A retrospective cohort mortality study was carried out in 20 industrial factories in the Local Health Unit Bologna Sud (Emilia Romagna, Italy), where different rubber and plastics products were manufactured. The cohort consisted of 925 subjects (578 males and 347 females) employed for at least six months continuously; follow-up was between the beginning of operation of each factory, ranging between mid fifties and mid seventies, and 31 December 1989. For those exposed more than one year cause specific Standardized Mortality Ratios (SMRs) were computed using regional rates for comparison, 90% confidence intervals (CI) were calculated assuming the Poisson distribution. Among the 748 subjects employed for more than one year (457 males and 291 females) there were no lost to follow-up, 54 individuals were dead (41 males and 13 females) and for three subjects the cause of death was unknown. The results showed that all causes mortality was above expectancy in the total cohort (SMR = 123; 54 Obs; 90% CI = 97-154), among males (SMR = 117; 41 Obs; 90% CI = 89-152) and females (SMR = 143; 13 Obs; 90% CI = 85-228). Increased mortality for all malignant tumours was observed in the total cohort (SMR = 150; 25 Obs; 90% CI = 104-209) and for both genders. All nine lung cancer cases were observed among males, the SMR was equal to 218 and was statistically significant; seven cases occurred at duration of exposure less than 10 years and six at latency up to 20 years. The interpretation in terms of causality of the present investigation is limited by the small number of observations and by exposure definition solely in terms of employment in the study factories; nonetheless the results are indicating the existence, in this group of rubber and plastics product makers, of an adverse health effect which deserve further investigation.

译文

一项回顾性队列死亡率研究是在Bologna Sud当地卫生部门(意大利Emilia Romagna,意大利)的20家工厂中进行的,这些工厂生产了各种橡胶和塑料产品。该队列由925名受试者(578名男性和347名女性)组成,这些受试者连续工作了至少六个月。随访是在每个工厂开始运营之间(从五十年代中期到七十年代中期)至1989年12月31日。对于暴露时间超过一年的企业,使用区域比率作为比较标准,计算出特定的标准死亡率90,假设泊松分布,则计算%置信区间(CI)。在一年以上受雇的748名受试者(男性457名,女性291名)中,没有失访的危险,有54人死亡(41名男性和13名女性),而三名受试者的死因未知。结果显示,在男性(SMR = 117; 41 Obs; 90%CI = 89-152)中,所有人群的所有原因死亡率均高于预期(SMR = 123; 54 Obs; 90%CI = 97-154)。女性(SMR = 143; 13 Obs; 90%CI = 85-228)。在总队列中(SMR = 150; 25 Obs; 90%CI = 104-209)和男女均观察到所有恶性肿瘤的死亡率增加。在男性中观察到所有9例肺癌病例,SMR等于218,具有统计学意义;有7例发生在暴露时间少于10年的病例中,有6例发生在潜伏期长达20年的病例中。关于本次调查因果关系的解释受到少数观察结果的限制,并且仅受研究工厂雇用情况的暴露定义所限制;但是,结果表明,在这组橡胶和塑料制品制造商中,存在着不利的健康影响,值得进一步研究。

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