青石棉环境污染与肺癌的病例对照研究

目的　探索云南省××县肺癌高发的主要危险因素 ,为采取防制措施提供依据。方法　作者对以往进行死因调查时发现的 31例肺癌病例进行调查 ,并按 1∶ 4的比例匹配了与病例性别相同、出生年月相差不超过 2年的对照。调查内容包括一般情况、是否从事过石棉生产、环境石棉污染情况、吸烟、肿瘤家族史等。结果　家庭中使用石棉炉和吸烟与肺癌之间的关联有显著性差异 ,OR分别为 4.2 8(95 %CI,1.39～ 13.2 1)和 6 .0 2 (95 %CI,1.83～ 19.78)。同时还发现 ,随着使用石棉炉的年数和个数增加 ,肺癌的发病危险也有逐渐增加的趋势。结论　该地区肺癌高发可能与家庭环境中石棉污染和吸烟有关 ,其中使用石棉炉可能是一个主要的石棉污染方式。

The Risk Factors of Lung Cancer in Crocidolite-contaminated Environmental Area: A Case-control Study

Objective To explore the risk factors of lung cancer in somowhere of Yunnan Province, which is a crocidolite-contaminated area. Methods A case-control study was carried out, including 31 cases of lung cancer. Each case was matched with 4 controls on sex and age (within 2 years). All of the study participants were residents in somewhere of Yunnan Province. Data on sociodemographic characteristics, smoking, asbestos occupational and environmental exposure and family history of cancer were collected from the study subjects through a standardized questionnaire administered by trained interviewers. Odds ratios (ORs) and their 95% confidence intervals (95% CI) were derived from conditional logistic regression model by STATA software. Results Multivariate analysis showed that using asbestos stove in family and smoking were both significantly associated with lung cancer, and the odds ratios were 4.28(95% CI 1.39-13.21) and 6.02 (95% CI 1.83-19.78)respectively. Moreover, as the years and amount of using asbestos stove in family increased, the risk of lung cancer rose correspondingly. Conclusion This study suggested that asbestos environmental exposure, especially using asbestos stove in family and smoking, are probably the main risk factors of lung cancer in somewhere of Yunnan Province.