橡胶职业暴露与肝癌关系的病例-队列研究

CASE-COHORT STUDY ON THE RELATION BETWEEN THE OCCUPATIONAL EXPOSURE TO RUBBER AND THE LIVER CANCER

为研究橡胶职业暴露与肝癌之间的关系，应用标化死亡率和病例队列研究对上海某橡胶厂轮胎和胶鞋制造工人进行了２３年（１９７３～１９９５）的随访调查，结果表明，全队列人群总的死亡率低于普通人群，但按工种分组分析，发现男性胶鞋工种肝癌死亡超额明显［ＳＭＲ为１０（２／２．０），９５％ＣＩ＝２．４３～１０８．３］；病例—队列准似然多因素分析表明，胶鞋和机修工种的肝癌危险度较高，但无统计学显著性；非职业因素中，家庭燃煤肝癌危险度增高（ＲＲ＝３．０５，９５％ＣＩ：１．２８～７．２８）。认为，橡胶工人总的肝癌危险度稍低于普通人群，但某些工种的肝癌ＲＲ增高。

In order to study the relationship between the occupational exposure to rubber and the liver cancer,the case-cohort study and standard mortality were used to do the following-up visit on the workers in a rubber factory in Shanhai from 1973 to 1995. The results showed that the mortality of the cohort was lower than that of the general people, but the elevated relative risk(RR) of liver cancer of the workers producing rubber shoes was significant[SMR 10(2/2.0), 95%CI=2.43￣108.3]. The relative risk of liver cancer was higher for the workers producing rubber shoes and repairing the machines, however, there's not statistic significance. Among non-occupational factors, the significantly elevated RR of home coal fume(RR=3.05,95%CI=1.28￣7.28) was found. These findings suggest that the high RR of liver cancer is likely related with the occupational exposure to solvent and talc in the rubber factory.