase in cancer deaths and to discuss the possible risk factors related to such an increase. The study proposed the use of a screening methodology based on standardized mortality ratio (SMR) in order to classify priority areas for future studies. Cities considered high priority for further investigation were: Andradas, for lung cancer in men (SMR = 208 (106-310)) and liver cancer in women (SMR = 403 (104-701)); Po?os de Caldas, leukemia in men and women (SMR = 284 (156-412)) and SMR = 211 (111-312), respectively); Pouso Alegre, leukemia in men (SMR = 333 (127-540)) and hematological cancers in women (SMR = 257 (188-396)). Epidemiological studies are necessary to evaluate the role of radiation and other risk factors in these cancers and thus to support future preventive and control measures.     

2016-2017年新疆石河子市老年人恶性肿瘤发病与死亡分析

目的 分析2016-2017年石河子市老年人恶性肿瘤发病与死亡情况,为该地老年人肿瘤防控提供最新依据。方法 利用2016-2017年石河子市肿瘤登记数据,通过计算肿瘤发病率、死亡率、构成比及顺位等描述石河子市老年人恶性肿瘤的流行情况。结果 2016-2017年石河子老年人恶性肿瘤新发病例为2078例,占全人群中恶性肿瘤新发病例的56.61%,发病率为830.52/10万,男性高于女性(P<0.05);死亡人数为1214例,占全人群中恶性肿瘤死亡病例的的64.20%,死亡率为485.20/10万,男性高于女性(P<0.05)。肺癌、胃癌、结直肠癌、前列腺癌、肝癌及乳腺癌是石河子市老年人高发肿瘤,占老年人群新发病例的53.47%,死亡病例的60.87%。结论 石河子市老年人恶性肿瘤发病、死亡水平较高,其中肺癌、胃癌及结直肠癌更明显。因此,有针对性地开展老年人肿瘤防控工作十分必要。     

Mortality study of persons exposed to dioxin in a trichlorophenol-process accident that occurred in the BASF AG on November 17, 1953

Twenty-seven years after an accident which occurred in the BASF, Ludwigshafen plan in 1953, a mortality study of persons exposed to dioxin in an uncontrolled reaction during a trichlorophenol process was undertaken. The follow-up was 100% successful and involved 74 persons. Overall mortality (21 deaths) did not differ in this group from the rate expected in three external reference populations or from that observed in two internal comparison groups, where 18-20 deaths were observed. Of the 21 deceased persons, 7 had cancer, compared with 4.1 expected. In addition, two other cases of cancer (one bronchial carcinoma, and one carcinoma of the prostate) are still alive. Three deaths due to stomach cancer, at ages 64, 66, and 69 years, were found, compared with 0.6 expected from regional mortality data. One stomach cancer occurred among 148 individuals in the two comparison cohorts.     

Racial differences in ill defined cancer mortality in the United States and in the District of Columbia.

STUDY OBJECTIVE--The aim was to examine the epidemiology of unknown primary cancer mortality in the USA during 1979 to 1988 by age, sex, race, year, and geographical area. DESIGN--National (US) and state data were abstracted for deaths due to ill defined cancer (ICD-9 195.0 to 199.1) and all cancers combined (ICD-9 140.0-209.9). Age adjusted mortality rates were calculated using the 1980 USA population as the standard, and standardised rate ratios were derived. National total cancer incidence data were obtained from the surveillance, epidemiology and end results (SEER) program, and age and sex specific relative (black/white) cancer incidence rates were derived and compared to relative (black/white) mortality rates for ill defined cancer. State and regional median family income levels were obtained from the 1980 census and compared to corresponding mortality rates. SETTING--This study used data for the US population, the 50 states, and the District of Columbia. MEASUREMENTS AND MAIN RESULTS--During 1984-1988, ill defined cancers accounted for an average of 34,921 deaths each year in the USA (13.7 per 100,000 population). The mortality rate due to ill defined cancers is greater among blacks (19.3 per 100,000) than whites (13.2 per 100,000) (RR = 1.5) and has not declined since 1979. There is considerable geographical variation in the ill defined cancer mortality rate. Thus among blacks the highest rates were clustered in the central states (23 per 100,000) and the lowest rates were seen in the mountain and western states (17 per 100,000). The District of Columbia had the highest overall rate (21.7 per 100,000) when compared to all other states. The black/white relative mortality rate due to ill defined cancer was consistently greater than the black/white relative incidence of all cancers. CONCLUSIONS--Ill defined cancer mortality is the fourth leading site of cancer mortality in the USA, and accounts for 7.4% of cancer deaths annually. The large proportion of ill defined cancer deaths may have biased the accuracy of national and local cancer incidence and mortality statistics. The higher mortality of ill defined cancer among blacks is not explained by the higher overall cancer incidence among blacks and suggests the influence of socioeconomic or cultural barriers that may result in underutilisation of health services or substandard health care. Ill defined cancer mortality may be a sentinel indicator of deficiencies in the health care delivery system as well as a measure of progress against cancer.     

Cancer mortality in counties near two former nuclear materials processing facilities in Pennsylvania, 1950-1995

There has been concern that living near nuclear installations might increase the risk of cancer, including childhood leukemia, in surrounding communities. Such concern has been voiced by residents in Armstrong and Westmoreland Counties in Western Pennsylvania in conjunction with the operation of two former nuclear materials processing facilities located in the Apollo borough and the Parks township, just three miles apart. These facilities began operating in 1957 and 1960 and processed uranium and plutonium for commercial and naval applications. To evaluate the possibility of increased cancer rates in communities around the Apollo-Parks nuclear facilities, a cancer incidence and a cancer mortality survey were conducted. The county mortality findings are reported here. Nearly 40,000 cancer deaths occurred in the population residing in Armstrong and Westmoreland Counties from 1950 through 1995. Each of these two study counties was matched for comparison to three control counties in the same region on the basis of age, race, urbanization, and socioeconomic factors available from the 1990 U.S. Census. There were over 77,000 cancer deaths in the 6 control counties during the 45 y studied. Following similar methods used by the National Cancer Institute, Standardized Mortality Ratios (SMRs) were computed as the ratio of observed numbers of cancers in the study and control counties compared to the expected number derived from general population rates of the United States. Relative risks (RR) were computed as the ratios of the SMRs for the study and the control counties. There were no significant increases in the study counties for any cancer when comparisons were made with either the U.S. population or the control counties. In particular, deaths due to cancers of the lung, bone, liver, and kidney were not more frequent in the study counties than in the control counties. These are the cancers of a priori interest given that uranium and/or plutonium might be expected to concentrate in these tissues. Deaths from all cancers combined also were not increased in the study counties, and the RRs of cancer mortality before the facilities operated (1950-1964), during plant operations (1965-1980) and after plant closure (1980-1995) were similar: 0.96, 0.95 and 0.98, respectively. For childhood leukemia mortality, the relative risk comparing the study counties with their controls before plant start-up was 1.02, while during operations (RR 0.81) and after closure (RR 0.57) the relative risks were lower. The study is limited by the correlational approach and the relatively large size of the geographic areas of the counties studied.     

Risk of lung, larynx, pharynx and buccal cavity cancers among carbon electrode manufacturing workers

Among workers employed in factories producing carbon graphite products the risk of cancer due to exposure to polycyclic aromatic hydrocarbons was estimated. In one cohort (plant A), a cancer incidence study was carried out; the number of cases were not significantly increased for lung cancers [7 cases, standardized incidence ratio (SIR) 79] or for cancers of the upper respiratory and alimentary tract (10 cases, SIR 103). In another cohort (plant B), a mortality study was carried out; neither the mortality from lung cancer [13 deaths, standardized mortality ratio (SMR) 118] nor that from upper respiratory and alimentary tract cancers (10 deaths, SMR 125) was significantly higher than expected. Within each cohort, a case-referent study was carried out. In plant A the odds ratios were high but nonsignificant for lung cancers (odds ratio 3.42) and upper respiratory and alimentary tract cancers (odds ratio 2.19) and they showed a nonsignificant relationship with duration of exposure. In plant B, the odds ratios were low for every cancer site.     

中国联苯胺作业工人职业性膀胱癌发病率和死亡率流行病学调查

本文研究了1972年至1977年在册的累计专业工龄一年以上天津、上海和吉林1972名联苯胺男工的膀胱癌发病率和死亡率。与上海市普通居民相比联苯胺工人膀胱癌的标化死亡比(SMR)为17.5(95%可信限:7.5～34.5)、标化发病比(SIR)为25.0(95%可信限:16.9～35.7)。联苯胺工人膀胱癌发病率增高25倍,与接触水平有关。低接触组SIR=4.8;中接触组SIR=36.2;高接触组SIR=158.4(X~2趋势检验P<0.01)。联苯胺生产工人SIR=45.7(95%可信限:20.9～86.8),联苯胺使用工人SIR=20.9(95%可信限:12.9～32.0)。联苯胺吸烟者危险度增加31倍(95%可信限:20.4～46.4),而非吸烟者仅11倍(95%可信限:3.6～25.8)。     

Mortality of United Kingdom acrylonitrile polymerisation workers.

The mortality of 1111 men who worked on the polymerisation of acrylonitrile and the spinning of acrylic fibre from 1950 to 1968 was surveyed up to the end of 1978. Seventy-nine deaths were identified. The population was drawn from six factories, where polymerisation started before 1968, in England, Wales, Scotland, and Northern Ireland. In the group of men exposed to acrylonitrile for at least one year the total number of deaths was smaller than expected. An excess of deaths from all cancers was found, arising mainly from cancers of the lung, stomach, colon, and brain, but the excess was not statistically significant. Significant excesses of stomach cancer overall and in those aged 55-64, and of lung cancer in those aged 15-44 were found. Consideration of deaths according to factory indicated that the excesses of stomach cancer may have been due to regional factors. The excess of lung cancer was investigated further in view of the fact that, unusually, it occurred in relatively young men, but no consistent difference between the duration of exposure to acrylonitrile of the three young patients with lung cancer and matched controls was found. The study is limited and further analysis in the future is needed. The results are not conclusive and neither add to nor detract from existing suspicions that acrylonitrile is a human carcinogen but, taken together with evidence from other studies, indicate the necessity for the continuing surveillance of the exposed population in the United Kingdom.     

Mortality and incidence of bladder cancer in benzidine-exposed workers in China.

We examined bladder cancer mortality and incidence to 1981 in 1,972 workers employed in benzidine-exposed jobs in Tianjin, Shanghai, and Jilin, China, between 1972 and 1977, and in 1,974 unexposed workers employed during the same time period. In comparison to general population rates, in the benzidine-exposed group the ratio of observed to expected deaths (SMR) was 17.5 (95% C.I.: 7.5-34.5) and the ratio of observed to expected incident cases (SIR) was 25.0 (95% C.I.: 16.9-35.7). No excess was noted in the unexposed group. The 25-fold increase in bladder cancer incidence in the exposed group was related to level of exposure, with the SIR rising from 4.8 for low exposure to 36.2 for medium exposure, and 158.4 for high exposure. Risks were elevated both for producers of benzidine (SIR = 45.7; 95% C.I.: 20.9-86.8) and for users (SIR = 20.9; 95% C.I.: 12.9-32.0) of benzidine dyes. Benzidine-exposed workers who smoked tobacco had a 31-fold risk (95% C.I.: 20.4-46.4), while non-smoking workers had an 11-fold risk (95% C.I.: 3.6-25.8), suggestive of a multiplicative relationship between these two carcinogens.