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目的 用荟萃 (meta)分析探讨单纯接触温石棉人员的癌症是否高发。方法 凡满足明确是单纯温石棉暴露且为癌症死亡率队列研究的资料均被纳入研究对象 ,以直接法与随机效应模型法计算主要部位癌症的标准化死亡比 (SMR)及其 95 %可信区间 ,计算Q统计量与Z值检验研究结果异质性及其来源。结果 共有 2 6个队列符合入选标准 ,平均间皮瘤死亡百分比为 0 4 2 % ,全死因、全癌亡、呼吸系统全癌、肺癌和胃癌的meta SMR显著上升 ,分别为 1 2 8、1 2 6、2 2 4、2 2 9与1 2 7。肺癌的meta SMR在纺织 (3 6 4 )、石棉制品加工 (3 0 7)、采选矿 (2 2 4 )和石棉水泥制品加工(1 2 2 )显著升高 ,胃癌的meta SMR在石棉制品加工 (1 4 8)显著升高。其余部位癌症的meta SMR均无显著意义。结论 单纯温石棉暴露能使作业人员肺癌、间皮瘤显著高发 ,与其他部位癌症似无病因联系。
Aim To investigate the incidence of cancer in people exposed to chrysotile asbestos alone using meta-analysis. Methods All data were included in the cohort study that were specifically enrolled in the study and were directly exposed to chrysotile asbestos exposure. The standardized death rate (SMR) and its 95% confidence interval , Calculate the heterogeneity of Q test and Z value test results and their sources. Results A total of 26 cohorts were eligible for inclusion. The average percentage of death from mesothelioma was 0 42%. The meta-SMRs of all-cause, all-cancer, respiratory system, lung cancer and gastric cancer increased significantly 2 6,2 2 4,2 2 9 and 1 2 7. The meta SMR for lung cancer was significantly higher in the textile (364), asbestos product processing (307), beneficiation (224) and asbestos cement products processing (122), and the meta SMR for gastric cancer was asbestos product processing (148) increased significantly. The rest of the cancer meta-SMR were not significant. Conclusion Asbestos exposure alone can cause lung cancer and mesothelioma in workers to be significantly higher than those in other parts of the cancer.