A 37-year observation of mortality in Chinese chrysotile asbestos workers
A 37-year observation of mortality in Chinese chrysotile asbestos workers
复制标题
DOI：
10.1136/thoraxjnl-2011-200169
复制
发表时间：
2011-09
期刊：
影响因子：
10
通讯作者：
Xiaorong Wang;E. Yano;H. Qiu;I. Yu;Midori N. Courtice;L. Tse;Sihao Lin;Mian-zhen Wang
中科院分区：
文献类型：
--
作者：
Xiaorong Wang;E. Yano;H. Qiu;I. Yu;Midori N. Courtice;L. Tse;Sihao Lin;Mian-zhen Wang
目的这项长达37年的前瞻性队列研究旨在为暴露于温石棉的死亡风险提供更多证据。方法1972~2008年对原队列中577名石棉工人和435名对照工人进行跟踪调查，随访率分别为99%和73%。道德比率是基于人-年的观察而确定的。在考虑年龄、吸烟和石棉暴露水平的同时，构建了COX比例风险模型来估计特定死因死亡率的比率。结果石棉队列中有259例(45%)死亡，其中96例死于所有癌症。肺癌(n=53)和非恶性呼吸道疾病(n=81)是主要死因，而对照组为9例肺癌和11例呼吸系统疾病。石棉工人全死因死亡率和所有癌症的年龄和吸烟调整后的相对危险度分别为2.05(95%可信区间1.56~2.68)和1.89(1.25~2.87)。石棉工人患肺癌和呼吸系统疾病死亡的危险性是对照组的3倍以上(HR 3.31[95%CI 1.60~6.87]；HR 3.23[95%CI 1.68~6.22])。吸烟者和不吸烟者的石棉暴露水平和肺癌死亡率存在明显的暴露-反应趋势。结论这一前瞻性队列的数据提供了强有力的证据表明，在考虑吸烟影响的情况下，与温石棉接触有关的死亡风险增加，特别是肺癌和非恶性呼吸道疾病。
Objectives This 37-year prospective cohort study was undertaken to provide additional evidence for mortality risks associated with exposure to chrysotile asbestos. Methods 577 asbestos workers and 435 control workers in original cohorts were followed from 1972 to 2008, achieving a follow-up rate of 99% and 73%, respectively. Morality rates were determined based on person-years of observation. Cox proportional hazard models were constructed to estimate HRs of cause-specific mortality, while taking into account age, smoking and asbestos exposure level. Results There were 259 (45%) deaths identified in the asbestos cohort, and 96 died of all cancers. Lung cancer (n=53) and non-malignant respiratory diseases (n=81) were major cause-specific deaths, in contrast to nine lung cancers and 11 respiratory diseases in the controls. Age and smoking-adjusted HRs for mortality by all causes and all cancers in asbestos workers were 2.05 (95% CI 1.56 to 2.68) and 1.89 (1.25 to 2.87), respectively. The risks for lung cancer and respiratory disease deaths in asbestos workers were over threefold that in the controls (HR 3.31(95% CI 1.60 to 6.87); HR 3.23 (95% CI 1.68 to 6.22), respectively). There was a clear exposure–response trend with asbestos exposure level and lung cancer mortality in both smokers and non-smokers. Conclusion Data from this prospective cohort provide strong evidence for increased mortality risks, particularly from lung cancer and non-malignant respiratory diseases, associated with exposure to chrysotile asbestos, while taking into account of the smoking effect.