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Mortality in a cohort of US firefighters from San Francisco, Chicago and Philadelphia: an update.

来自旧金山、芝加哥和费城的美国消防员队列死亡率: 更新。

  • 影响因子:2.97
  • DOI:10.1136/oemed-2019-105962
  • 作者列表:"Pinkerton L","Bertke SJ","Yiin J","Dahm M","Kubale T","Hales T","Purdue M","Beaumont JJ","Daniels R
  • 发表时间:2020-02-01
Abstract

OBJECTIVES:To update the mortality experience of a previously studied cohort of 29 992 US urban career firefighters compared with the US general population and examine exposure-response relationships within the cohort. METHODS:Vital status was updated through 2016 adding 7 years of follow-up. Cohort mortality compared with the US population was evaluated via life table analyses. Full risk-sets, matched on attained age, race, birthdate and fire department were created and analysed using the Cox proportional hazards regression to examine exposure-response associations between select mortality outcomes and exposure surrogates (exposed-days, fire-runs and fire-hours). Models were adjusted for a potential bias from healthy worker survivor effects by including a categorical variable for employment duration. RESULTS:Compared with the US population, mortality from all cancers, mesothelioma, non-Hodgkin's lymphoma (NHL) and cancers of the oesophagus, intestine, rectum, lung and kidney were modestly elevated. Positive exposure-response relationships were observed for deaths from lung cancer, leukaemia and chronic obstructive pulmonary disease (COPD). CONCLUSIONS:This update confirms previous findings of excess mortality from all cancers and several site-specific cancers as well as positive exposure-response relations for lung cancer and leukaemia. New findings include excess NHL mortality compared with the general population and a positive exposure-response relationship for COPD. However, there was no evidence of an association between any quantitative exposure measure and NHL.

摘要

目的: 更新先前研究的 29 992 名美国城市职业消防员队列与美国普通人群相比的死亡率经验,并检查队列内的暴露-反应关系。 方法: 2016年更新生命状态,增加 7 年的随访。通过寿命表分析评估与美国人群相比的队列死亡率。完整的风险集,匹配达到的年龄,种族, 创建了出生日期和消防部门,并使用 Cox 比例风险回归分析,以检查选择死亡率结果和暴露替代者 (暴露-天, 火灾运行和火灾时间)。通过包括就业持续时间的分类变量,对健康工人幸存者效应的潜在偏倚进行了校正。 结果: 与美国人群相比,所有癌症、间皮瘤、非霍奇金淋巴瘤 (NHL) 和食管癌、肠癌、直肠癌、肺癌和肾癌的死亡率均轻度升高。观察到肺癌、白血病和慢性阻塞性肺疾病 (COPD) 死亡的阳性暴露-反应关系。 结论: 本更新证实了以前所有癌症和几种部位特异性癌症的超额死亡率以及肺癌和白血病的阳性暴露-反应关系的发现。新的发现包括与普通人群相比 NHL 死亡率过高以及 COPD 的阳性暴露-反应关系。然而,没有证据表明任何定量暴露测量与 NHL 之间存在关联。

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