ENVIRONMENTAL EXPOSURES AND RISK OF DIGESTIVE CANCERS

申请者最近发现了几种过度的消化系统癌症。 对一大群有接触的汽车工人的先天兴趣 到金属加工液。自从上次申请以来，我们已经完成了 基于全面内部比较的暴露-反应分析 一群汽车工人。根据泊松回归模型的结果， 统计上显著的相对风险最高可达三倍。 食道癌与不断增加的MF暴露水平之间 研磨作业的过程。较弱关联的证据， 在1.5到2.0之间，在研磨和胃部之间观察到 胰腺癌。也观察到了强有力的证据表明两者之间存在联系 直接加工液和直肠癌和喉癌之间的关系。 这项修订后的提案要求基金采取下一个合乎逻辑的步骤来 进一步检查食道癌、胃癌、 一系列嵌套式病例对照分析中的胰腺、结肠和直肠。 对曝光数据提出了一些补充意见。相比之下， 然而，之前的提议将不会有额外的情况 确定。估计接触硫磺、氯、 精选的金属、亚硝胺和杀生剂现已上市。半- 硫磺和多环芳烃暴露的定量估计 碳氢化合物(PAH)将在拟议的研究范围内开发。 NIOSH估计，美国有120万名工人从事金属工作 磨削或机械加工作业会暴露在这些液体中，而在 600万工人更普遍地接触到 液体。所有要评估的成分和常见添加剂 拟议的研究是已知或可疑的致癌物质、肿瘤促进剂或 共同致癌物质。更好地说明这项工作中的因果关系(S) 环境对于评估与金属有关的风险是必不可少的 今天使用的工作液。

The applicants have recently found excesses of several digestive cancers of a priori interest in a large cohort of automobile workers with exposure to metal working fluids. Since the previous application we have completed an exposure-response analysis based on internal Comparisons in the full cohort of autoworkers. Based on results of Poisson regression models, statistically significant relative risks of up to three fold were found between esophagus cancer and increasing levels of exposure to MF used in the course of grinding operations. Evidence of weaker associations, between 1.5 and 2.0, were observed between grinding and stomach and pancreatic cancer. Strong evidence was also observed for associations between straight machining fluids and rectal and larynx cancer. This revised proposal requests funds to take the next logical step to examine further the elevated risks for cancer of the esophagus, stomach, pancreas, colon and rectum in a series of nested case-control analyses. Some additions to the exposure data are proposed. By contrast with the previous proposal, however, there will be no additional case ascertainment. Estimates of duration of exposure to sulfur, chlorine, selected metals, nitrosamines and biocides are now available. Semi- quantitative estimates of exposure to sulfur and polycyclic aromatic hydrocarbones (PAH) will be developed in the scope of the proposed study. NIOSH has estimated that 1.2 million workers in the US engaged in metal grinding or machining operations are exposed to these fluids, while over 6 million workers are more generally exposed to the various components of the fluids. All of the components and common additives to be evaluated in the proposed study are known or suspect carcinogens, tumor promoters, or co-carcinogens. Better specification of the causal agent(s) in this work environment is essential for an assessment of risk associated with metal working fluids in use today.