Cholangiocarcinoma among offset colour proof-printing workers exposed to 1,2-dichloropropane and/or dichloromethane
Cholangiocarcinoma among offset colour proof-printing workers exposed to 1,2-dichloropropane and/or dichloromethane
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DOI：
10.1136/oemed-2012-101246
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发表时间：
2013-07-01
影响因子：
4.9
通讯作者：
Ichihara, Gaku
中科院分区：
文献类型：
--
作者：
Kumagai, Shinji;Kurumatani, Norio;Ichihara, Gaku
目的了解日本大阪某小型印刷公司胶印彩色打样作业工人职业性化学物质暴露与胆管癌发病的关系。方法调查1991~2006年间在打样车间工作的51人和在前厅工作满1年以上的11人。我们就他们使用的化学品采访了他们，并估计了他们接触化学品的水平。调查11例胆管癌患者的病历资料，计算1991~2011年的标化死亡率(SMR)。结果1985~2006年工人使用1，2-二氯丙烷(1，2-DCP)，1985~1997/1998年使用二氯甲烷(DCM)。在打样工人中，1，2-DCP的暴露浓度估计为100-670ppm，DCM的暴露浓度为80-540ppm。11例患者均经病理诊断为胆管细胞癌。在6名死者中，确诊年龄为25-45岁，死亡年龄为27-46岁。原发癌部位为肝内胆管5例，肝外胆管6例。所有患者均接触1，2-二氯苯酚7~17年，并在首次接触后7~20年诊断为胆管癌。10例患者还暴露于DCM 1-13年。胆管细胞癌的SMR值为2900(预期死亡：0.00204人，95%可信区间为1100~6400)。
Objectives The present study was conducted to investigate the relationship between occupational chemical exposure and incidence of cholangiocarcinoma among workers in the offset colour proof-printing section of a small printing company in Osaka, Japan.Methods We identified 51 men who had worked in the proof-printing room, and 11 men who had worked in the front room for at least 1 year between 1991 and 2006. We interviewed them about the chemicals they used, and estimated their levels of exposure to chemicals. We also investigated the medical records of 11 cholangiocarcinoma patients, and calculated the standardised mortality ratio (SMR) from 1991 to 2011.Results Workers used 1,2-dichloropropane (1,2-DCP) from approximately 1985 to 2006, and dichloromethane (DCM) from approximately 1985 to 1997/1998. Exposure concentrations were estimated to be 100-670 ppm for 1,2-DCP and 80-540 ppm for DCM among the proof-printing workers. All 11 patients were pathologically diagnosed with cholangiocarcinoma. Ages at diagnosis were 25-45 years, and ages at death were 27-46 years among the six deceased individuals. The primary cancer site was the intrahepatic bile duct for five patients, and the extrahepatic bile ducts for six. All patients were exposed to 1,2-DCP for 7-17 years and diagnosed with cholangiocarcinoma 7-20 years after their first exposure. Ten patients were also exposed to DCM for 1-13 years. The SMR for cholangiocarcinoma was 2900 (expected deaths: 0.00204, 95% CI 1100 to 6400) for all workers combined.Conclusions These findings suggest that 1,2-DCP and/or DCM may cause cholangiocarcinoma in humans.