目的 探讨单纯接触温石棉的工人恶性肿瘤，尤其肺癌是否超高。 方法 采用固定队列研究方法。研究队列为515例男性石棉工人，入列条件为1972年1月1日工资在册，工龄满1年，没有明显心肺疾患者。对照队列为650例不接尘男性工人，其余条件同研究队列。追踪27年(1972～1998)。 结果 (1)研究队列全癌死亡50例(SMR=144)，其中肺癌22例(SMR=652)；对照队列全癌死亡11例(SMR=34)，肺癌3例(SMR=89)。两队列间全癌和肺癌差异均有显著性(P<0.05)。(2)不接触石棉的吸烟者肺癌RR为2.6，不吸烟的石棉接触者肺癌RR为12.2，而接触石棉的吸烟者RR高达32.1。吸烟和石棉暴露协同指数为2.2。(3)研究队列发生胸膜间皮瘤2例。 结论 单纯暴露于温石棉的工人肺癌显著超高。%Objective To explore whether excess risk of malignant tumor,especially lung cancer in workers simply exposed to chrysotile. Methods A fixed prospective cohort was established.515 male exposed workers employed at least over one year in chrysotile plant in Jan 1,1972 were as study cohort and 650 male unexposed workers selected from a comparable plant were as control cohort,and the study was followed up for 27 years(Jan 1,1972～Dec 31,1998). Results (1)There were 50 cases died of all cancer in the study cohort (SMR=144),22 of them with lung cancer(SMR=652),whereas 11 cases died of all cancer in the control cohort (SMR=34) and 3 of them with lung cancers (SMR=89).The differences of all cancers and lung cancer between two cohorts were significant (P<0.05).(2)The lung cancer RR was 2.6 for unexposed smokers,12.2 for exposed but non smoking workers and 32.1 for exposed smokers.The index of synergistic effect of smoking and asbestos exposure was 2.2,indicating a multiplying effect to elevate the risk of lung cancer.(3)There were two mesotheliomas developed in chrysotile exposed workers. Conclusions Chrysotile could cause excess risk of lung cancer in exposed workers.
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