Mortality from lymphohematopoietic malignancies among workers in formaldehyde industries
Mortality from lymphohematopoietic malignancies among workers in formaldehyde industries
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DOI：
10.1093/jnci/djg083
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发表时间：
2003-11-05
影响因子：
10.3
通讯作者：
Blair, A
中科院分区：
文献类型：
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作者：
Hauptmann, M;Lubin, JH;Blair, A
背景：许多美国工厂工人暴露在甲醛中。虽然在接触甲醛的医务工作者和其他专业人员中发现患白血病的风险增加，但对被认为接触甲醛较多的工业工人的研究却显示出不一致的关联。我们延长了一组产业工人的随访，以评估甲醛暴露与淋巴造血癌之间的关系。方法：该队列包括25 619名工人（865 708人年），于1966年1月1日之前在美国10家工业工厂之一工作，并随访至1994年12月31日。我们分析了甲醛暴露（峰值暴露、平均暴露强度、累积暴露和暴露持续时间）和淋巴造血恶性肿瘤的死亡率，使用标准化死亡率、相对风险和基于泊松回归的95%置信区间（ci）。统计检验是双侧的。结果：队列中有178例死于淋巴造血恶性肿瘤。白血病（69例死亡），特别是髓性白血病（30例死亡）的相对风险随着甲醛暴露而增加。与暴露于低峰值水平甲醛（0.1-1.9 ppm）的工人相比，暴露于峰值水平2.0-3.9 ppm和大于或等于4.0 ppm的工人患髓性白血病的相对风险分别为2.43 （95% CI = 0.81至7.25）和3.46 (95% CI = 1.27至9.43)（P-trend = 0.009）。与暴露于低水平甲醛平均暴露强度（0.1-0.4 ppm）的工人相比，暴露于0.5-0.9 ppm和大于或等于1.0 ppm平均暴露强度的工人的相对风险分别为1.15 （95% CI = 0.41至3.23）和2.49 (95% CI = 1.03至6.03)（p趋势= 0.088）。白血病的相对危险度与累积暴露无关，但与暴露时间有弱相关性。霍奇金氏病的相对风险也随着甲醛的暴露而增加。结论：暴露于甲醛可能导致人类白血病，特别是髓性白血病。然而，其他调查的结果好坏参半，表明在得出明确结论时要谨慎。
Background: Many U.S. factory workers are exposed to formaldehyde. Although increased risks for leukemia have been found in medical workers and other professionals exposed to formaldehyde, studies in industrial workers, who are thought to have higher exposures, have shown inconsistent associations. We extended follow-up of a cohort of industrial workers to evaluate the association between formaldehyde exposure and lymphohematopoietic cancers. Methods: The cohort consisted of 25 619 workers (865 708 person-years) employed before January 1, 1966, at one of 10 U.S. industrial plants and followed through December 31, 1994. We analyzed formaldehyde exposure (peak exposure, average exposure intensity, cumulative exposure, and duration of exposure) and mortality from lymphohematopoietic malignancies using standardized mortality ratios and relative risks and 95% confidence intervals (CIs) based on Poisson regression. Statistical tests were two-sided. Results: Among the cohort, there were 178 deaths from lymphohematopoietic malignancies. Relative risks for leukemia (69 deaths), particularly for myeloid leukemia (30 deaths), increased with formaldehyde exposure. Compared with workers exposed to low peak levels of formaldehyde (0.1-1.9 ppm), relative risks for myeloid leukemia were 2.43 (95% CI = 0.81 to 7.25) and 3.46 (95% CI = 1.27 to 9.43) for workers exposed to peak levels of 2.0-3.9 ppm and greater than or equal to4.0 ppm, respectively (P-trend =.009). Compared with workers exposed to low levels of average exposure intensity of formaldehyde (0.1-0.4 ppm), workers exposed to 0.5-0.9 ppm and greater than or equal to1.0 ppm average intensity had relative risks of 1.15 (95% CI = 0.41 to 3.23) and 2.49 (95% CI = 1.03 to 6.03), respectively (P-trend =.088). The relative risk for leukemia was not associated with cumulative exposure but was weakly associated with duration of exposure. Relative risks for Hodgkin's disease also increased with formaldehyde exposure. Conclusions: Exposure to formaldehyde may cause leukemia, particularly myeloid leukemia, in humans. However, results from other investigations are mixed, suggesting caution in drawing definitive conclusions.