某石棉矿接尘工人恶性肿瘤10年回顾性调查

Ten-year retrospective study on malignant tumor in workers exposed to asbestos dust in an asbestos mine

目的了解接触石棉粉尘工人恶性肿瘤患病情况,为制定石棉所致肿瘤的防护措施提供依据。方法选择某石棉矿1972—1981年接触石棉粉尘1年以上工人为调查对象,同时选择该矿附近县城关镇11个村居民作为对照组,采用统一方法进行流行病学调查,研究资料进行回顾性对比分析和统计学处理。结果①某石棉矿恶性肿瘤年平均粗死亡率55.82/10万,标化死亡率(SMR)70.82/10万;②石棉接尘工恶性肿瘤相对危险度(RR12.42)与对照组(RR3.76)对比分析差异有显著性(P<0.01);③石棉接尘工和对照组肺癌SMR比两者差异有显著性(P<0.01);④肺癌患病与接尘工龄长短呈正相关(r=0.87,P<0.025);⑤肺癌死亡工种分布:选矿最高、辅助工次之,采矿第3位,包装和生产管理人员未见肺癌患者;⑥吸烟工人肺癌高于不吸烟者(P<0.05)。结论接触石棉粉尘可引起肺癌患病率升高,消化道癌患病率也可升高,肺癌患病率与接尘工龄长短呈正相关,与接触粉尘浓度高低(工种)有关,粉尘浓度越大、接触时间越长,肺癌患病率越高,石棉粉尘接触是引起石棉矿肺癌高发的原因,吸烟对石棉所致肺癌有协同作用。

Objective To study the incidence of malignant tumor in workers exposed to asbestos dust and to provide a basis for drawing a method to prevent the tumors caused by asbestos dust. Methods The workers who had been working in asbestos dust environment for more than one year during 1972--1981 were selected as the research objects. The residents from 11 villages near the asbestos mine were selected as the control. The data from the epidemiological investigation with a unified method were analyzed. Results （1） Average crude mortality of workers with malignant tumor was 55. 82/105 in the asbestos mine, and the standardized mortality rate （SMR） was 70. 82/105 ; （2）There was a significant difference of relative risk between the workers exposed to asbestos dust （RR 12.42） and the control （RR 3.76 ,P 〈 0. 01 ） ;（3）The standardized mortality rate （SMR） was significantly different between the exposure group and the control group（ P 〈 0. 01 ） ;（4）The incidence of lung cancer was interrelated with the years exposed to asbestos dust （r = 0. 87, P 〈 0. 025 ） ;（5）The job distribution of the death patients with lung cancer was the first in the beneficiation, auxiliary job was followed, mining was the third. There was no lung cancer patient in the staff of management and packaging;（6）The incidence of lung cancer in smoking workers was higher than that of non-smoking workers. Conclusion The incidence of lung cancer in the workers exposed to asbestos dust can be obvious raised, and also increased in the incidence of gastrointestinal cancer. The incidence of lung cancer was interrelated with the years exposed to asbestos dust, and also with the dust concentration in workplaces. The incidence of lung cancer in the workers of asbestos mine was increased with the dust concentrations and the exposure time. Asbestos dust was a main risk factor inducing high incidence of lung cancer in asbestos mine. At the same time, tobaccos smoking was an important cooperative effect on lung cancer.