石棉暴露所致癌症的流行病学及人群防控研究进展

Advances in epidemiology and population-based prevention and control of cancers caused by asbestos exposure

摘要:

石棉是6种被广泛商业化使用的天然矿物纤维的总称，分为两类：角闪石石棉 （青石棉、阳起石、透闪石、直闪石和铁闪石） 和蛇纹石纤维 （温石棉），其中温石棉占石棉总产量的 90% 以上。国际癌症研究署“人类致癌危害鉴定专著”认定：所有类型的石棉对人体是有充分证据的1类致癌物；石棉是恶性间皮瘤、肺癌、喉癌和卵巢癌的1类致癌物。随着中国人口老龄化趋势加剧以及既往石棉暴露水平的累积效应，预计石棉暴露所致癌症的负担将持续加重。本文系统梳理全球范围内石棉暴露相关癌症的流行病学数据及人群防控政策，以期为石棉暴露所致癌症的人群防控提供科学依据。

Abstract:

Asbestos is a collective term for six natural mineral fibers that have been widely used commercially. These fibers are classified into two main groups: amphibole asbestos (including crocidolite, tremolite, actinolite, anthophyllite, and amosite) and serpentine fibers (primarily chrysotile), with chrysotile accounting for more than 90% of total asbestos production. According to the International Agency for Research on Cancer (IARC) Monographs on the Evaluation of Carcinogenic Risks to Humans, all types of asbestos are classified as Group Ⅰ carcinogens, with sufficient evidence of carcinogenicity in humans. Asbestos is a Group Ⅰ carcinogen for malignant mesothelioma, lung cancer, laryngeal cancer, and ovarian cancer. With the accelerating aging of the Chinese population and the cumulative effects of past asbestos exposure, the cancer burden attributable to asbestos exposure in China is expected to continue rising. This article systematically reviews the epidemiological data on asbestos-related cancers and population-based prevention and control strategies worldwide, aiming to provide scientific evidence for the prevention and control of asbestos-related cancers in China.