大姚县青石棉污染区肺癌、间皮瘤危险因素的病例对照研究

THE RISK FACTORS OF LUNG CANCER AND MESOTHELIOMA IN DAYAO COUNTY OF YUNNAN PROVINCE:A CASE-CONTROL STUDY.

目的 :探索云南省大姚县肺癌、间皮瘤高发的主要危险因素 ,为预防控制工作提供依据。方法 :采用 1∶ 2配比病例对照研究的方法 ,对当地发现的 4 7例病例 (31例肺癌和 16例间皮瘤 )和匹配了性别、年龄的 94例对照的各种可能与肺癌、间皮瘤有关的危险因素 (包括吸烟习惯、石棉暴露情况及肿瘤家族史等 )进行调查 ,用条件 L ogistic回归模型对资料进行分析。结果 :资料分析显示 ,家庭环境中石棉污染、吸烟同肺癌和间皮瘤之间关联差异有显著性 ,OR分别为 3.6 0(95 % CI1.0 3,12 .6 2 )和 3.30 (95 % CI1.90 ,10 .0 2 ) ;在石棉污染的几个因素中 ,使用石棉炉与肺癌的关联差异有显著性 ,OR为 1.6 3(95 % CI1.30 ,2 0 .2 4 )。单因素分析发现 ,使用石棉炉时间的长短与肺癌有关 ,使用石棉炉在 11～ 2 0年、 2 1～ 30年及 31年以上者的 OR分别是 5 .34(95 % CI1.12 ,2 5 .4 7)、 8.5 0 (95 % CI0 .78,93.2 3)、 14 .0 9(95 % CI0 .91,2 18.6 1)。结论 :大姚县肺癌和间皮瘤的高发可能与当地的石棉环境污染有关 。

Objective:To explore and evaluate the risk factors of lung cancer and mesothelioma in Dayao county of Yunnan province.Methods:A case control study was carried out,including 47 cases(31 lung cancer and 16 mesothelioma) and 94 controls.All of study participants were residents in Dayao county.Information on sociodemographic characteristics,cigarette smoking,asbestos exposure and family history of cancer were collected from the study subjects through a structured,standardized questionnaire administered by trained interviewers.For each case,two controls were matched on sex and age(within three years).Odds ratios(ORs) and their 95% confidence intervals(95% CI) were derived from conditional logistic regression.Results:Multivariate analysis showed that environmental asbestos exposure in family and smoking was significantly associated with lung cancer and mesothelioma,and odds ratios were 3 60(95%CI1 03,12 62) and 3 30(95%CI1 09,10 02),respectively.Among several factors of environmental asbestos exposure in family,using asbestos stove in family was associated with lung cancer(OR=1 63,95%CI1 30,20 24).Moreover,the duration of using asbestos stove in family was associated with lung cancer.Compared with 1~10years,the ORs of three levels(11~20years,21~30years and ≥31years) were 5 34(95%CI1 12,25 47),8 50(95%CI0 78,93 23) and 14 09(95%CI0 91,218 61),respectively.Conclusion:This study suggested that environmental asbestos exposure,especially using asbestos stove in family,may be a main risk factor of lung cancer and mesothelioma in Dayao county.