A prospective cohort study on the effect of occupational dust exposure and smoking on mortality

Abstract

OBJECTIVE: To study the effect of dust exposure and smoking on mortality. METHODS: Based on the Guangzhou Occupational Health Surveillance Record System established in 1989-1992, 61,648 factory workers, aged > or = 30, occupationally exposed to dust and non-exposure to dust or any other hazardous substances(controls), were included in a prospective cohort study. RESULTS: (1) 28 were lost to follow-up. Malignant neoplasm was most common among 1,186 deaths. (2) Most subjects were male workers, aged 35 to 44, with secondary education, and married. 42.2% had ever smoked and 32.8% were ever-drinkers. (3) To compare with non-exposure, non-smoking + non-smoking and non-exposure respectively, the adjusted RR of death from all causes, malignant neoplasm and respiratory diseases were 1.24, 1.34 and 1.96 respectively for dust exposed workers(compared to control, P < 0.01), 1.16, 1.37 and 1.63 respectively for those smoking(compared to non-smoker except RR of death from respiratory diseases, P < 0.01), and 1.48, 1.85 and 3.12 respectively for those smoking and dust exposure, which were far greater than those either smoked or exposed to dust alone(P < 0.01). (4) The influence of dust exposure on death was mainly showed in occupational exposure to silica dust and wood dust. CONCLUSION: Both dust exposure and smoking may increase the mortality, and they had synergistic effect.

目的 研究接塵和吸煙對死亡的影響。方法 以 1989～ 1992年廣州市實施并建立的職工職業健康監護檔案為基礎資料 ,選年齡≥ 30歲的接塵工人和無任何粉塵及其他有害物質接觸的職工 (對照組 ) 6 16 4 8名為研究對象 ,進行前瞻性隊列研究。結果 (1)隊列失訪 2 8例 ,死亡 1186例 ,以惡性腫瘤死亡為主 ;(2 )本隊列男性多于女性 ,年齡 35～ 4 4歲居多 ,主要為工人 ,中學文化 ,已婚 ,吸煙率 4 2 .2 % ,飲酒率 32 .8% ;(3)調整相應混雜因素后 ,全死因、惡性腫瘤和呼吸系疾病死亡接塵者相對危險度 (RR)分別為 1.2 4、1.34和 1.96 ,與對照組比較 ,差異均有顯著性 (P <0 .0 1) ,吸煙者RR分別為1.16、1.37和 1.6 3,與不吸煙者比 ,前二者差異有顯著性 (P <0 .0 1) ;既接塵又吸煙者上述相應死因死亡RR分別為 1.4 8、1.85和 3.12 ,明顯高于單純接塵或單純吸煙者 ,差異有顯著性 (P <0 .0 1) ;(4)接塵對死亡的影響主要表現在職業接觸矽塵和木塵。結論 接塵與吸煙均可致死亡危險性增加 ,并存在協同作用。