最初接触石棉和石棉相关疾病之间的时间可能跨越几十年。石棉监测计划旨在检测 8,565 名以前接触石棉的电力行业工人的早期石棉相关疾病。石棉接触模式如何影响癌症死亡率和死亡潜伏期？ 8,476 名参与者 (99%) 的生命状况以及 89.9% 已故参与者的可用死亡证明。计算了石棉相关癌症的标准化死亡率（SMR）。间皮瘤和肺癌的 SMR 按暴露时间、累积石棉暴露和吸烟情况进行分层。使用多元线性回归分析检查首次接触年龄、累积石棉接触和吸烟对死亡潜伏期的影响。间皮瘤 (n = 104) 的死亡风险随着累积石棉接触的增加而增加，但不随接触时间的增加而增加；在进行短期极高暴露（蒸汽轮机修正）活动的参与者中观察到最高死亡率（SMR：23.20；95% CI：17.62-29.99）。肺癌死亡率（n = 215）没有增加（SMR：1.03；95% CI：0.89-1.17）。间皮瘤至死亡的中位潜伏期为 46 (15-63) 年，肺癌为 44 (15-70) 年，死亡发生在 64 至 82 岁之间。死亡潜伏期不受首次暴露年龄、累积暴露或吸烟的影响。对于估计间皮瘤死亡风险，累积剂量似乎比暴露持续时间更合适。此外，应考虑短时间内高累积剂量的暴露。由于本研究仅记录了肺癌死亡率，而非发病率，因此无法评估与石棉暴露相关的肺癌风险，并且肺癌死亡率低于预期，可能是由于筛查效果和治疗方法的改进。石棉相关癌症死亡的关键时间窗口是七岁到九岁之间。未来的研究应该进一步探讨延迟的概念，特别是因为整个文献中都报道了较大的延迟范围。版权所有 © 2024。由 Elsevier B.V. 出版。

The time between initial asbestos exposure and asbestos-related disease can span several decades. The Asbestos Surveillance Program aims to detect early asbestos-related diseases in a cohort of 8,565 power industry workers formerly exposed to asbestos.How does asbestos exposure patterns affect cancer mortality and the duration of latency until death?A mortality follow-up was conducted with available vital status for 8,476 participants (99 %) and available death certificates for 89.9 % of deceased participants. Standardised mortality ratios (SMR) were calculated for asbestos-related cancers. The SMR of mesothelioma and lung cancer were stratified by exposure duration, cumulative asbestos exposure and smoking. The effect of age at first exposure, cumulative asbestos exposure and smoking on the duration of latency until death was examined using multiple linear regression analysis.The mortality risk of mesothelioma (n = 104) increased with cumulative asbestos exposure but not with exposure duration; the highest mortality (SMR: 23.20; 95 % CI: 17.62-29.99) was observed in participants who performed activities with short extremely high exposures (steam turbine revisions). Lung cancer mortality (n = 215) was not increased (SMR: 1.03; 95 % CI: 0.89-1.17). Median latency until death was 46 (15-63) years for mesothelioma and 44 (15-70) years for lung cancer and deaths occurred between age 64 and 82 years. Latency until death was not influenced by age at first exposure, cumulative exposure, or smoking.Cumulative dose seems to be more appropriate than exposure duration for estimating the risk of mesothelioma death. Additionally, exposure with high cumulative doses in short time should be considered. Since only lung cancer mortality, not incidence, was recorded in this study, lung cancer risk associated with asbestos exposure could not be assessed and the lung cancer mortality was lower than expected probably due to screening effects and improved treatments. The critical time window of death from asbestos-related cancer is between the seventh and ninth decade of life. Future studies should further explore the concept of latency, especially since large ranges are reported throughout the literature.Copyright © 2024. Published by Elsevier B.V.