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Influence of Alternative Exposure Estimates in the Diesel Exhaust Miners Study: Diesel Exhaust and Lung Cancer

机译：替代性排放估计对柴油机排气矿工研究的影响：柴油机排气与肺癌

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The landmark Diesel Exhaust in Miners Study (DEMS) studied the relationship between diesel exhaust exposure (DEE) and lung cancer mortality of workers at eight nonmetal mines who were followed from beginning of dieselization of the mines (1947-1967) through December 31, 1997. The original analyses quantified DEE exposures using exposure to respirable elemental carbon (REC) to represent DEE, and CO as a surrogate for REC. However, this use of CO data, and the CO data themselves, have numerous shortcomings. We developed new estimates of REC exposures using historical data on use of diesel equipment, diesel engine horsepower (HP), mine ventilation rates, and the documented reduction in particulate matter emissions per HP in diesel engines from 1975 through 1995. These new REC estimates were applied in a conditional logistic regression of the DEMS nested case-control data very similar to the one applied in the original DEMS analyses. None of the trend slopes calculated using the new REC estimates were statistically significant (p > 0.05). Moreover, these trend slopes were smaller by roughly factors of five without control for radon exposure and factors of 12 with control for radon exposure compared to those estimated in the original DEMS analyses. Also, the 95% confidence intervals for these trend slopes had only minimal overlap with those for the slopes in the original DEMS analyses. These results underscore the uncertainty in estimates of the potency of diesel exhaust in causing lung cancer based on analysis of the DEMS data due to uncertainty in estimates of exposures to diesel exhaust.
机译：具有里程碑意义的矿工柴油机排气研究（DEMS）研究了八个非金属矿场的柴油机排气暴露（DEE）与肺癌死亡率之间的关系，这些工人从矿场开始进行柴油化处理（1947-1967）一直到1997年12月31日原始分析使用暴露于可呼吸元素碳（REC）的DEE和CO作为REC的替代物来量化DEE暴露。然而，CO数据的这种使用以及CO数据本身具有许多缺点。我们使用有关柴油设备使用，柴油发动机功率（HP），矿井通风率以及从1975年至1995年有记录的每HP柴油机颗粒物排放量减少的历史数据，开发了REC暴露的新估算。这些新的REC估算是应用于DEMS嵌套条件控制数据的条件逻辑回归中，与原始DEMS分析中应用的非常相似。使用新的REC估算值计算出的趋势斜率均无统计学意义（p> 0.05）。此外，与原始DEMS分析中所估计的相比，这些趋势斜率在不控制without暴露的情况下大约小5倍，在控制control暴露的情况下大约12倍。同样，这些趋势斜率的95％置信区间与原始DEMS分析中的斜率仅有最小的重叠。这些结果强调了基于DEMS数据分析的柴油机排气致肺癌估计值的不确定性，这是由于柴油机排气暴露估计值的不确定性所致。

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