Lung cancer in chrysotile asbestos workers: analyses based on the two-stage clonal expansion model.
Lung cancer in chrysotile asbestos workers: analyses based on the two-stage clonal expansion model.
复制标题
温石棉工人肺癌：基于两阶段克隆扩增模型的分析。
DOI：
10.1007/s10552-009-9297-z
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发表时间：
2009
期刊：
影响因子：
--
通讯作者：
Richardson,DavidB
中科院分区：
文献类型：
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作者：
Richardson,DavidB
目的评价温石棉暴露后肺癌风险的大小和时间模式。方法我分析了暴露于几乎纯温石棉的石棉纺织工人的肺癌死亡率数据。就业历史和工业卫生数据被用来得出石棉暴露估计。这些数据在两期克隆扩张（TSCE）模型和Cox比例风险模型的框架内进行分析。结果在TSCE模型下，温石棉与肺癌死亡率之间的关系主要是由于暴露诱导的起始细胞增殖增加。在长期接触温石棉的情况下，该模型表明，估计的危险比在40至65岁之间达到最大值。Cox回归分析支持这些结论；在年龄<65岁时，每纤维年/ml的估计超额相对风险为0.053 (95% CI: 0.023, 0.124)，而在年龄较大时，几乎没有证据表明存在关联。结论TSCE模型很好地拟合了这些数据，适应了与比例风险假设的观测偏差。这些分析表明，温石棉暴露对肺癌风险的影响随达到的年龄而变化。
ObjectiveTo evaluate the magnitude and temporal pattern of lung cancer risk following exposure to chrysotile asbestos.MethodsI analyzed data on lung cancer mortality in a cohort of asbestos textile workers who were exposed to almost pure chrysotile. Employment history and industrial hygiene data were used to derive asbestos exposure estimates. These data were analyzed within the framework of the two-stage clonal expansion (TSCE) model and the Cox proportional hazards model.ResultsUnder the TSCE model, the association between chrysotile asbestos and lung cancer mortality was primarily due to an exposure-induced increase in the proliferation of initiated cells. In a setting of protracted exposure to chrysotile asbestos, this model implies that the estimated hazard ratio was at its maximum between ages 40 and 65 years. Cox regression analyses support these conclusions; the estimated excess relative risk per fiber-year/ml was 0.053 (95% CI: 0.023, 0.124) at ages <65 years, while there was minimal evidence of association at older attained ages.ConclusionsThe TSCE model fits these data well, accommodating the observed departure from the proportional hazards assumption. These analyses suggest that the effect of chrysotile asbestos exposure on lung cancer risk varies with attained age.