目的:在罗马和都灵的都市纵向研究中评估职业部门与呼吸道死亡率之间的关联。
方法:回顾性队列研究。
方法:分析了2011年罗马和都灵30岁及以上、在1970年代至2011年间在私营部门工作至少一年的居民的人口普查队列。从2011年10月9日至2018年12月31日对纳入研究的个体进行了随访。职业史是从国家社会保险局(INPS)的私营部门捐款档案中获得的,然后与纵向研究的数据相关联。
方法:研究结果是非恶性呼吸道死亡率。感兴趣的暴露是个人是否在所考虑的25个职业部门之一(农业和渔业,钢铁工业,纸张和印刷,制药,制造,纺织品,能源和水,食品和烟草行业,非金属矿,玻璃和水泥行业,金属加工,电气施工,鞋类和木材工业,建筑,贸易,酒店和餐馆,交通运输,保险,healthcare,服务,洗衣店,废物管理,美发,清洁服务,和加油站)。职业部门与呼吸系统死亡率之间的关联,调整了潜在的混杂因素(年龄,婚姻状况,出生地,教育水平),是用考克斯模型估计的。所有分析均按性别和城市分层。
结果:共分析了罗马的910,559人和都灵的391,541人。在八年的随访中,罗马有4,133人和都灵有2,772人死于呼吸道疾病。在这两个城市中,与男性高呼吸死亡率相关的行业是鞋类和木材行业(调整后的年龄HR:罗马和都灵的1.37(95CI1.07-1.76)和1.48(95CI1.08-2.03),分别),建筑(HR:罗马1.31(95CI1.20-1.44)和都灵1.51(95CI1.31-1.74)),酒店和餐饮业(人力资源:罗马1.25(95CI1.07-1.46)和都灵1.68(95CI1.20-2.33)),和清洁服务(人力资源:罗马1.57(95CI1.19-2.06)和都灵1.97(95CI1.51-2.58))。一些部门只有两个城市之一的呼吸道死亡率很高:在罗马,食品和烟草行业,还有加油站,在都灵,金属加工行业。在女工中,在罗马和都灵,清洁服务部门与较高的呼吸道死亡率相关(HR:分别为1.52,95CI1.27-1.82,e1.58,95CI1.17-2.12).
结论:数据证实了先前已知的职业部门与特定部门暴露特征的呼吸系统死亡率之间的关联,比如建筑,酒店和餐厅部门,和清洁服务。两个城市之间报告的差异反映了劳动力的不同组成和两个研究人群的规模。行政社会保险数据可以为职业暴露的流行病学研究提供有用的信息。
OBJECTIVE: to assess the association between the occupational sector and respiratory mortality in the metropolitan longitudinal studies of
Rome and Turin.
METHODS: retrospective cohort study.
METHODS: the 2011 census cohorts of residents of
Rome and Turin aged 30 years and older who had worked for at least one year in the private sector between 1970s and 2011 was analysed. The individuals included in the study were followed from 9 October 2011 to 31 December 2018. Occupational history was obtained from archives of private sector contributions at the National Social Insurance Agency (INPS) and then was linked to data from the longitudinal studies.
METHODS: the study outcome was non-malignant respiratory mortality. The exposure of interest was whether or not individuals had worked in one of the 25 occupational sectors considered (agriculture and fishing, steel industry, paper and printing, pharmaceuticals, manufacturing, textile, energy and water, food and tobacco industry, non-metal mining, glass & cement industry, metal processing, electrical construction, footwear and wood industry, construction, trade, hotel and restaurants, transportation, insurance, healthcare, services, laundries, waste management, hairdressing, cleaning services, and gas stations). The association between the occupational sector and respiratory mortality, adjusted for potential confounders (age, marital status, place of birth, educational level), was estimated using Cox models. All analyses were stratified by sex and city.
RESULTS: a total of 910,559 people were analysed in
Rome and 391,541 in Turin. During the eight years of follow-up, 4,133 people in Rome and 2,772 people in Turin died from respiratory causes. The sectors associated with high respiratory mortality in both cities among men were footwear and wood industry (adjusted HR for age: 1.37 (95%CI 1.07-1.76) and 1.48 (95%CI 1.08-2.03) in Rome and Turin, respectively), construction (HR: 1.31 (95%CI 1.20-1.44) in
Rome and 1.51 (95%CI 1.31-1.74) in Turin), hotel and restaurant sector (HR: 1.25 (95%CI 1.07-1.46) in Rome and 1.68 (95%CI 1.20-2.33) in Turin), and cleaning services (HR: 1.57 (95%CI 1.19-2.06) in
Rome and 1.97 (95%CI 1.51-2.58) in Turin). Some sectors had high respiratory mortality only in one of the two cities: in Rome, the food& tobacco industry, and gas stations, while in Turin, the metal processing industry. Among female workers, the cleaning services sector was associated with higher respiratory mortality in both Rome and Turin (HR: 1.52, 95%CI 1.27-1.82, e 1.58, 95%CI 1.17-2.12, respectively).
CONCLUSIONS: the data confirm the previously known associations between occupational sectors and respiratory mortality for exposures characteristic of specific sectors, such as construction, hotel and restaurant sector, and cleaning services. The differences reported between the two cities reflect the different composition of the workforce and the size of the two study populations. Administrative social insurance data can provide helpful information for epidemiological studies of occupational exposure.