环境接触青石棉肿瘤发生危险的15年随访调查

目的探讨环境接触青石棉队列人群患肿瘤的危险。方法采用回顾队列调查方法对大姚县6254人进行15年(1987～2001)的追踪研究，调查石棉相关肿瘤的死亡率及相对危险度(RR)。结果观察组中有186例死于癌症，死亡率为2160．5／10^6人年(RR=1．293；95％CI：1．032～1．618)。其中20例间皮瘤，死亡率为232．3／10^6人年(RR=17．929；95％CI：2．406～133．592)，男女分别为267．5／10^6人年和186．7／10^6人年；56例死于肺癌，死亡率(650．5／10^6人年)的增加与对照组比较差异无统计学意义(RR=1．434；95％CI：0．968～2．486)；胃肠道肿瘤的死亡率在两组中差异无统计学意义(P＞0．05)，但在观察组男性中患肠癌的危险显著增加(RR=3．781；95％CI：1．077～13．270)。结论环境接触青石棉后人群患间皮瘤的危险明显增加，男性患肠癌危险度的增加需进一步证实。

A Study on Risk of Malignant Neoplasm and Environmental Exposure to Crocidolite

OBJECTIVE: To explore the risk of developing malignant neoplasm in a cohort with the history of environmental exposure to crocidolite asbestos. METHODS: A retrospective cohort and follow-up study covering 15 years (1987 --> 1995 --> 2001) was carrid out in a small town in Yunnan province. The cohort comprised 6254 local inhabitants. The deaths from and the RR of asbestos-related malignant neoplasms were studied. RESULTS: There were 186 deaths from neoplasms in the observation group, the mortality being 2160.5 per 10(6) person-years (RR=1.293, 95%CI: 1.032-1.618), 20 of those deaths were caused by mesothelioma, with a crude mortality of 232.3 per 10(6) person-years (RR=17.929; 95%CI: 2.406-133.592). The mortalities for men and women were 267.5 and 186.7 per 10(6) person-years respectively. The crude mortality from lung cancer (56 deaths) was 650.5 per 10(6) person-years,there is no significance between the two groups (RR=1.434; 95%CI: 0.968-2.486). The difference in mortality from gastrointestinal cancer between the two groups is not significant, whereas the risk of man intestinal cancer in the observation is significant (RR=3.71; 95%CI: 1.077-13.270). CONCLUSION: The risk of developing mesothelioma is significantly increased in the population with environmental exposure to crocidolite. The risk of man intestinal cancer in the town awaits additional studies.