Cancer mortality in workers exposed to phenoxy herbicides, chlorophenols, and dioxins - An expanded and updated international cohort study
Cancer mortality in workers exposed to phenoxy herbicides, chlorophenols, and dioxins - An expanded and updated international cohort study
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DOI：
10.1093/oxfordjournals.aje.a009069
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发表时间：
1997-06-15
影响因子：
5
通讯作者：
Saracci, R
中科院分区：
文献类型：
--
作者：
Kogevinas, M;Becher, H;Saracci, R
作者在一项历史队列研究中检查了12个国家36个暴露于苯氧基除草剂，氯酚和二恶英的21，863名男女工人的癌症死亡率。这项由国际癌症研究机构协调的更新和扩展的多国研究的受试者从1939年到1992年进行了随访。暴露重建工作记录，公司接触问卷，血清和脂肪组织二恶英水平。在接触受2，3，7，8-四氯二苯并对二恶英（TCDD）或更高氯化二恶英污染的苯氧除草剂的工人中，软组织肉瘤的死亡率（6人死亡;标准化死亡率（SMR）= 2.03，95%置信区间（CI）0.75-4.43）高于全国死亡率的预期。所有恶性肿瘤（710例死亡; SMR = 1.12，95% CI 1.04-1.21）、非霍奇金淋巴瘤（24例死亡; SMR = 1.39，95% CI 0.89-2.06）和肺癌（225例死亡; SMR = 1.12，95% CI 0.98-1.28）的死亡率略有升高。自首次接触以来，所有肿瘤、肉瘤和淋巴瘤的风险均随时间增加。在接触苯氧基除草剂的工人中，（398例死亡; SMR = 0.96，95% CI 0.87-1.06），非霍奇金淋巴瘤（9例死亡; SMR = 1.00）和肺癌（148例死亡; SMR = 1.03）与预期相似，软组织肉瘤的死亡率略有升高（2例死亡; SMR = 1.35）。在泊松回归分析中，暴露于四氯二苯并对二恶英或更高氯代二恶英的工人与暴露于苯氧基除草剂和氯酚但很少或没有暴露于四氯二苯并对二恶英和更高氯代二恶英的同一队列的工人相比，所有肿瘤的风险增加（率比= 1.29，95% CI 0.94-1.76）。这些研究结果表明，接触被四氯二苯并对二恶英和高氯二恶英污染的除草剂可能与总体癌症风险和特定癌症风险的小幅增加有关。
The authors examined cancer mortality in a historical cohort study of 21,863 male and female workers in 36 cohorts exposed to phenoxy herbicides, chlorophenols, and dioxins in 12 countries. Subjects in this updated and expanded multinational study coordinated by the International Agency for Research on Cancer were followed from 1939 to 1992. Exposure was reconstructed using job records, company exposure questionnaires, and serum and adipose tissue dioxin levels. Among workers exposed to phenoxy herbicides contaminated with 2,3,7,8-tetrachlorodibenzo-p-dioxin (TCDD) or higher chlorinated dioxins, mortality from soft-tissue sarcoma (6 deaths; standardized mortality ratio (SMR) = 2.03, 95% confidence interval (CI) 0.75-4.43) was higher than expected from national mortality rates. Mortality from all malignant neoplasms (710 deaths; SMR = 1.12, 95% CI 1.04-1.21), non-Hodgkin's lymphoma (24 deaths; SMR = 1.39, 95% CI 0.89-2.06), and lung cancer (225 deaths; SMR = 1.12, 95% CI 0.98-1.28) was slightly elevated. Risks for all neoplasms, for sarcomas, and for lymphomas increased with time since first exposure. In workers exposed to phenoxy herbicides with minimal or no contamination by TCDD and higher chlorinated dioxins, mortality from all neoplasms (398 deaths; SMR = 0.96, 95% CI 0.87-1.06), non-Hodgkin's lymphoma (9 deaths; SMR = 1.00), and lung cancer (148 deaths; SMR = 1.03) was similar to that expected, and mortality from soft-tissue sarcoma was slightly elevated (2 deaths; SMR = 1.35). In a Poisson regression analysis, workers exposed to TCDD or higher chlorinated dioxins had an increased risk for all neoplasms (rate ratio = 1.29, 95% CI 0.94-1.76) compared with workers from the same cohort exposed to phenoxy herbicides and chlorophenols but with minimal or no exposure to TCDD and higher chlorinated dioxins. These findings indicate that exposure to herbicides contaminated with TCDD and higher chlorinated dioxins may be associated with a small increase in overall cancer risk and in risk for specific cancers.