【摘要】 为评价游离二氧化硅（简称矽尘或ＳｉＯ２）是否致肺癌？矽肺是否是肺癌前变基础？选择四类接尘厂矿进行队列和队列内病例对照研究。队列对象６８２８５人。有矽肺６４８７例，肺癌３３０例（男３１９，女１１），配对照１３５８例。根据厂矿历年工业卫生记录和近期对已知致癌物监测结果，定量评估了每个对象的接尘水平及每个病例对照的累积接触量。研究对象追访到１９８９年底，死亡６１９２人。与全国居民死亡平均数计算的期望值近似。全死因中癌症是第一死因，但全癌低于国家居民死亡率。分析结果说明：（１）矽尘单独存在时不是肺致癌剂。肺癌不超高，与接尘关系不明显；（２）在６４８７名矽肺队列中，肺癌相对危险度仅比非矽肺高０．２２倍，主要反应在铜铁矿工人中（Ｒ＝２．２），而矽肺患病率最严重的钨矿工人，其肺癌危险度反而随接尘水平上升而下降，再则肺癌死亡率与矽肺期别不呈正比；形态学上观察也不支持肺癌病变与矽肺纤维化病变相关。本研究结果难以支持矽尘或矽肺与肺癌病因学相关的假说。更多还原

【Abstract】 In an attempt to assess whether silica or silicosis induces lung cancer,acohort study of 68285 subjects and a nested case-control study of 330 lung cancer cases(male 319, femal 11) and 1358 controls was carried out among four kind dusty mines and factories. There were 6487 silicosis. Exposure to dust and silica for each study subject was evaluated quantitatively by cumulative exposure measures based on the historical industrial hygiene records and recenty measurements on confounders. Study subjects were followed up to December 31, 1989 and 6192 deaths were revealed, a number close to that expected based on the National Mortality Rates. Among the full deaths, the leading cause of death was cancer, but the number of cancer was lower than the Rates of National Mortality. The results showed:(1) Silica existed alone is not a lung carcinogen and no significantly relationship with dust exposure; (2)Relative risks of lung cancer among silicotic subjects were slightly higher (RR=0.22) than non-silicosis, but only increased in iron-copper miners (RR=2.2). Incidence of silicosis among tungsten miners was much higher than other mines and factories, but the risk of lung cancer decrease in inverse proportion to the dust-exposed level. And rate of lung cancer was out of proportion to stage of silicosis. Also the results of morphologic observation were not support for association between lung cancer and pathological changes from silicosis. The results of this study provide hardly support to the aetiological relationship between silica or silicosis and lung cancer.更多还原