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Historical cohort study of 10 109 men in the North American vinyl chloride industry, 1942-72: update of cancer mortality to 31 December 1995

机译：1942-72年，北美氯乙烯行业中10 109名男性的历史队列研究：至1995年12月31日癌症死亡率的更新

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OBJECTIVES—To update and assess mortality from neoplasms to 31 December 1995 among 10 109 men employed in a job exposed to vinyl chloride for at least 1 year between 1942 and 1972 at any of 37 North American factories. Previous analyses indicated associations between employment in vinyl production and increased mortality risk from cancers of the liver and biliary tract, due to increased mortality from angiosarcoma of the liver, and brain cancer.
METHODS—Standardised mortality ratio (SMR) analyses, overall and stratified by several work related variables, were conducted with United States and state reference rates. Cox's proportional hazards models and stratified log rank tests were used to further assess occupational factors.
RESULTS—895 of 3191 deaths (28%) were from malignant neoplasms, 505 since the previous update to the end of 1982. Mortality from all causes showed a deficit (SMR 83, 95% confidence interval (95% CI) 80 to 86), whereas mortality from all cancers combined was similar to state referent rates. Mortality from cancers of the liver and biliary tract was clearly increased (SMR 359, 95% CI 284 to 446). Modest excesses of brain cancer (SMR 142, 95% CI 100 to 197) and cancer of connective and soft tissue (SMR 270, 95% CI 139 to 472) were found. Stratified SMR and Cox's proportional hazard analyses supported associations with age at first exposure, duration of exposure, and year of first exposure for cancers of the liver and soft tissues, but not the brain.
CONCLUSIONS—Excess mortality risk from cancer of the liver and biliary tract, largely due to angiosarcoma, continues. Risk of mortality from brain cancer has attenuated, but its relation with exposure to vinyl chloride remains unclear. A potentially work related excess of deaths from cancer of connective and soft tissue was found for the first time, but was based on few cancers of assorted histology.


Keywords: vinyl chloride; angiosarcoma; liver; brain; connective tissue; soft tissue; neoplasms
机译：目的-更新和评估1995年12月至1942年至1972年间在37个北美工厂中从事氯乙烯工作至少10年的10 109名男性中的肿瘤死亡率。先前的分析表明，从事乙烯基生产的人与肝脏和胆道癌的死亡风险增加（由于肝脏血管肉瘤的死亡率增加）和脑癌之间存在关联。方法—采用美国和各州参考率进行了标准化死亡率比（SMR）的总体分析，并按几个与工作有关的变量进行了分层。使用Cox比例风险模型和分层对数秩检验进一步评估职业因素。结果-3191例死亡中的895例（28％）来自恶性肿瘤，自上次更新至1982年底以来有505例。各种原因的死亡率均存在缺陷（SMR 83，95％置信区间（95％CI）80至86）。 ，而所有合并癌症的死亡率均与州推荐率相似。肝脏和胆道癌的死亡率明显增加（SMR 359，95％CI 284至446）。发现适度过量的脑癌（SMR 142，95％CI 100至197）和结缔组织和软组织癌（SMR 270，95％CI 139至472）。分层的SMR和Cox的比例风险分析支持与肝脏和软组织（而非大脑）癌症的首次接触年龄，接触时间和首次接触年份之间的关联。结论-主要由于血管肉瘤，肝癌和胆道癌的死亡风险仍在继续。脑癌致死的风险有所降低，但其与氯乙烯接触的关系尚不清楚。首次发现与结缔组织和软组织癌死亡相关的可能与工作有关的死亡，但这是基于几种组织学类型的癌症。关键字：氯乙烯；血管肉瘤肝;脑;结缔组织;软组织;肿瘤

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