Exposure-specific lung cancer risks in Chinese chrysotile textile workers and mining workers.
Exposure-specific lung cancer risks in Chinese chrysotile textile workers and mining workers.
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DOI：
10.1016/j.lungcan.2014.04.011
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发表时间：
2014-08
期刊：
影响因子：
5.3
通讯作者：
Xiaorong Wang;Sihao Lin;E. Yano;I. Yu;Midori N. Courtice;Y. Lan;D. Christiani
中科院分区：
文献类型：
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作者：
Xiaorong Wang;Sihao Lin;E. Yano;I. Yu;Midori N. Courtice;Y. Lan;D. Christiani
目的 接触温石棉的采矿工人和纺织工人之间肺癌的暴露-反应斜率是否存在差异尚未得到充分证实。本研究旨在评估中国温石棉纺织工人和采矿工人的特定暴露肺癌风险。对象和方法温石棉采矿工人队列和温石棉纺织工人队列同时观察26年。收集了工人的生命状况、职业史和吸烟习惯等信息，并从死亡登记处核实了死亡原因和日期。根据不同车间的定期灰尘/纤维测量、职位和持续时间估算个人累积纤维暴露量，并将其分为四个级别（Q1-Q4）。参考全国死亡率，按行业和职称计算并分层肺癌标准化死亡率（SMR）。 Cox比例风险模型适合估计年龄和吸烟情况后的特定暴露肺癌风险，其中由未接触石棉的产业工人组成的外部对照队列被用作纺织和采矿工人的参考组。结果SMR与职称和车间的暴露水平几乎一致。在两个队列中都观察到肺癌死亡率和暴露水平之间存在明显的暴露-反应关系。在低暴露水平（第一季度和第二季度）下，纺织工人患肺癌的死亡风险高于采矿工人。然而，在较高暴露水平下观察到同样相当高的风险，在调整年龄和吸烟后，纺织工人和采矿工人在第三季度和第四季度的风险比分别超过8和11。结论在相对较低的暴露水平下，温石棉纺织工人似乎比采矿工人有更高的肺癌风险，但在高暴露水平下没有观察到差异，两个队列都表现出相当高的风险。
ObjectiveWhether there is a difference in the exposure–response slope for lung cancer between mining workers and textile workers exposed to chrysotile has not been well documented. This study was carried out to evaluate exposure-specific lung cancer risks in Chinese chrysotile textile workers and mining workers.Subjects and methodsA chrysotile mining worker cohort and a chrysotile textile worker cohort were observed concurrently for 26 years. Information on workers’ vital status, occupational history and smoking habits were collected, and causes and dates of deaths were verified from death registries. Individual cumulative fiber exposures were estimated based on periodic dust/fiber measurements from different workshops, job title and duration, and categorized into four levels (Q1–Q4). Standardized mortality ratios (SMRs) for lung cancer were calculated and stratified by industry and job title with reference of the national rates. Cox proportional hazard models were fit to estimate the exposure-specific lung cancer risks upon adjustment for age and smoking, in which an external control cohort consisting of industrial workers without asbestos exposure was used as reference group for both textile and mining workers.ResultsSMRs were almost consistent with exposure levels in terms of job titles and workshops. A clear exposure–response relationship between lung cancer mortality and exposure levels was observed in both cohorts. At low exposure levels (Q1 and Q2), textile workers displayed higher death risks of lung cancer than mining workers. However, similarly considerably high risks were observed at higher exposure levels, with hazard ratios of over 8 and 11 at Q3 and Q4, respectively, for both textile and mining workers, after both age and smoking were adjusted.ConclusionThe chrysotile textile workers appeared to have a higher risk of lung cancer than the mining workers at a relatively low exposure level, but no difference was observed at a high exposure level, where both cohorts displayed a considerably high risk.