Exposure to nickel compounds and smoking in relation to incidence of lung and nasal cancer among nickel refinery workers
Exposure to nickel compounds and smoking in relation to incidence of lung and nasal cancer among nickel refinery workers
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DOI：
10.1136/oem.53.10.708
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发表时间：
1996-10-01
影响因子：
4.9
通讯作者：
Norseth, T
中科院分区：
文献类型：
--
作者：
Andersen, A;Berge, SR;Norseth, T
目的：探讨镍精炼厂工人职业危害与长期接触不同形态镍的关系，以及吸烟与总接触镍之间的交互作用。方法队列包括379名1916-40年首次工作且至少工作3年的工人和4385名1946-83年工作至少一年的工人。结果：在1953-93年的随访中，203例新发肺癌病例为68例预期病例(标准化发病率比(SIR)3.0，95%可信区间(95%CI)2.6-3.4)，32例鼻癌病例为预期病例(SIR为18.0，95%可信区间为12-25)。泊松回归分析显示，肺癌的超额风险与可溶形式的镍接触有关，相对风险(RR)增加三倍(P<；0.001)，吸烟和接触镍的乘数效应。从未吸烟的接触者的相对危险度为1.1(95%可信区间0.2~5.1)，吸烟的暴露者的相对危险度为5.1(95%可信区间1.3~20.5)。结论：尚不能确定哪种镍化合物是致癌的，但接触可溶镍或与其他形式的镍联合接触的工人存在显著的超额风险。目前的研究表明，吸烟和接触镍具有乘数效应。
Objectives-To investigate the relation between occupational hazards among nickel refinery workers and their exposure to different forms of nickel over time and the interaction between smoking and total exposure to nickel.Methods-The cohort consisted of 379 workers with first employment 1916-40 and at least three years of employment and 4385 workers with at least one year of employment 1946-83. Data on smoking (ever or never) were available for almost 95% of the cohort; Two analyses were used, indirect standardisation from observed and expected numbers and Poisson regression.Results-During the follow up 1953-93, 203 new cases of lung cancer were observed v 68 expected (standardised incidence ratio (SIR) 3.0, 95% confidence interval (95% CI) 2.6-3.4) and 32 cases of nasal cancer were observed v 1.8 expected (SIR 18.0, 95% CI 12-25). The Poisson regression analysis showed an excess risk of lung cancer in association with exposure to soluble forms of nickel, with a threefold increase in relative risk (RR) (P < 0.001) and a multiplicative effect of smoking and exposure to nickel. The RRs were 1.1 (95% CI 0.2-5.1) for exposed workers who had never smoked and 5.1 (95% CI 1.3-20.5) for exposed workers who smoked.Conclusion-It is not possible to state with certainty which specific nickel compounds are carcinogenic, but a significant excess risk was found for workers exposed to soluble nickel alone or in combination with other forms of nickel. The present study suggests a multiplicative effect of smoking and nickel exposure.