目标:在意大利,在意大利两个最大的造船厂所在的意大利地区中,胸膜癌死亡率和发病率最高。这项研究的目的是评估在Monfalcone雇用的男性工人之间间皮瘤的暴露-反应关系,意大利,造船厂.
方法:我们进行了基于尸检的病例对照研究。病例(N=102)为间皮瘤患者,对照组为肺癌患者(N=84)。可以获得完整的工作历史;使用X射线荧光扫描电子显微镜测量肺纤维含量,根据欧洲呼吸学会指南进行样品制备后。间皮瘤按纤维类型和肺纤维负荷的赔率和95%置信区间,作为分类变量或连续变量,通过无条件逻辑回归进行评估,自接触停止后的年龄和时间进行了调整。对闪石和温石棉肺纤维负荷的分析进行了相互调整。我们通过将工作暴露矩阵应用于研究案例的工作历史来计算累积暴露指数,并评估其与肺纤维负担的相关性。
结果:我们发现最高肺纤维负荷类别的比值比为22.0(置信区间5.66-85.7)(平均每克干组织总石棉纤维4380万)与参考(平均0.48)相比。使用log10转化的肺纤维负荷,我们发现肺纤维负荷增加10倍的比值比为3.71(置信区间2.03~6.79).闪石肺纤维负荷的结果相似。温石棉肺纤维负荷类别的赔率增加(P趋势=0.025),增加10倍的比值比为4.73(置信区间0.32-70.4)。
结论:累积暴露指数与总肺纤维负荷和闪石肺纤维负荷相关,但不是温石棉肺纤维负担。间皮瘤风险与总风险成正比,闪石,船厂工人的温石棉肺纤维负担。
OBJECTIVE: In Italy, the highest pleural cancer mortality and incidence have been observed among Italian regions where the 2 largest Italian shipyards were (and are) located. The objective of this study was to assess the exposure-response relationship for mesothelioma among male workers employed in the Monfalcone, Italy, shipyard.
METHODS: We conducted a necropsy-based case-control study. Cases (N = 102) were mesothelioma decedents and controls were those with lung cancer (N = 84). Complete job histories were available; the lung fibre content was measured using a scanning electron microscope with X-ray fluorescence, after sample preparation according to the European Respiratory Society guidelines. Odds ratios and 95% confidence intervals of mesothelioma by fibre type and lung fibre burden, as a categorical or continuous variable, were assessed by unconditional logistic regression, adjusted for age and time since exposure cessation. Analyses for the amphibole and chrysotile lung fibre burden were mutually adjusted. We calculated a cumulative exposure index by applying a job-exposure matrix to the job histories of study cases and assessed its correlation with the lung fibre burden.
RESULTS: We found an odds ratio of 22.0 (confidence intervals 5.66-85.7) for the highest lung fibre burden category (mean 43.8 million total asbestos fibres per gram of dry tissue) compared with the reference (mean 0.48). Using log10-transformed lung fibre burden, we found that the odds ratio was 3.71 (confidence intervals 2.03-6.79) for a 10-fold lung fibre burden increase. Results for the amphibole lung fibre burden were similar. Odds ratios increased over chrysotile lung fibre burden categories (P-trend = 0.025), and the odds ratio for a 10-fold increase was 4.73 (confidence intervals 0.32-70.4).
CONCLUSIONS: The cumulative exposure index was correlated with total and amphibole lung fibre burden, but not with chrysotile lung fibre burden. Mesothelioma risk was proportional to total, amphibole, and chrysotile lung fibre burden in shipyard workers.