Polycyclic aromatic hydrocarbons and fatal ischemic heart disease
Polycyclic aromatic hydrocarbons and fatal ischemic heart disease
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DOI：
10.1097/01.ede.0000181310.65043.2f
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发表时间：
2005-11-01
期刊：
影响因子：
5.4
通讯作者：
Boffetta, P
中科院分区：
文献类型：
--
作者：
Burstyn, I;Kromhout, H;Boffetta, P
背景资料：多项毒理学和流行病学研究已经证明，多环芳烃（PAH）的职业暴露是缺血性心脏病（IHD）的危险因素。然而，一个明确的安全性-反应关系尚未被demonstrated.Methods：我们研究了暴露于PAH和死亡率IHD（418例）之间的关系在一个队列的12,367名男性沥青工人从丹麦，芬兰，法国，德国，以色列，荷兰和挪威。最早的随访（国家特定）始于1953年，最近一次结束于2000年，平均17年。使用测量驱动的暴露模型对苯并（a）芘的暴露进行了定量评估。根据公司代表提供的资料，以半定量的方式评估了煤焦油的接触情况。我们进行了敏感性分析，以评估潜在的混杂烟草smoking.Results：苯并（a）芘的累积和平均暴露指数与IHD的死亡率呈正相关。平均苯并（a）芘暴露量为273 ng/m3或更高时，观察到致死性IHD的最高相对风险，其相对风险为1.64（95%置信区间= 1.13-2.38）。煤焦油暴露也得到了类似的结果。敏感性分析表明，即使在一个现实的情况下，吸烟的混杂，我们会观察到约20%至40%的过量风险IHD在最高的PAH暴露categorization.Conclusions：我们的研究结果提供支持的假设，职业PAH暴露导致致命的IHD，并表现出一致的安全性-反应关系，这种关联。
Background: Several toxicologic and epidemiologic studies have produced evidence that occupational exposure to polycyclic aromatic hydrocarbons (PAH) is a risk factor for ischemic heart disease (IHD). However, a clear exposure-response relation has not been demonstrated.Methods: We studied a relation between exposure to PAH and mortality from IHD (418 cases) in a cohort of 12,367 male asphalt workers from Denmark, Finland, France, Germany, Israel, The Netherlands and Norway. The earliest follow up (country-specific) started in 1953 and the latest ended in 2000, averaging 17 years. Exposures to benzo(a)pyrene were assessed quantitatively using measurement-driven exposure models. Exposure to coal tar was assessed in a semiquantitative manner on the basis of information supplied by company representatives. We carried out sensitivity analyses to assess potential confounding by tobacco smoking.Results: Both cumulative and average exposure indices for benzo(a)pyrene were positively associated with mortality from IHD. The highest relative risk for fatal IHD was observed for average benzo(a)pyrene exposures of 273 ng/m(3) or higher, for which the relative risk was 1.64 (95% confidence interval = 1.13-2.38). Similar results were obtained for coal tar exposure. Sensitivity analysis indicated that even in a realistic scenario of confounding by smoking, we would observe approximately 20% to 40% excess risk in IHD in the highest PAH-exposure categories.Conclusions: Our results lend support to the hypothesis that occupational PAH exposure causes fatal IHD and demonstrate a consistent exposure-response relation for this association.