Occupational exposure to diesel engine emissions and risk of cancer in Swedish men and women
Occupational exposure to diesel engine emissions and risk of cancer in Swedish men and women
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DOI：
10.1023/a:1011262105972
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发表时间：
2001-01-01
影响因子：
2.3
通讯作者：
Silverman, D
中科院分区：
文献类型：
--
作者：
Boffetta, P;Dosemeci, M;Silverman, D
目的：在瑞典的一项大型记录-关联研究中调查接触柴油排放的工人的癌症风险。方法：瑞典癌症环境登记III收录了1971-1989年按1960年和1970年人口普查报告的职业和就业行业划分的全国癌症发病率数据。在排除农民之后，我们根据估计的接触柴油排放的概率和强度对工作和行业头衔进行了分类。在1960年的人口普查中，暴露的男子贡献了超过740万人年，暴露的妇女贡献了超过24万人年。结果：1960年人口普查中暴露的男性患肺癌的风险增加：低、中、高暴露强度的相对风险(RRS)分别为0.95(95%可信区间[CI]0.9-1.0)、1.1(1.1-1.2)和1.3(1.3-1.4)。接触概率的相应结果分别为1.1(1.0-1.1)、0.9(0.86-0.94)和1.2(1.1-1.2)。与其他组织学类型相比，肺鳞癌的风险更高。在女性中的结果没有提示影响(中或高暴露强度类别的RR为1.1，95%可信区间为0.6-1.8)。在接触柴油尾气的男性中，患胃癌(SIR 1.06)、胰腺癌(SIR 1.05)、喉癌(SIR 1.09)和肾癌(SIR 1.06)的风险有小幅但显著的增加，根据暴露的概率或强度没有明显的趋势。女性的SIR在胃癌、胰腺癌和喉癌中没有显著增加，但在肾癌中没有显著增加。此外，女性患口腔/咽癌(SIR 1.64)和宫颈癌(SIR 1.48)的风险显著增加，这表明存在剂量-反应关系。男性和女性患膀胱癌的风险都没有增加。结论：这项研究的结果提供了接触柴油尾气与男性肺癌风险之间存在正向暴露-反应关系的证据。其他肿瘤的阳性结果，如胃癌、胰腺癌、口腔/咽喉癌和宫颈癌，不能归因于柴油接触，但它们值得在未来的研究中注意。
Objective: To investigate the risk of cancer among workers exposed to diesel emissions in a large record-linkage study from Sweden.Methods: The Swedish Cancer Environment Register III contains nationwide data on cancer incidence during 1971-1989, by occupation and industry of employment as reported in the 1960 and 1970 censuses. After excluding farmers, we classified job and industry titles according to estimated probability and intensity of exposure to diesel emissions. Exposed men in the 1960 census contributed over 7,400,000 person-years, and exposed women contributed over 240,000. We compared them to the remainder of the employed population, using indirect standardization and multivariate Poisson regression analysis.Results: Men exposed in the 1960 census experienced an increased risk of lung cancer: the relative risks (RRs) were 0.95 (95% confidence interval [CI] 0.9-1.0), 1.1 (1.1-1.2) and 1.3 (1.3-1.4) for low, medium, and high intensity of exposure. Corresponding results for probability of exposure were 1.1 (1.0-1.1), 0.9 (0.86-0.94) and 1.2 (1.1-1.2). The risk was higher for squamous cell carcinoma of the lung than for other histological types. Results in women were not suggestive of an effect (RR in the category of medium or high intensity of exposure 1.1, 95% CI 0.6-1.8). A small but significant increase in risk of cancers of the stomach (SIR 1.06), pancreas (SIR 1.05), larynx (SIR 1.09), and the kidney (SIR 1.06) was present among men exposed to diesel emissions, without a clear trend according to either probability or intensity of exposure. The SIR among women was non-significantly increased for stomach, pancreatic, and laryngeal cancers, but not for kidney cancer. Furthermore, a significantly increased risk of oral/pharyngeal (SIR 1.64) and cervical (SIR 1.48) cancers was present among women, with a suggestion of a dose-response relationship. There was no increased risk of bladder cancer in either gender.Conclusions: The results of this study provide evidence of a positive exposure-response relationship between exposure to diesel emissions and lung cancer risk among men. The positive results for other neoplasms, such as stomach, pancreatic, oral/pharyngeal, and cervical cancers, cannot be attributed to diesel exposure, but they deserve attention in future investigations.