Data on TBL cancer attributable to occupational carcinogens were collected from the Global Burden of Disease Study 2019. Numbers and age-standardized rates (ASRs) of deaths, disability-adjusted life years (DALYs), and corresponding average annual percentage change (AAPC) were evaluated and stratified by geographic location, socio-demographic index (SDI) quintiles, age, and sex.
Globally, ASRs of deaths and DALYs in TBL cancer attributable to occupational carcinogens showed a downward trend (AAPC = - 0.69%, - 1.01%) while increases were observed in the low, low-middle, and middle SDI quintiles. Although males accounted for 82.4% and 81.5% of deaths and DALYs in 2019, respectively, it showed an upward trend of ASRs in females (AAPC = 0.33%, 0.02%). Occupational exposure to asbestos, silica and diesel engine exhaust were the top three causes of age-standardized TBL cancer deaths and DALYs. Over the past three decades, the percentage of age-standardized TBL cancer deaths and DALYs attributable to occupational asbestos and silica exposure decreased by 18.24, 6.71 and 20.52%, 4.00% globally, but increased significantly in lower SDI regions, while the burden attributable to occupational diesel engine exhaust exposure increased by 32.76, 37.23% worldwide.
Occupational exposure remains an important risk factor for TBL cancer. The burden of TBL cancer attributable to occupational carcinogens showed obvious heterogeneity which decreased in higher SDI but increased in lower SDI regions. The burden of males was significantly higher than females, but the females showed an increasing trend. Occupational exposure to asbestos was the main causes of the burden. Therefore, effective prevention and control measures tailored to local conditions are necessary.
■可归因于职业性致癌物的TBL癌症数据来自2019年全球疾病负担研究。死亡人数和年龄标准化率(ASR),残疾调整寿命年(DALYs),并按地理位置对相应的平均年变化百分比(AAPC)进行了评估和分层,社会人口统计学指数(SDI)五分位数,年龄,和性爱。
■全球,由职业性致癌物引起的TBL癌症的死亡和DALYs的ASR呈下降趋势(AAPC=-0.69%,-1.01%),而在低点观察到增加,中低端,和中间的SDI五分位数。尽管2019年男性分别占死亡人数和DALYs的82.4%和81.5%,女性ASR呈上升趋势(AAPC=0.33%,0.02%)。职业接触石棉,二氧化硅和柴油发动机废气是年龄标准化的TBL癌症死亡和DALY的三大原因。在过去的三十年里,职业性石棉和二氧化硅暴露导致的年龄标准化TBL癌症死亡和DALYs百分比下降了18.24、6.71和20.52%,全球4.00%,但在SDI较低的地区显著增加,而由职业性柴油机废气暴露引起的负担在全球范围内增加了32.76%,为37.23%。
■职业暴露仍然是TBL癌症的重要危险因素。职业性致癌物引起的TBL癌症负担表现出明显的异质性,在较高的SDI地区降低,但在较低的SDI地区增加。男性的负担明显高于女性,但是雌性呈增长趋势。职业接触石棉是造成负担的主要原因。因此,因地制宜的有效预防和控制措施是必要的。