2021年荷兰六种职业暴露所致癌症负担：一项健康影响评估研究

文献信息

中文摘要

引言： 尽管已知众多职业暴露具有致癌性，但其对荷兰癌症负担的贡献程度仍不明确。我们估算了2021年荷兰六种职业致癌物所致的年度癌症负担。
方法： 我们选择了国际癌症研究机构归类为1类人类致癌物的职业暴露及相关癌症部位，重点关注在一项英国研究中癌症负担最高的六种。这些暴露包括石棉、可吸入结晶二氧化硅、柴油发动机尾气、太阳紫外线（UV）辐射以及油漆工和焊工相关职业暴露。使用Levin方程计算人群归因分数（PAF），即归因于这些暴露的癌症病例比例。输入数据包括相关暴露期（1971-2011年）暴露人群比例，来源于荷兰统计局的资料；以及每种暴露-癌症部位组合的相对危险度，来源于现有文献。将2021年荷兰癌症登记处获得的癌症发病数据乘以PAF，以估算归因病例总数。
结果： 2021年，估计有3932例癌症病例（占所有病例的3.1%）归因于这六种职业暴露，男性比例（5.4%）高于女性（0.5%）。太阳紫外线辐射导致的病例最多（1720例皮肤鳞状细胞癌），其次是石棉（925例肺癌、463例间皮瘤、10例卵巢癌、9例喉癌）、油漆工相关暴露（156例肺癌、83例膀胱癌）、焊工相关暴露（201例肺癌、11例眼黑色素瘤）、可吸入结晶二氧化硅（233例肺癌）和柴油发动机尾气（187例肺癌）。
结论： 职业暴露对荷兰的癌症负担有贡献，尤其是在男性中。太阳紫外线辐射和石棉导致的归因癌症数量最高。针对性的暴露控制可大幅减少这一可预防的癌症负担。

英文摘要

INTRODUCTION: Although numerous occupational exposures are known to be carcinogenic, the extent to which they contribute to the cancer burden in the Netherlands remains unclear. We estimated the annual cancer burden attributable to six occupational carcinogens in the Netherlands for 2021.
METHODS: We selected occupational exposures and related cancer sites classified as group 1 human carcinogens by the International Agency for Research on Cancer, focusing on the six with the highest cancer burden in a UK study. These exposures include asbestos, respirable crystalline silica, diesel engine exhaust, solar ultraviolet (UV) radiation and painter- and welder-related occupational exposures. Population attributable fractions (PAFs), representing the proportion of cancer cases attributable to these exposures, were calculated using Levin's equation. Input data included the proportion of the population exposed during the relevant exposure period (1971-2011), derived from data from Statistics Netherlands; and relative risks for each exposure-cancer site combination, obtained from existing literature. Cancer incidence data in 2021, obtained from the Netherlands Cancer Registry, were multiplied by the PAFs to estimate the total numbers of attributable cases.
RESULTS: In 2021, an estimated 3932 cancer cases (3.1% of all cases) were attributable to the six occupational exposures, with a greater proportion in men (5.4%) than in women (0.5%). Solar UV radiation contributed to the most cases (1720 squamous cell carcinomas of the skin), followed by asbestos (925 lung cancers, 463 mesotheliomas, 10 ovarian cancers, 9 laryngeal cancers), painter-related exposures (156 lung cancers, 83 bladder cancers), welder-related exposures (201 lung cancers, 11 ocular melanomas), respirable crystalline silica (233 lung cancers) and diesel engine exhaust (187 lung cancers).
CONCLUSIONS: Occupational exposures contribute to the cancer burden in the Netherlands, especially among men. Solar UV radiation and asbestos result in the highest numbers of attributable cancers. Targeted exposure control could substantially reduce this preventable cancer burden.