大姚县青石棉天然暴露区主要恶性肿瘤死亡及其危险因素调查
An epidemiologic study on the malignant tumor induced death and risk factors in crocidolite contaminated area in Dayao county
-
摘要: 目的: 探讨云南省大姚县低剂量青石棉相关暴露与当地恶性肿瘤死亡的关联,为制定当地恶性肿瘤的防治策略提供依据。方法: 对大姚县部分青石棉污染区的农村居民进行27年回顾性队列(1984年2月至2011年4日)研究。结果: 观察队列共1 249人,随访总人年数为28 848.27人年,其中443人死亡,占全部随访对象的35.47%。队列中有121人死于恶性肿瘤,总死亡率为1 535.64/10万人年。居恶性肿瘤死因顺位首位的是肝癌,共29例,粗死亡率为100.53/10万人年(标化死亡率为51.22/10万人年);居第2位的是肺部恶性肿瘤(不含胸膜间皮瘤),共27例,粗死亡率为93.59/10万人年(标化死亡率为41.05/10万人年);居第3位的是胸膜间皮瘤,共26例,粗死亡率为90.13/10万人年(标化死亡率为54.36/10万人年)。肠癌与胃癌死亡率分别为45.06/10万人年(标化死亡率为23.68/10万人年)和41.60/10万人年(标化死亡率为18.27/10万人年)。多因素分析显示,当地主要青石棉暴露因素(生产石棉炉、使用石棉炉数量、石棉修路和居住时间)均与恶性肿瘤死亡相关。而且男性的相对危险度高于女性。结论: 消化道恶性肿瘤已成为严重危害大姚县居民健康的首位癌种,以肝癌、肠癌及胃癌为主,青石棉相关暴露是当地恶性肿瘤高发的主要危险因素。Abstract: Objective: To explore the association between environmental low-dose exposure to crocidolite and malignancy, so as to provide the epidemiologic evidence for malignancy prevention.Methods: A 27-year (February,1984 to January,2011)retrospective cohort study was conducted to evaluate the mortality of the major malignancy in the crocidolite-contaminated area in Dayao county, Yunnan province.Results: There were 1 249 subjects(575 males and 674 females)in the retrospective cohort and 28 848.27 personyears were observed totally.In this cohort,443 person were died,which accounted for 35.4% of the total subjects.Furthermore,121 person were died from cancer, the total mortality was 1535.64 per 100 000 person-years.Hepatic carcinoma(29 cases)was the first cause of tumor death and the mortality was 100.53 per 100 000 person-years(the standarized mortality rate is 51.22 per 100 000 person-years).Lung cancer(27 cases,not including pleura mesothelioma)was the second cause of tumor death and the mortality was 93.59 per 100 000 person-years (the standarized mortality rate is 41.5 per 100 000 person-years).The third cause was pleura mesothelioma,which contained 26 cases, the mortality was 90.13 per 100 000 person-years(the standarized mortality rate is 54.36 per 100 000 person-years).Gastric cancer and intestinal cancer mortality were 45.06 per 100 000 person-years(the standarized mortality rate is 23.68 per 100 000 person-years)and 18.27 per 100 000 person-years(the standarized mortality rate is 54.36 per 100 000 person-years).Multiple regression analysis showed that the exposure factors(producing asbestos stove,using asbestos stove,building the road with asbestos and the time of living in contaminated areas)were associated with the occurrence of malignancy in Dayao county. Meanwhile, the relative risk was higher among the male residents.Conclusions: Liver, lung, stomach, colon cancer,pleural mesothelioma and other malignant tumors are higher than those in Yunnan and the national average.Long-term environmental crocidolite exposure leads to high mortality of cancer among residents in crocidolite-Contaminated Area in Dayao county.
-
Key words:
- neoplasms /epidemiology /
- crocidolite /
- exposure /
- retrospective cohort study
-
[1] Ladou J,Castleman B,Frank A,et al.The case for a global ban on asbestos[J].Environ Health Perspect,2010,118(7):897-901. [2] Straif K,Benbrahim-Tallaa L,Baan R,et al.A review of human carcinogens-part C:metals,arsenic,dusts,and fibres[J].Lancet Oncol,2009,10(5):453-454. [3] 罗素琼,宋云和,穆世惠,等.大姚县青石棉污染的危害及预防与控制[J].中华劳动卫生职业病杂志,2000,18(4):213- 215. [4] 罗素琼,穆世惠,王津涛,等.环境接触青石棉肿瘤发生危险的15 年随访调查[J].四川大学学报,2005,36(1):105-107. [5] Luo S,Liu X,Wang C.Inhibitory effect of green tea extract on the carcinogenesis induced by asbestos plus benzo(a)pyrenein rat[J].Biomed Environ Sci,1995,8(1):54-58. [6] 李连弟,鲁风珠,张思维,等.1990 ～ 1992 年中国恶性肿瘤死亡流行分布情况分析[J].中华肿瘤杂志,1996,18(6):403-407. [7] 任建松,乔友林.原发性肝癌危险因素与预防研究进展[J].中国肿瘤,2008,17(4):292. [8] Hillerdal G.Mesothelioma:cases associated with non-occupational and low dose exposures [J].Occup Environ Med 1999,56(8):505-513. [9] Cvitanovic S.Malignant and non-malignant asbestos-related pleural and lung disease:10-year follow-up study[J].Croat Med J,2003,44(5):618-625. [10] McDonald JC,McDonald AD.The epidemiology of mesothelioma in historical context[J].Eur Respir,1996,9(9):1932-1942. [11] 周脉耕,王晓风,胡建平.2004 ～ 2005 年中国主要恶性肿瘤死亡的地理分布特点[J].中华预防医学杂志,2010,44(4):303-308. -
点击查看大图
计量
- 文章访问数: 3854
- HTML全文浏览量: 438
- PDF下载量: 224
- 被引次数: 0
下载:
