Occupational exposures and risk of esophageal and gastric cardia cancers among male Swedish construction workers
Occupational exposures and risk of esophageal and gastric cardia cancers among male Swedish construction workers
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DOI：
10.1007/s10552-005-1723-2
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发表时间：
2005-08-01
影响因子：
2.3
通讯作者：
Lagergren, J
中科院分区：
文献类型：
--
作者：
Jansson, C;Johansson, ALV;Lagergren, J
目的：食管和贲门腺癌发病率的上升和男性患者的明显优势仍然无法解释。我们假设传统男性主导行业中的职业空气暴露可能有助于这些观察结果。方法：对瑞典建筑工人进行的一项前瞻性大型队列研究与瑞典基于人口的癌症、死亡原因和总人口登记册相关联。从1971年到2000年，对260，052名男性进行了跟踪调查。工业卫生学家评估了200个职位的具体暴露，职业空气暴露分别和合并进行了分析。采用多变量考克斯回归模型估计发病率比（IRR）及其95%置信区间（CI），该模型调整了实际年龄、日历周期、吸烟状况和体重。我们发现大量接触石棉（IRR 4.5 [95% CI 1.4-14.3]）和水泥粉尘（IRR 3.8 [95% CI 1.5-9.6]）与食管腺癌风险之间的关系。沥青烟雾（IRR 2.3 [95% CI 1.0-5.3]）和木尘（IRR 4.8 [95% CI 1.2-19.4]）的高暴露与贲门腺癌风险之间存在相关性。没有一致的协会食管鳞状细胞癌被发现。结论：暴露于石棉和水泥粉尘可能是食管腺癌的危险因素，暴露于沥青烟雾和木材粉尘可能会增加贲门腺癌的风险。然而，这些关联不能解释这些肿瘤的主要性别差异或发病率增加的趋势。
Objective: The rising incidence and the strong male predominance among patients with esophageal and gastric cardia adenocarcinoma remain unexplained. We hypothesized that occupational airborne exposures in a traditional male dominated industry might contribute to these observations.Methods: A prospective, large cohort study of Swedish construction workers was linked to the Swedish population-based registers of Cancer, Causes of Death and Total Population. 260,052 men were followed from 1971 through 2000. Industrial hygienists assessed specific exposures for 200 job titles, and occupational airborne exposures were analyzed separately and combined. Incidence rate ratios (IRR), with 95% confidence intervals (CI), were estimated in multivariable Cox regression models adjusted for attained age, calendar period, smoking status and body mass.Results: We found positive associations between high exposure to asbestos (IRR 4.5 [95% CI 1.4-14.3]) and cement dust (IRR 3.8 [95% CI 1.5-9.6]) and risk of esophageal adenocarcinoma. Associations were seen between high exposure to asphalt fumes (IRR 2.3 [95% CI 1.0-5.3]) and wood dust (IRR 4.8 [95% CI 1.2-19.4]) and risk of cardia adenocarcinoma. No consistent associations regarding esophageal squamous-cell carcinoma were found.Conclusions: Exposure to asbestos and cement dust may be risk factors for esophageal adenocarcinoma, and exposure to asphalt fumes and wood dust may increase the risk of cardia adenocarcinoma. However, these associations cannot explain the major sex differences or the increasing incidence trends of these tumors.