Risk of Cancer Among Workers Exposed to Trichloroethylene: Analysis of Three Nordic Cohort Studies
Risk of Cancer Among Workers Exposed to Trichloroethylene: Analysis of Three Nordic Cohort Studies
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DOI：
10.1093/jnci/djt107
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发表时间：
2013-06-01
影响因子：
10.3
通讯作者：
McLaughlin, Joseph K.
中科院分区：
文献类型：
--
作者：
Hansen, Johnni;Sallmen, Markku;McLaughlin, Joseph K.
三氯乙烯（TCE）是一种广泛使用的氯化溶剂，在动物试验中证明具有致癌性。一些流行病学研究报告了肾癌、宫颈癌、肝癌和胆道癌、非霍奇金淋巴瘤和食管腺癌的风险增加，我们建立了一个汇总队列，包括芬兰、瑞典和丹麦的5553名有记录的TCE暴露工人。从1947年到1989年，研究参与者被监测尿液中TCE代谢物三氯乙酸，并跟踪癌症。根据三个国家人群的癌症发病率计算标准化发病率比（SIR）。考克斯比例风险分析用于内部比较。统计学显著性检验是双侧的。总体而言，在154778人年的随访中，确定了997例癌症病例（男性683例，女性314例）。我们观察到原发性肝癌（1.93; 95%置信区间[CI] 1.19至2.95）和宫颈癌（2.31; 95% CI 1.32至3.75）的标准化发病率在统计学上显著升高。基于32例病例，肾癌的标准化发病率比为1.01（95% CI 0.70 - 1.42）;我们未观察到非霍奇金淋巴瘤（SIR 1.26; 95% CI 0.89 - 1.73）或食管腺癌（SIR 1.84; 95% CI 0.65 - 4.65）的风险统计学显著增加。与烟草和酒精相关的癌症在统计学上没有显着增加。我们的结果表明TCE暴露可能与肝癌风险增加有关。TCE暴露与低发病率癌症风险之间的关系以及受生活方式和我们队列中未知的其他因素混淆的癌症风险之间的关系需要进一步研究。
Trichloroethylene (TCE) is a widely used chlorinated solvent with demonstrated carcinogenicity in animal assays. Some epidemiologic studies have reported increased risk of cancer of the kidney, cervix, liver and biliary passages, non-Hodgkin lymphoma, and esophageal adenocarcinoma.We established a pooled cohort, including 5553 workers with individual documented exposure to TCE in Finland, Sweden, and Denmark. Study participants were monitored for the urinary TCE metabolite trichloroacetic acid from 1947 to 1989 and followed for cancer. Standardized incidence ratios (SIRs) were calculated based on cancer incidence rates in the three national populations. Cox proportionate hazard analyses were used for internal comparisons. Tests of statistical significance are two-sided.Overall, 997 cases of cancer (n 683 in men; n 314 in women) were identified during 154 778 person-years of follow-up. We observed statistically significant elevated standardized incidence ratios for primary liver cancer (1.93; 95% confidence interval [CI] 1.19 to 2.95) and cervical cancer (2.31; 95% CI 1.32 to 3.75). The standardized incidence ratio for kidney cancer was 1.01 (95% CI 0.70 to 1.42) based on 32 cases; we did not observe a statistically significant increased risk of non-Hodgkins lymphoma (SIR 1.26; 95% CI 0.89 to 1.73) or esophageal adenocarcinoma (SIR 1.84; 95% CI 0.65 to 4.65). Tobacco- and alcohol-associated cancers were not statistically significantly increased.Our results suggest TCE exposure is possibly associated with an increased risk for liver cancer. The relationship between TCE exposure and risks of cancers of low incidence and those with confounding by lifestyle and other factors not known in our cohort require further study.