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Childhood leukaemia and ordnance factories in west Cumbria during the Second World War

机译:第二次世界大战期间坎布里亚郡西部的儿童白血病和军械厂

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摘要

Much evidence has accumulated that childhood leukaemia (CL) is a rare response to a common, but unidentified, infection and in particular that situations involving the unusual mixing of urban and rural groups (approximating to, respectively, groups infected with, and susceptible to, the relevant microorganism) can produce localised epidemics with consequent increases of the infrequent leukaemic complication. During the Second World War, explosives production factories were built and operated at Drigg and Sellafield, and a shell filling factory at Bootle, in west Cumbria, England, requiring substantial numbers of construction workers to be brought into this remote and isolated area. Following the design of an earlier study of CL near large (post-war) rural construction sites, mortality from this disease was investigated with the help of the Office of National Statistics, in the area around these Cumbrian factories where local workers largely lived, during the construction period and with particular reference to the overlapping construction and operational phase when the mixing of local and migrant workers would have been greatest. An excess of leukaemia deaths at ages 1–14 was found during the construction period (observed 3; observed/expected (O/E) 2.2, 95% confidence interval (CI): 0.6, 6.0), which was more marked and statistically significant during the overlap with operations (O 3; O/E 4.5, 95% CI: 1.1, 12.2), especially at ages 1–4 (O 2; O/E 7.1, CI: 1.2, 23.6). A previous investigation did not detect this excess because it considered only a small part of west Cumbria that omitted the communities where most of the workforce lived, having incorrectly attributed the post-war expansion of the village of Seascale (situated between Drigg and Sellafield) to the wartime ordnance factories. The present findings are consistent with the results of the earlier study of rural construction projects and with the general evidence that marked rural–urban population mixing increases the risk of CL.
机译:已有许多证据表明,儿童白血病(CL)是对常见但未确定的感染的罕见反应,尤其是涉及城市和农村人群(分别接近感染和易感人群的人群)异常混合的情况相关微生物)可产生局部流行病,从而导致罕见的白血病并发症增加。第二次世界大战期间,炸药生产工厂在德里格(Drigg)和塞拉菲尔德(Sellafield)建造和运营,而炮弹填充工厂在英格兰西部坎布里亚郡布特尔(Bottle)建造,需要将大量建筑工人带到这个偏远和孤立的地区。在早期对大型(战后)农村建筑工地附近的CL进行研究之后,在国家统计局的帮助下,在这些坎伯里亚工厂周围地区(当地工人主要居住的地区)调查了这种疾病的死亡率。建造阶段,特别是重叠的建造和运营阶段,这时本地工人和移民工人的混合将是最大的。在施工期间发现了1-14岁的白血病死亡过多(观察到3;观察/预期(O / E)2.2,95%置信区间(CI):0.6,6.0),这是更加明显的和具有统计学意义的在操作重叠期间(O 3; O / E 4.5,95%CI:1.1,12.2),尤其是在1-4岁时(O 2; O / E 7.1,CI:1.2,23.6)。先前的调查没有发现这种过剩现象,因为它只考虑了坎布里亚郡西部的一小部分,而忽略了大部分劳动力居住的社区,他们错误地将战后海斯卡尔斯村(位于德里格和塞拉菲尔德之间)的扩张归因于战时兵工厂。目前的发现与早期农村建设项目的研究结果相符,并且与表明城乡人口混合增加CL风险的一般证据是一致的。

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