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1.
Although female breast cancer rates are lower in China than in Western countries, rates have been rising rapidly in China. This increase may be due to changes in established breast cancer risk factors, but it is possible that exposure to occupational and environmental carcinogens in Shanghai also have contributed to the rise in incidence. We used data collected by the Shanghai Cancer Registry and the Chinese Third National Census to study the risk of breast cancer by occupation and by occupational exposures. Standardized incidence ratios (SIRs) were used to compare observed cases to expected numbers of cases, based on the incidence rates for Shanghai and the number of women in each occupation according to the 1982 census. Statistically elevated SIRs for breast cancer were seen for a number of professional occupational categories, with the greatest risk seen among scientific research workers (SIR = 3.3). Administrative clerks, political and security personnel, and makers of rubber and plastics products also had significant excesses. Significant deficits of risk were seen for the categories of production and related workers, construction workers, and transportation equipment operators. For specific occupations, the highest SIRs were observed among doctors of Chinese-Western medicine (SIR = 14.7, 95% CI = 5.9-30.3) and doctors of Chinese medicine (SIR = 7.2, 95% CI = 4.4-11.4). We also found excesses among teachers at each level of education, librarians, clerical workers, electrical and electronic engineers, nurses, lab technicians, accountants and bookkeepers, rubber manufacturing products makers, weavers, and knitters. SIRs were significantly elevated for high probability of exposure to organic solvents (SIR = 1.4). For benzene exposure, we found significant excesses for overall exposure (SIR = 1.1) and for medium level of exposure (SIR = 1.3). There was no evidence of an association between risk and electromagnetic fields (EMF) exposure. Based on a small number of exposed, SIRs were elevated for both medium probability and high level of exposure to pesticides. The elevations in occupations reported here support some previous reports. Our finding of an increased risk associated with benzene also has been reported previously; the finding for organic solvents is new. However, the literature on the risk of breast cancer related to occupational exposures is limited and there is no consistent body of literature for any of the exposures studied here. Further, many comparisons were made and the problem of multiple hypothesis testing cannot be ignored in a survey such as ours.  相似文献   

2.
STUDY OBJECTIVE: To evaluate the influence of occupational exposure to carcinogens in explaining the association between socioeconomic status and lung cancer. DESIGN: A prospective cohort study. Data on diet, other lifestyle factors, sociodemographic characteristics and job history were collected by means of a self administered questionnaire. Follow up for incident cancer was established by record linkage with a national pathology register and with regional cancer registries. SETTING: Population originating from 204 municipalities in The Netherlands. PARTICIPANTS: These comprised 58 279 men aged 55-69 years in September 1986. After 4.3 years of follow up there were 470 microscopically confirmed incident lung cancer cases with complete data on dietary habits and job history. MEASUREMENTS AND MAIN RESULTS: Estimation of occupational exposure to asbestos, paint dust, polycyclic aromatic hydrocarbons, and welding fumes was carried out by two experts, using information on job history from the baseline questionnaire. Socioeconomic status was measured by means of highest attained level of education and two indicators based on occupation. In the initial multivariate analyses of socioeconomic status and lung cancer, adjustment was made for age, smoking habits, intake of vitamin C, beta-carotene and retinol, and history of chronic obstructive pulmonary disease or asthma. Additional adjustment for occupational exposure to the four carcinogens mentioned above did not change the inverse association between the level of education and lung cancer risk (initial model: RR highest/lowest level of education = 0.53; 95% CI 0.34, 0.82; additional model: RR highest/lowest level of education = 0.53; 95% CI 0.34, 0.84). Nor was the association between the two occupation based indicators of socioeconomic status and lung cancer risk influenced by occupational exposure to carcinogens. The effect of occupational exposure on the association between the level of education and lung cancer risk did not differ between ex-smokers and current smokers. CONCLUSIONS: Occupational exposure to asbestos, paint dust, polycyclic aromatic hydrocarbons, and welding fumes could not explain the inverse association between socioeconomic status and lung cancer risk. More research which explicitly addresses possible explanations for the association between socioeconomic status and lung cancer risk is needed.  相似文献   

3.
In the framework of occupational disease surveillance program, based on integration of current information systems, the first Italian occupational mortality study was carried out. This paper reports on excess lung cancer risk by industry and occupation. The study population consists of subjects included in the Italian Cross-Sectional Study (STI) and in the Turin Longitudinal Study (SLT), both of which are surveys based on record-linkage procedures between census records and death certificates. The STI is a six-month follow-up of Italian residents at the 1981 census. The SLT is a prospective study of Turin residents at the 1981 census, followed for mortality up to 1989. Only persons aged 18-64 years at entry, and economically active, were eligible for the occupational mortality analysis (i.e. 15,734 deceased individuals out of 13 million subjects in the STI, and 435,608 individuals, among whom 10,789 deaths occurred, in the SLT). Information about job and economic activity recorded at census consisted of the Italian standard 1981 industry and occupation codes. Lung cancer relative risks by category of industry and job were estimated as mortality odds ratios (MOR) in the STI, and as observed to expected death ratios (SMR) in the SLT. Only excess risks based on > or = 3 observed cases and with p < 0.1, were included in the present report. Lung cancer mortality was increased in different industries and jobs. The excess risks found in the mechanic and transport industries are of particular interest in a public health perspective, due to the high number of Italian workers employed in these sectors. From an etiologic point of view, however, careful attention should be paid to the excess lung cancer risks among workers in the wood manufacturing industry, in meat preparation, and in nursing occupations, where detailed analytical studies of exposure profile and cancer risk are warranted.  相似文献   

4.
We conducted a study of occupation and mortality from reproductive cancers among women, based on death certificates from 24 US states for the period 1984-1993. There were 9,523 cervical cancer deaths, 12,335 endometrial cancer deaths, and 25,212 ovarian cancer deaths. Usual occupation and industry, which were obtained from death certificates, were coded using the 1980 Bureau of Census classification system. Mortality odds ratios (MORs) and 95% confidence intervals (CIs) were calculated, using all non-cancer deaths as the referent disease category. In general, jobs involving professional or administrative occupations were related to increased risk of mortality from endometrial and ovarian cancer, while cervical cancer mortality was increased among women employed in manufacturing, service, farm work, and health care technician and aide occupations. Associations with some occupations involving exposure to chemicals and metals, such as the associations between cervical cancer and employment in printing, typesetting, and machine operating occupations, deserve further attention. Similarly, further investigations should be made into the excess of ovarian cancer observed in several occupations in health care, an industry that has numerous hazardous exposures, including radiation, chemotherapeutic drugs, and viruses. The study results reflect, in part, socioeconomic factors and reproductive patterns but may also indicate a possible etiologic role for occupational chemical exposures.  相似文献   

5.
OBJECTIVES: To investigate whether occupational exposure to organic solvents increases the risk of dementia. METHODS: Cases of dementia were identified from the computed tomography records of eight neuroradiology centres in England and Wales, and were compared with two sets of controls investigated at the same centres. The first set of controls were patients with brain cancer and the second set were patients with other disorders that were not chronically disabling. Lifetime occupational histories were obtained through a postal questionnaire completed by the subjects or their next of kin. Associations between dementia and occupation were examined by logistic regression. RESULTS: Usable questionnaires were returned for 204 (61%) of the cases, 225 (51%) of the controls with brain cancer, and 441 (61%) of the other controls. The findings with each of the two sets of controls were similar. In comparison with all controls combined, cases had less often worked ever as a painter or printer (odds ratio (OR) 0.6, 95% confidence interval (95% CI) 0.3 to 1.2), and were less likely to have worked for > 1 year as a printer, painter, or launderer or dry cleaner (OR 0.6, 95% CI 0.3 to 1.4). CONCLUSIONS: These findings provide no support for the hypothesis that occupational exposure to solvents is a cause of dementia. An excess risk in subsets of workers with extremes of exposure cannot be discounted, but the data indicate that any influence of exposure to solvents on the overall incidence of severe dementia in the general population of England and Wales is small.  相似文献   

6.
A case-control study of nasal cancer, based on death certificate statements on occupation in North Carolina counties with furniture-manufacturing industries, revealed a 4-fold excess risk linked to this occupation. Although woodworking exposures have been associated with nasal adenocarcinomas in several areas of the world, this is the first report of such a relationship in the United States.  相似文献   

7.
OBJECTIVES: Several investigators have reported that African-American men with clinically localized prostate cancer have poorer survival than do white men. In addition, prostate cancer in African-American men is commonly diagnosed at a more advanced stage of disease. Is race or ethnicity predictive of outcome of clinically localized prostate cancer? It has been reported that the presence of positive surgical margins significantly influences time to progression independently of other prognostic factors. Therefore, we have elected to conduct a multivariate analysis of clinical factors including race as potential predictors of positive surgical margin outcome. METHODS: We studied 369 consecutive men (120 African-American and 249 white) who had radical prostatectomies at a single institution. Comparisons by race of Gleason score, stage, presence of positive surgical margins, and mean preoperative prostate-specific antigen (PSA) level were carried out. RESULTS: Our data demonstrate that African-American men have more pathologically locally advanced prostate cancer than do white American men: 69% among blacks compared with 57% among whites. However, the difference in rate of positive surgical margins between blacks and whites is statistically significant: 58% among blacks versus 40% among whites (P = 0.002). Four factors were predictive of positive surgical margins: preoperative PSA level, race, clinical stage, and Gleason score. CONCLUSIONS: We have demonstrated that race is an independent predictor of positive surgical margins among patients with clinically localized prostate cancer and should be included in treatment decisions. In addition, the risk of positive surgical margins increases noticeably when PSA is greater than 10 ng/mL.  相似文献   

8.
OBJECTIVE: To investigate whether risk of male breast cancer is associated with workplace exposures. METHODS: A case-control study of 178 cases of male breast cancer and 1041 controls was carried out with data from the United States national mortality follow-back survey, which collected questionnaire information from proxy respondents of a 1% sample of all 1986 United States deaths among subjects aged 25-74 years. Occupational exposure to electromagnetic fields, high temperatures, polycyclic aromatic hydrocarbons (PAHs), herbicides, other pesticides, and organic solvents was assessed by applying job-exposure matrices, based on the 1980 United States census occupation and industry codes, to the longest job held by study subjects as reported by the informants. A socioeconomic status index was created by combining information on annual family income, education, assets, and occupation to assess the association of socioeconomic status with male breast cancer. Relative risks were derived from logistic regression modelling, which included age, socioeconomic status, marital status, and body mass index, as well as occupational exposures. RESULTS: Risk for male breast cancer increased significantly with increasing socioeconomic status index (test for trend: p < 0.01), but the risks associated with individual socioeconomic status variables were smaller and the trends were not significant. A significant increase in risk of male breast cancer was associated with employment in blast furnaces, steel works, and rolling mills (odds ratio (OR) 3.4; 95% confidence interval (95% CI) 1.1 to 10.1, based on six cases), and motor vehicle manufacturing (OR 3.1; 95% CI 1.2 to 8.2, based on seven cases). However, exposures to electromagnetic fields, high temperature, PAHs, herbicides, other pesticides, and organic solvents were not associated with risk of male breast cancer. CONCLUSIONS: The role of workplace exposures in increasing risk of breast cancer among men employed in motor vehicle manufacturing and in blast furnaces, steel works, and rolling mills deserves further investigation. The finding on socioeconomic status suggests that, as well as reproductive factors, other lifestyle factors such as diet that may be related to high socioeconomic status in men should be investigated further.  相似文献   

9.
The study presents mortality rates for lung cancer in the town of Casale Monferrato, where the largest Italian asbestos cement-plant was located. Cases of lung cancer dying in 1989-94 were exhaustively searched for in the register of deaths. Each case of lung cancer has been identified as ever or never employed in the factory with a linkage to the rosters of employees in the plant. Women were also identified as ever or never married to an asbestos-cement worker. The number of person-years at risk for asbestos cement workers and their wives was measured on the basis of the most recent follow-up. Mortality rates were computed separately for those exposed (workers and wives of workers) and for those with no evidence of exposure. Mortality rates for non-exposed were similar to rates in Piedmont (the region where Casale is located). The relative risk (ever exposed vs. never exposed) was 2.8 among men and 2.1 among women. Attributable risk among the exposed was 64.5% for men and 53.1% for women while among the general population it was 18.1% for men and 13.2% for women. The study confirms the dramatic effect of occupational asbestos exposure in Casale Monferrato but does not suggest an increase in lung cancer mortality among people with no occupational activity in the asbestos-cement production.  相似文献   

10.
Using mortality and incidence data from Alameda County, California, this study attempted to determine whether the higher occurrence rate of prostatic cancer among black men as compared with whites in the United States might be explained by racial differences in factors associated with socioeconomic status. Each death or case of prostatic cancer was assigned to a social class based on census tract of residence, and rates by race and socioeconomic status were computed. Comparison of age-specific mortality and incidence rates by socioeconomic status reveals no gradient in either whites or blacks. The higher risk for blacks holds up at almost every age and socioeconomic level. However, the racial differences are less pronounced for incidence than for mortality. Racial differences in the occurrrence of deaths appearing in Part II of the death certificate are also examined.  相似文献   

11.
We assessed exposure to pesticides, farming, well water use, and rural living as risk factors for Parkinson's disease (PD) in a population-based case-control study consisting of men and women > or = 50 years of age who had primary medical care at Henry Ford Health System in metropolitan Detroit. Enrolled PD patients (n = 144) and control subjects (n = 464) were frequency-matched for age, race, and sex. When adjusted for these variables and smoking status, there was a significant association of occupational exposure to herbicides (odds ratio [OR], 4.10; 95% CI, 1.37, 12.24) and insecticides (OR, 3.55; 95% CI, 1.75, 7.18) with PD, but no relation was found with fungicide exposure. Farming as an occupation was significantly associated with PD (OR, 2.79; 95% CI, 1.03, 7.55), but there was no increased risk of the disease with rural or farm residence or well water use. The association of occupational exposure to herbicides or insecticides with PD remained after adjustment for farming. The association of farming with PD was maintained after adjustment for occupational herbicide exposure and was of borderline significance after adjustment for occupational insecticide exposure. These results suggest that PD is associated with occupational exposure to herbicides and insecticides and to farming and that the risk of farming cannot be accounted for by pesticide exposure alone.  相似文献   

12.
BACKGROUND: Standardized proportionate mortality ratio (SPMR) was found to be 2.2 (95% CI = 1.3-3.5) for esophageal cancer (EC) among workers exposed to refractory brick dust in a large iron-steel complex in China. METHODS: A nested case-control design within a cohort of industrial workers. One hundred and twenty-five EC cases and 250 controls were identified from the death registry file. Interviews were conducted of the next of kin for past exposure information on job, domestic, and lifestyle factors. History of occupational exposure to various dusts was reconstructed from personnel files and by interviewing colleagues utilizing a job-exposure matrix. RESULTS: After adjusting for confounders, occupational exposure to silica dust was the most important risk factor among all variables investigated, with a 2.8-fold risk and a clear dose-response by length of exposure. Alcohol drinking (OR = 1.8) and coal cooking (OR = 2.0) were risk factors and high consumption of fruit diet (OR = 0.5) and meat diet (OR = 0.6) were protective factors. CONCLUSIONS: The relationship between occupational exposure to silica dust and the risk of EC found in an earlier SPMR study was confirmed. Ingestion of silica particles after lung clearance may increase the risk of EC among workers exposed to silica.  相似文献   

13.
We estimated the number of cancers attributed to occupational exposures in Spain, and examined the prevalence of carcinogenic exposures in the workplace. We used population, labour, mortality and morbidity statistics and applied an approach used by Doll and Peto for the population of the USA. In men 6% and in women 1% of all cancers can be attributed to occupational exposures. Lung cancer accounts for 62% of all occupational cancers. About 402,346 men and women are employed in industries or occupations entailing a well recognised carcinogenic risk. In addition, a large but unquantifiable number of workers are employed in various other occupations and industries where exposure to carcinogenic chemical or physical agents may occur. The identification and control of carcinogenic exposures may lead to the prevention of a considerable number of cancers in the Spanish adult population.  相似文献   

14.
OBJECTIVES: To estimate the risk of cancer due to occupational exposure to petroleum products in the Swedish transport and refinery industries. METHODS: In a retrospective cohort study the cancer incidence in 4128 men and 191 women, who had worked for at least one year in the petroleum industry, was compared with the incidence in the general population. The job titles and employment times for each person were found in personal files in the industries. The men had on average worked in jobs exposed to petroleum for 11.6 years at the end of the observation period. The cases of cancer were identified by record linkage with the Swedish cancer register. RESULTS: In total there were 146 cases of cancer v 157.6 expected (standardised mortality ratio (SMR) 0.93 90% confidence interval (90% CI) 0.80 to 1.1). Operators at refineries had an increased risk of leukaemia (6 cases v 1.7 expected, 90% CI of relative risk (RR) 1.5 to 7.0). Five of the six cases had started to work at the refineries in the 1950s or later. No other significantly increased risk of cancer was found. Distribution workers had a decreased incidence of lung cancer (no cases, 90% CI of RR 0 to 0.4). CONCLUSIONS: Operators at Swedish refineries had an increased risk of leukaemia. A possible cause is exposure to benzene. There was no increased risk of leukaemia in distribution workers. Distribution workers had a decreased risk of lung cancer.  相似文献   

15.
Radon exposure was shown to be carcinogenic and suggested as a possible causative factor for lung cancer in man. A hypothesis is introduced that medium high radon (between 110 and 165 Bq/m3) causes lower cancer risk among women younger than 61 years, independent of the type of cancer. The presented results verify this statement with a probability of not less than 98%.  相似文献   

16.
Attributable risks (ARs) for bladder cancer were computed in relationship to cigarette smoking, coffee consumption, low intake of vegetables, history of cystitis, and occupation using data from a case-control study conducted in northern Italy between 1985 and 1993. Cases were 431 patients with histologically confirmed bladder cancer, and controls were 491 patients admitted to the same network of hospitals for acute, nonneoplastic, and non-urinary-tract diseases. Overall, the AR estimates were 49% for cigarette smoking, 23% for coffee consumption, 16% for low intake of vegetables, 12% for history of cystitis, and 4% for occupation. These five factors together explained more than 70% of bladder cancer cases in this population. The AR for cigarette smoking was significantly higher among men (56%) than women (17%), whereas coffee consumption, low vegetable intake, and cystitis were more important (but not significantly so) among women. These results suggest that more than 2500 of the 5400 deaths due to bladder cancer in Italy in 1990 could have been prevented by the elimination of cigarette smoking. With some appropriate dietary modification and intervention to prevent urinary tract infections and occupational exposures, this figure could approach 4000 avoidable deaths. Thus, bladder cancer could become a rare cause of death in this population.  相似文献   

17.
Occupation and industry codes on death certificates from 23 states for 1984-1988 were used to evaluate mortality risks among white and nonwhite, male and female farmers. Proportionate mortality and proportionate cancer mortality ratios were calculated using deaths among nonfarmers from the same states to generate expected numbers. Among farmers there were 119,648 deaths among white men, 2,400 among white women, 11,446 among nonwhite men, and 2,066 among nonwhite women. Deficits occurred in all race-sex groups for infective and parasitic diseases, all cancer combined, lung cancer, liver cancer, diseases of the nervous system, multiple sclerosis, hypertension, and emphysema. As reported in other studies, white male farmers had excesses of cancer of the lymphatic and hematopoietic system, lip, eye, brain, and prostate. Excesses of cancers of the pancreas, kidney, bone, and thyroid were new findings. Regional patterns were evident, particularly among white men. Significant excesses for accidents, vascular lesions of the central nervous system (CNS), and cancers of the prostate tended to occur in most geographic regions, while excesses for mechanical suffocation, non-Hodgkin's lymphoma, and cancers of the lip, brain, and the lymphatic and hematopoietic system were limited to the Central states. Increases among nonwhite men were similar to those in white men for some causes of death (vascular lesions of the CNS and cancers of the pancreas and prostate), but were absent for others (lymphatic and hematopoietic system, lip, eye, kidney, and brain). Women (white and nonwhite) had excesses for vascular lesions of the CNS, disease of the genitourinary system (white women only), and cancers of the stomach and cervix (nonwhite women only). Cancer of the buccal cavity and pharynx was slightly elevated among women, and white women had nonsignificant excesses of multiple myeloma and leukemia. Excesses for leukemia and non-Hodgkin's lymphoma occurred among white men and women, but not among nonwhites. Excesses for several types of accidental deaths were seen among all race-sex groups.  相似文献   

18.
OBJECTIVES: This study evaluated the mortality experience of workers from the styrene-butadiene rubber industry. Concerns about a possible association of 1,3-butadiene and styrene with lymphohaematopoietic, gastrointestinal, and lung cancers prompted the investigation. METHODS: A retrospective follow up study was conducted of 15,649 men employed for at least one year at any of eight North American styrene-butadiene rubber plants. Analyses used standardised mortality ratios (SMRs) to compare styrene-butadiene rubber workers' cause specific mortalities (1943-91) with those of the United States and Ontario general populations. RESULTS: On average, there were 25 years of follow up per subject. The standardised mortality ratio (SMR) was 87 (95% confidence interval (95% CI) 85 to 90) for all causes of death combined and was 93 (95% CI 87 to 99) for all cancers. There was an excess of leukaemia (SMR 131, 95% CI 97 to 174), restricted to hourly workers (SMR 143, 95% CI 104 to 191). For causes of death other than leukaemia, SMRs were close to or below the null value of 100. Results by work area (process group) were unremarkable for non-Hodgkin's lymphoma, multiple myeloma, and stomach cancer. Maintenance workers had a slight increase in deaths from lung cancer, and certain subgroups of workers had more than expected deaths from cancer of the large intestine and the larynx. CONCLUSION: This study found an excess of leukaemia that is likely to be due to exposure to butadiene or to butadiene plus other chemicals. Deaths from non-Hodgkin's lymphoma, multiple myeloma, and stomach cancer did not seem to be related to occupational exposure. The excess deaths from lung cancer among maintenance workers may be due in part to confounding by smoking, which was not controlled for, and in part to an unidentified occupational exposure other than butadiene or styrene. Increases in cancer of the large intestine and larynx were based on small numbers, did not seem to be due to exposure to butadiene or styrene, and may be chance observations.  相似文献   

19.
To clarify lead exposure and factors relevant to it, an occupational health survey and air lead-concentration survey were conducted among 425 workers in the ceramics industry in the Seto region in Aichi Prefecture. As for biological monitoring, blood lead level was measured according to sex, job, product, factory size and duration of lead exposure. The following major findings were obtained in the present analysis. Workers making dolomite novelties showed higher blood lead levels than those making porcelain novelties, semi-porcelain novelties and tableware. The difference in blood lead level by job was statistically significant, but not that by factory size. In males, the highest blood lead level was found for spray painting work (28.7 micrograms/dl), followed by glazing work (28.0 micrograms/dl), kiln work (23.3 micrograms/dl) and painting work (22.3 micrograms/dl). In females, the blood lead level for painting work (13.5 micrograms/dl) was lower than those for glazing work (26.1 micrograms/dl) and kiln work (31.4 micrograms/dl). The blood lead level was significantly increased with the number of years of lead exposure in females (painting work). It was coincidentally clarified that the environmental lead concentration varied according to the job in which workers were engaged. As protective measures against lead exposure for workers in the ceramics industry, the development of nonlead paint and glaze and the introduction of more effective dust collectors at the workplace should be established.  相似文献   

20.
OBJECTIVES: To describe the sociodemographic distribution of habitual physical activity and to analyse its relationship with self-perceived health status and occupational status, among the population older that 16 years of age in the city of Barcelona, Spain. METHODS: A sample of 1,885 adult men and 2,196 women answered the Health Interview Survey of Barcelona in 1992. Those whose habitual activity required high physical exertion or walking were considered as active. Bivariate and multivariate analyses adjusting logistic regression models were used to study the relationship between habitual physical activity and the rest of variables, for each occupational situation. RESULTS: Fifty six percent of adults reported being physically active. Physical activity was lower among workers than non workers, although workers reported more physical exertion (14.5% in men and 8.0% in women). Physical activity was associated with occupation and educational level among male workers, but only with occupation among female workers. In the non working population, physical activity was lower among those who perceived their health status as fair or poor, compared with those that described it as good or very good, (ORa in men was 0.2, 95% confidence interval = 0.1-0.5; ORa in women was 0.5, 95% confidence interval = 0.3-0.8). CONCLUSIONS: More than half of the Barcelona population were physically active in an habitual manner. Among workers, this activity was mainly determined by the occupation. Non-workers with a poor self-perceived health status did less physical activity.  相似文献   

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