MORTALITY IN WORKERS WITH INTERMITTENT ASBESTOS EXPOSURE

石棉暴露的有害影响已被确定在许多 参与开采和制造石棉产品的群体。这 提案要求资金用于队列和嵌套的易控分析， 钣金工人、建筑业从业员及 间歇性石棉暴露。 虽然有几项研究描述了石棉暴露的影响， 关于建筑工人的健康，大多数是横向的， 筛查项目或比例死亡率分析。这些研究 证明存在石棉相关疾病，但由于 方法的局限性不能量化风险水平：大多数 关于建筑中石棉疾病风险的数据来自 从绝缘体的研究。然而，绝缘体，面临的风险远 高于大多数建筑行业。调查 钣金工人的死亡率提供了直接 在一个队列中测量石棉相关疾病的风险， 间歇性石棉暴露，继发于他们的建筑工作。 拟议研究的另一个独特优势是有机会 联合收割机将死亡率分析与筛查结果结合起来 与石棉有关的疾病。1986年，钣金工人 这一群体的成员被邀请参加一个全国性的 医疗筛查计划。关于工作历史、工作任务、当前 症状，吸烟史和肺功能测试结果- 为12 454名工会成员提供了胸部X光检查。存在 这些数据允许探索与健康状况有关的假设 在医学筛查时，随后死亡。 还建议在筛选队列中进行巢式病例对照研究 检查是否有放射学迹象的重要问题， 石棉暴露，胸膜和实质改变，预测肺癌 mortality.为了提高X射线数据的质量， “B”读取器将重新读取所有X线片。 最后，比较不同人群的死因特异性死亡率 参与筛查计划的人（受访者） 不（非应答者），将允许检查参与偏倚。这 在职业队列中，探索参与偏倚的能力是罕见的 问题研究

The harmful effects of asbestos exposure have been identified in numerous cohorts involved in the mining and fabrication of asbestos products. This proposal requests funds for a cohort and nested ease-control analysis of mortality among Sheet Metal Workers, members of the building trades with significant, intermittent asbestos exposure. Although several studies have described the effect of asbestos exposure on health of construction workers, the majority have been cross-sectional screening programs or analyses of proportionate mortality. These studies demonstrate the presence of asbestos related disease, but due to methodological limitations do not quantify levels of risk: The majority of data available on the risk of asbestos disease in construction comes from studies of insulators. However, insulators, faced exposures far higher than the majority of the building trades. Investigation of mortality in Sheet Metal Workers provides the opportunity to directly measure the risk of asbestos related disease in a cohort with intermittent asbestos exposure, secondary to their work in construction. A further, unique advantage of the proposed study is the opportunity to combine the analysis of mortality with the findings of a screening program for asbestos related disease. In 1986, Sheet Metal Workers who were members of this cohort were invited to participate in a nationwide medical screening program. Data on work history, job tasks, current symptoms, smoking histories and the results of pulmonary function tests - and chest x-rays are available for 12,454 union members. The existence of these data allows the exploration of hypotheses relating health status at the time of medical screening with subsequent mortality. A nested case-control study within the screened cohort is also proposed to examine the important question of whether radiographic signs of asbestos exposure, pleural and parenchymal changes, predict lung cancer mortality. To increase the quality of the x-ray data, a panel of three "B" readers will re-read all x-rays. Finally, comparison of cause specific mortality between the population participating in the screening program (respondents) with those who did not (non-respondents), will allow examination of participation bias. This ability to explore participation bias is rare in occupational cohort studies.