3章 有害性の同定

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1 3. DE DE Waxweiler ,743 1, Ahlman DE 3 DE PAH BaP 20ng/m 3 CONO X 5ppm 25ppm 20% 1 Raffle DE 1, Kaplan ,506 DE

2 Williams % 13,179 7,518 57% 1.5 Wegman % 4.4% Leupker , p< Waller Rushton , Howe , , DE p< p<0.001 DE Schenker

3 % CI :80~95 rate ratio %CI: 0.45~ HallWynder %CI: 0.6~ %CI: 0.8~2.4 NIOSHNational Institute for Occupational Safety & Health DE 3 DE Buiatti %CI: 1.0~ %CI: 2.1~20.9 Wong , ,046 3,345 1, healthy worker effect Gustafsson , , Damper

4 National Population Registry 58998% 58296% 45397% Lerchen %CI: 0.8~ %CI: 1.1~ %CI: 0.8~ %CI: 1.4~ %CI: 1.4~ %CI: 0.2~2.0 Tsugane Edling Boffetta DE %CI:

5 Garshick 1987 U.S. Railroad Retirement Board %CI: 1.06~ DE %CI: 0.7~ %CI: 1.2~ %CI: 0.7~1.6 Garshick , ,396 1, %CI: 1.01~ %CI: 1.06~ %CI: 1.13~ %CI: 1.30~2.55 Benhamou %CI: 1.1~ %CI: 1.1~ ~1.9 Minowa AB A 126 B

6 Hayes ,444 1, %CI: 1.2~1.9 50% Gustafsson DE Boffetta 1990 Wynder probablepossiblelow probability of exposure reference group Mantel-Haenszel probable %CI: 0.75~ %CI: 0.78~ %CI: 0.64~ %CI: 0.67~1.15 DE 35 Mantel-Haenszel %CI: 0.78~ %CI: 0.73~2.02 Steenland , %CI: 0.97~ %CI: 1.04~

7 Burns 1991 case-referent study % 95.4% %CI: 1.37~2.58 driver sales2.2195%ci: 1.13~ %CI: 1.24~ %CI: 1.15~ %CI DE Guberan , , , % 15 SIR 12895%CI: 115~142 Hansen , , , %CI: 104~ %CI: 126~ %CI: 142~1024 Swanson , %CI: 1.4~4.4 Emmelin / Pfluger 1994 DE DE

8 ICD-8:162 ICD-8:188 ICD-8:150 ICD-8:410~ Axelson %CI: 1.99~ %CI: 1.30~1.68 Steenland 1998 Steenland 1990 DE 5µg/m %95%CI: 0.4~3.1 Hansen %CI: 1.2~ %CI: 1.2~ %CI: 1.3~1.5 Jöckel DE %CI: 1.27~ Gustavsson ~ ~

9 ,196 1,042 87% 1,441 1,274 88% 1,090 82% 7 DE DE unconditional logistic regression 2.38mg-years/m 3 160µg/m %CI: 1.13~ :1.14~2.33 Nyberg 2000 Gustavsson / / / NO 2 SO ~30 10 NO 2 NO 2 SO ~30 NO µg/m 3 NO ~1.99 NO 2 SO ~ ~30 10 NO µg/m 3 90% NO 2 SO 2 Larkin 2000 DE 55, ~ ~

10 ~44 DE %CI: 1.14~ %CI: 1.01~2.05 DE Boffetta DE DE 3 DE DE 25% 2574% 75% 2,800 1,500 DE DE SIR %CI: 1.06~ %CI: 0.85~1.42 Poisson %CI:0.9~ %CI: 1.1~ %CI: 1.3~ %CI: 1.0~ %CI: 0.86~ %CI: 1.1~1.2 95%CI: 0.6~1.8 2 Howe % %CI: 1.2~394.5DE 2.895%CI: 0.8~11.8 Coggon DE 1.095%CI: 0.7~ %CI: 0.9~3.3 Wynder DE %CI: 0.49~5.73 Hoar

11 %CI: 0.9~ %CI: 1.3~ %CI: 1.2~ :3.095%CI: 1.2~7.4 DE DE 1.595%CI: 0.8~2.8 Vineis ~ %CI: 1.3~ %CI: 0.8~ %CI: 2.7~ %CI: 0.6~ %CI: 1.0~ %CI: 0.9~ %CI: 0.9~ %CI: 0.6~2.5 Silverman ,909 3, %CI: 1.1~ %CI: 1.6~ %CI: 1.1~ %CI: 1.2~ %CI: 0.9~ %CI: 0.6~ p< %CI: 0.7~ %CI: 2.3~61.1 Steenland Iscovich %

12 %CI: 6.9~10.3 Jensen % % %CI: 1.06~ %CI: 1.04~ Risch , , DE %CI: 1.17~ %CI: 1.24~ %CI: 1.08~1.41 Silverman ,100 3, %CI: 1.2~ %CI: 1.1~ %CI: 0.9~ %CI: 1.1~ %CI: 0.8~ Iyer 1990 American Health Foundation DE DE 3 low probabilitypossibleprobable DE possibleprobable 1.295%CI:0.8~2.0 Steineck

13 DE 1.795%CI:0.9~ %CI:0.3~ %CI:0.9~58.8 Brooks grade stage % high grade 1.795%CI:1.1~ high grade 2.395%CI:1.0~5.3 stage 60 grade stage 1.595%CI:1.1~1.9 gradestage Notani %CI:1.3~ %CI:1.2~ %CI:0.8~ %CI:0.9~ %CI:1.2~16.5 Cordier DE %CI:0.32~3.03 Netterstrom %CI:96~ %CI:110~ %CI:125~ %CI:91~ %CI:111~

14 10 Flodin 1987 case-referent study % 80% 2.395%CI:1.4~3.7 Siemiatycki DE 1.395%CI:1.1~ %CI:1.1~ %CI:1.0~2.0 Garland ,275, SIR %CI:2.1~ %CI:1.2~ %CI:0.5~ SIR 3.895%CI:2.1~6.3p< Partanen % 68% 338 industrial hygienist %CI:1.03~2.87 DE %CI:1.05~3.98 DE %CI:0.23~2.01 Aronson DE BMI 30 possible 5 5 probable definite probable definite

15 %CI:1.04~ %CI:0.68~1.64 possible probable 1.195%CI:0.7~ %CI:1.0~ %CI:0.1~ %CI:0.8~ %CI:1.0~ %CI:0.7~ %CI:0.4~ %CI:1.1~2.1 Hodgson Robertson ,045 54, % 60 Parent %CI:0.58~ %CI:1.36~17.02 Hou 1995 Glutathione transferase class mugstµ GSTµ GSTµ acetylation slow acetylator rapid acetylator NATs N-Acetylation of aromatic amine procacinogens by N-acetyl transferase T cloning assay hypoxantine-guanine phophoribosyl transferasehprt P-postlabelling assay DNA GSTµ NATs DE

16 DE DNA DNA GSTM1 DNA slow acetylator-rapid acetylator slow acetylator GSTM1 DNA GSTµ NATs DNA mutagen DNA DNA GSTM1 slow acetylator 1 2 Nielsen 1994 DE genotoxicity polycyclic aromatic hydrocarbon PAHnitro-PAH 2 biomarker adduct pattern 32P-postlabeling assay for DNA adducts relative adduct labeling RAL adduct concentration 2 adduct patterns total adduct concentrations Nielsen 1996 DNA ethene HPU1-hydroxypyrenePAH PAH DE PAH Willems Schenker sensitive microsuspension

17 Hitosugi ~ % 97.0% 3 Shimizu m 2550m5075m 75100m 4 Savitz , %CI: 1.3~5.9 10, %CI: 1.6~13.5 Pearson 2000Savitz ,500ft 450m %CI: 1.69~ %CI: 2.09~32.80 Feyching m , NO 2 NO 2 39µg/m 3 50µg/m %CI: 0.9~8.5 80µg/m %CI: 1.2~12.1 Raachou-Nielsen ,989 1:21:31:5 ID

18 NO 2 NO 2 1 Steenland DE DE 2 CohenHiggins1995 HEI 30 DE DE a DE b DE c 20% 1.2 Muscat SMR DE overload overload DE Muscat1996 DE

19 pack-years DE DE Cox1997 DE DE DE AI Garshick 1988 DE DE Bhatia 1998 MEDLINE DE 35 DE %CI:1.24~ %CI:1.18~ %CI:1.21~ %CI:1.20~ %CI:1.20~ Funnel plot DE LipsettCampleman heterogeneity DE

20 1.4795%CI:1.29~1.67 Bruske-Hohlfeld Jöckel DE %CI: 1.23~ Boffetta %CI: 1.06~ %CI: 1.22~ %CI: 1.00~ %CI: 1.18~

21 3-1 SMR Waxweiler ,743 1, PAH BaP 20ng/m Ahlman CONOx 5ppm ppm 1, Raffle Kaplan , % 13,179 7,518 Williams 1977 OR1.5 57% % Wegman % Leupker 1978 SMR 184,

22 3-1 Waller 1981 Rushton 1983 Howe 1983 Schenker SMR , , p<0.001 rate ratio %CI: ~ NIOSH %CI:0.6~5.5 Hall & Wynder %CI:0.8~2.4 ±5 OR1.895%CI: 1.0~ Buiatti 1985 OR6.5 95%CI: 2.1~ Wong , ~ ~ ~

23 Gustafsson , SMR , Damber 1987 National OR Population Registry Lerchen OR0.6, 95%CI: 0.2~ Tsugane OR Edling

24 Boffetta 1988 Garshick %CI: 0.97~ OR ±2.5 95CI:1.06~1.88 ± CI:1.01~1.44 5~ CI:1.06~ ~ %CI: Garshick ~ ~ CI: 1.30~ OR 2.195%CI:1.1~4.3 Benhamou , ~ ~ Gustafsson Minowa OR OR A 126 B 120 Hayes OR %CI:1.2~

25 probable %CI: 0.75~1.12 probable, Boffetta 1990Wynder 1977 possible, low probability of exposure reference group 0.95 :0.78~ ~ OR %CI: 0.97~ Steenland OR ~3.42 1,085 OR %CI: 1.37~2.58 Burns 1991 driver sales2.2195%ci: 1.13~ %CI: 1.24~ %CI: 1.15~ %CI 1,726 6,630 SIR 12895%CI: ~142 Guberan ~1961 4,192 14,225 Hansen CI:126~ , Swanson 1993 OR 2.595%CI:1.4~ OR Emmelin

26 CI: Pfluger ~ Steenland ìg/m Steenland %95%CI: 0.4~ OR Hansen %CI: 1.2~ %CI: 1.2~1.5, 1.495%CI: 1.3~ OR OR Jöckel %CI: 1.27~2.80 OR NO mg-years/m 3 Gustavsson 160µg/m %CI:1.13~ :1.14~ NO 2 SO 2 NO 2 SO 2 Nyberg 2000 Gustavsson ~ NO µg/m 3 NO %CI: 1.05~1.99NO 2 SO %CI: 1.07~

27 %CI:1.01~2.05 Larkin 2000 Garshick 1988 DE SIR %CI: 1.06~ %CI: 0.85~ Boffetta %CI:0.9~ %CI:1.1~ %CI:1.3~

28 3-2 Howe % OR9.095%CI:1.2~ ~ Coggon OR %CI: 0.7~ ~ Wynder 1985 OR1.6895%CI: 0.49~5.73 Hoar 1985 Vineis 1985 OR 1.595%CI: 0.9~ OR2.395%CI: 1.3~ ~ %CI: 1.2~7.4 OR ~ %CI: 1.3~ %CI: ~ %CI: 2.7~ %CI: 0.6~ %CI: 1.0~ %CI: 0.9~ %CI: 0.9~ %CI: 0.6~2.5 Silverman %CI: 0.9~1.9 1,909 3, %CI: 0.6~3.9 OR OR Steenland OR 2.2 Iscovich OR

29 3-2 Jensen 1987 OR %CI: 1.06~ OR %CI: 94.4% 1.04~ Risch ,251 OR %CI: 1.17~2.00 8~ %CI: 1.24~ ,483 OR %CI: ~1.41 2,100 Silverman ,874 OR %CI: 1.2~ %CI: 1.1~ %CI: 0.9~2.1 OR1.5 95%CI:1.1~ %CI: 0.8~ possible, probable OR Iyer %CI: 0.8~2.0 low probability, possible, probable 320 OR 1.795%CI:0.9~ ~4.3 Steineck ~58.8 2, high Brooks 1992 grade grade adjusted OR= 2.3 stage 95%CI: 1.0 ~

30 3-2 Notani %CI: 1.2~ Cordier OR %CI: 0.32~ 3.03 SMR %CI: 96~ %CI: 110 2,465 ~ %CI: 125~ ~ 1984 Netterstrom1988 SMR 15395%CI: 91~ %CI: 111~ SMR 6 1 Flodin OR 2.395%CI: 1.4~ ,762 OR 1.395%CI: 1.1 Siemiatycki 1988 ~ %CI: 1.1~ %CI: 1.0~ SIR 6.995%CI: 2.1~ Garland ,275, %CI: 1.2~ %CI: 0.5~ SIR 3.895%CI: 2.1~6.3, p<

31 3-2 Partanen 1991 Aronsen ~1978 industrial hygienist OR %CI:1.03~2.87 hygienist 1979~ OR1.5495%CI: 1.04~ OR1.0595%CI: 0.68~

21 1.37 15 49 0.67 0.66 15 49 Lx 10 15 49 Lx 4 3 1-4 gross reproduction rate 1 15 49 1 100 1 total fertility rate 15 49 net reproduction rate 15 49 1

21 1.37 15 49 0.67 0.66 15 49 Lx 10 15 49 Lx 4 3 1-4 gross reproduction rate 1 15 49 1 100 1 total fertility rate 15 49 net reproduction rate 15 49 1 18 2006 19 2007 20 2008 21 2009 22 2010 12,790.0 12,803.1 12,808.3 12,803.0 12,805.6 3 3 1 2,805.6 22 10 1 21 2.6 16 17 1-1 6,250.1 6,555.5 100 population sex ratio 95.3 2008 67.5 80 10 2005 342 /km 2

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