Lung cancer among workers in chromium chemical production.
Lung cancer among workers in chromium chemical production.
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DOI：
10.1002/1097-0274(200008)38:2
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发表时间：
2000-08
影响因子：
3.5
通讯作者：
H. Gibb;P. Lees;P. Pinsky;B. C. Rooney
中科院分区：
文献类型：
--
作者：
H. Gibb;P. Lees;P. Pinsky;B. C. Rooney
背景铬酸盐生产设施工人肺癌风险升高以前曾有报道。这种过度的风险被认为是暴露于六价铬的结果。关于三价铬暴露是否也与肺癌风险过高有关，有不同的报道。以前的研究测量六价铬暴露和肺癌风险没有检查吸烟作为一个危险因素。方法：对1950年至1974年在铬酸盐生产厂首次就业的2,357名工人进行了队列研究。工人的生命状况一直跟踪到1992年12月31日。队列成员的工作历史是从就业开始到1985年工厂关闭的那一年汇编的。1950年至1985年，根据历史接触测量结果，对该厂每个职位的年平均接触量进行了估计。这些暴露估计值用于计算研究人群中每个成员的累积六价铬暴露。工厂关闭后，收集了沉降的灰尘样品，并分析了六价铬和三价铬。每个厂区的三价/六价铬浓度比与历史空气采样数据相结合，以估计研究队列中每个个体的累积三价铬暴露量。从公司记录中确定了入职时的吸烟状态（是/否）和潜在铬刺激的临床体征。结果六价铬累积暴露与肺癌的发生呈明显的剂量-反应关系。临床症状的刺激，累积三价铬暴露，并没有发现持续时间与肺癌的风险时，包括在一个比例风险模型与累积六价铬暴露和吸烟。提供了关于累积六价铬暴露、观察到的和预期的肺癌病例数以及观察人年的特定数据。结论：六价铬累积暴露与肺癌风险增加相关，而三价铬累积暴露则与肺癌风险增加无关。与累积六价铬暴露相关的肺癌过度风险不受吸烟状况的混淆。目前的研究为六价铬暴露与肺癌之间的关系提供了迄今为止最好的定量证据。Am. J. Ind. Med. 38：115-126，2000.出版2000 Wiley-Liss，Inc.
BACKGROUND An elevated risk of lung cancer among workers in chromate production facilities has previously been reported. This excess risk is believed to be the result of exposure to hexavalent chromium. There have been mixed reports about whether trivalent chromium exposure is also associated with an excess lung cancer risk. Previous studies of measured hexavalent chromium exposure and lung cancer risk have not examined cigarette smoking as a risk factor. METHODS A cohort of 2,357 workers first employed between 1950 and 1974 at a chromate production plant was identified. Vital status of the workers was followed until December 31, 1992. Work histories of cohort members were compiled from the beginning of employment through 1985, the year the plant closed. Annual average exposure estimates, based on historical exposure measurements, were made for each job title in the plant for the years 1950-1985. These exposure estimates were used to calculate the cumulative hexavalent chromium exposure of each member of the study population. Following closure of the plant, settled dust samples were collected and analyzed for hexavalent and trivalent chromium. The trivalent/hexavalent concentration ratios in each plant area were combined with historic air-sampling data to estimate cumulative trivalent chromium exposure for each individual in the study cohort. Smoking status (yes/no) as of the beginning of employment and clinical signs of potential chromium irritation were identified from company records. RESULTS Cumulative hexavalent chromium exposure showed a strong dose-response relationship for lung cancer. Clinical signs of irritation, cumulative trivalent chromium exposure, and duration of work were not found to be associated with a risk of lung cancer when included in a proportional hazards model with cumulative hexavalent chromium exposure and smoking. Age-specific data on cumulative hexavalent chromium exposure, observed and expected numbers of lung cancer cases, and person-years of observation are provided. CONCLUSIONS Cumulative hexavalent chromium exposure was associated with an increased lung cancer risk; cumulative trivalent chromium exposure was not. The excess risk of lung cancer associated with cumulative hexavalent chromium exposure was not confounded by smoking status. The current study offers the best quantitative evidence to date of the relationship between hexavalent chromium exposure and lung cancer. Am. J. Ind. Med. 38:115-126, 2000. Published 2000 Wiley-Liss, Inc.