某热电厂回顾性队列死亡调查──10年随访

A RETROSPECTIVE COHORT MORTALITY STUDY ON WORKEKS OF A THERMOELECTRIC POWER PLANT:TEN-YEAR FOLLOW-UP RESULTS

虽然有许多文章评价火力发电厂对周围环境的危害，但是很少关于直接接触粉尘、高温、噪声、毒物等有害因素对电厂职工健康影响的报道，为了查明这些因素对电厂职工死亡率和肿瘤死亡率有没有影响，我们对某热电厂进行了１０年回顾性队列调查研究，结果１６２４人组成的队列，１０年提供１５４１３．７３人年，死亡５２人，其中１６人死于恶性肿瘤，队列全死因死亡率稍低于本市居民人口（ＳＭＲ＝０．７８，９５％可信限０．５６～０．９９）（健康工人效应）。实际肿瘤死亡人数与按本市居民肿瘤死亡率计算的预期死亡人数比较未见明显差异（ＳＭＲ＝０．９８，９５％可信限０．５６～１．６０）。然而比较电厂内部各组ＳＭＲ，发现锅炉最高，“机、炉、电、热”次之，不接尘组第三，行政第四，接尘组最低，提示电厂粉尘危害与高温、噪声、电磁场、职业紧张等危害因素有联合作用。可能会影响恶性肿瘤死亡率。

Although many studies have been performed to evaluate the environmentalimpact of coal energy production,few studies are available on the health risk for the peopleworking in coal power plants who directly exposure to dust,noise,high temperature,poisonat the workshop.In order to investigate the association between exposure to these occupa-tional hazard and mortality for all causes or all cancers a retrospective cohort ten-year follow-up study was performed on the workers of a thermoelectric power plant. Acohort of 1624 workers was folloewd up from 1983 to 1992(15413. 73 person-yearwere supplied)and experinced 52 deaths,16 of them dying from cancer. Compared with thesame city population they had a slightly reduced risk of dying from all causes(SMR=0.78,95%confidence interval,0.56～0.99)(known as healthy workers effect),but no significantdifference in risk of dying from all cancers (SMR=0.98,95%confidence interval,0.56～1.60).Compared with each workshop in the power plant,the SMR of boiler workshop is1. 85 (the highest among them);The SMR of“turbine,boiler,electric and pyroelectric”is thesecond.That is higher than administration’s or only exposure to dust’s. These results sug-gest that there is a cooperation effect among dust,high temperature,noise,electricmagneticand occupational stress which may probably affect the mortality of cancer in the thermoelec-tric power plant.