臨床医学に環境・労働の観点を

・先日関西労働医学研究会というとっても小さな勉強会に参加しましたが、標題の話題提供がありました。

・2007年12月5日/HealthDay Newsの翻訳が、NIKKEI NETに載っております。

http://health.nikkei.co.jp/hsn/news.cfm?i=20071213hj000hj

一部貼り付けます。

 バー、コンビニエンスストア、病院などでの夜間勤務が発癌（がん）リスクを増大させる可能性があるという。これは発癌リスクを評価する世界保健機関（WHO）所属組織である国際癌研究機関（IARC）による結論で、IARCは夜間勤務を「発癌性がおそらくある因子（probable carcinogen）」として正式にリストに加えることを予定している。

　IARCが疫学データ、動物研究の結果、夜間勤務と腫瘍形成とを結びつけるメカニズムに関する研究について詳細に調べた結果、いずれのデータからも、夜間勤務がヒトの癌に何らかの形で寄与している可能性が示されたと、IARC作業部会長のAaron Blair氏は述べている。この知見は、医学誌「Lancet Oncology」12月号に掲載された。

　これまで数々の研究から夜間勤務と癌との関係が示されてきたが、IARCによる評価は今回が初めて。疫学データでは、看護師、航空機の客室乗務員など交代制勤務を行うさまざまな職種で、乳癌リスクが高いことが最も強く示されており、次いで前立腺癌、大腸（結腸）癌のリスク増大も認められているという。動物での研究でも、夜間の活動時間に光に曝露したラットで癌の発症率が高いことが示されている。

と、いうことだそうです。

・IARCは、以下のように発ガンリスクを分類していますが、化学物質や物理因子のみでなく、環境や職種も発ガンの「原因」に含んで、分類しています。

• グループ1：発がん性がある
• グループ2A：おそらく発がん性がある
• グループ2B：発がん性があるかもしれない
• グループ3：発がん性を分類できない
• グループ4：おそらく発がん性はない

・以下にGroup2Aを貼り付けておきますが、交替勤務がリストの下のほうに出てきます。（赤色の字）

Group 2A: Probably carcinogenic to humans (66)

Agents and groups of agents

Acrylamide [79-06-1] (Vol. 60; 1994)
(NB: Overall evaluation upgraded from 2B to 2A with supporting evidence from other relevant data)

Adriamycin [23214-92-8] (Vol. 10, Suppl. 7; 1987)
(NB: Overall evaluation upgraded from 2B to 2A with supporting evidence from other relevant data)

Androgenic (anabolic) steroids (Suppl. 7; 1987)

Aristolochic acids (naturally occurring mixtures of) (Vol. 82; 2002)

Azacitidine [320-67-2] (Vol. 50; 1990)
(NB: Overall evaluation upgraded from 2B to 2A with supporting evidence from other relevant data)

Bischloroethyl nitrosourea (BCNU) [154-93-8] (Vol. 26, Suppl.7; 1987)

Captafol [2425-06-1] (Vol. 53; 1991)
(NB: Overall evaluation upgraded from 2B to 2A with supporting evidence from other relevant data)

Chloramphenicol [56-75-7] (Vol. 50; 1990)
(NB: Overall evaluation upgraded from 2B to 2A with supporting evidence from other relevant data)

a-Chlorinated toluenes (benzal chloride [98-87-3], benzotrichloride [98-07-7], benzyl chloride [100-44-7]) and benzoyl chloride [98-88-4] (combined exposures) (Vol. 29, Suppl. 7, Vol. 71; 1999)

1-(2-Chloroethyl)-3-cyclohexyl-1-nitrosourea (CCNU) [13010-47-4](Vol. 26, Suppl. 7; 1987)
(NB: Overall evaluation upgraded from 2B to 2A with supporting evidence from other relevant data)

4-Chloro-ortho-toluidine [95-69-2] (Vol. 77, Vol. 99; in preparation)

Chlorozotocin [54749-90-5] (Vol. 50; 1990)
(NB: Overall evaluation upgraded from 2B to 2A with supporting evidence from other relevant data)

Cisplatin [15663-27-1] (Vol. 26, Suppl. 7; 1987)
(NB: Overall evaluation upgraded from 2B to 2A with supporting evidence from other relevant data)

Clonorchis sinensis (infection with) (Vol. 61; 1994)
(NB: Overall evaluation upgraded from 2B to 2A with supporting evidence from other relevant data)

Cyclopenta[cd]pyrene [27208-37-3] (Vol. 32, Suppl. 7, Vol. 92; in preparation)
(NB: Overall evaluation upgraded from 2B to 2A with supporting evidence from other relevant data)

Dibenz[a,h]anthracene [53-70-3] (Vol. 32, Suppl. 7, Vol. 92; in preparation)
(NB: Overall evaluation upgraded from 2B to 2A with supporting evidence from other relevant data)

Dibenzo[a,l]pyrene [191-30-0] (Vol. 32, Suppl. 7, Vol. 92; in preparation)
(NB: Overall evaluation upgraded from 2B to 2A with supporting evidence from other relevant data)

Diethyl sulfate [64-67-5] (Vol. 54, Vol. 71; 1999)
(NB: Overall evaluation upgraded from 2B to 2A with supporting evidence from other relevant data)

Dimethylcarbamoyl chloride [79-44-7] (Vol. 12, Suppl. 7, Vol. 71; 1999)
(NB: Overall evaluation upgraded from 2B to 2A with supporting evidence from other relevant data)

1,2-Dimethylhydrazine [540-73-8] (Vol. 4, Suppl. 7, Vol. 71; 1999)
(NB: Overall evaluation upgraded from 2B to 2A with supporting evidence from other relevant data)

Dimethyl sulfate [77-78-1] (Vol. 4, Suppl. 7, Vol. 71; 1999)
(NB: Overall evaluation upgraded from 2B to 2A with supporting evidence from other relevant data)

Epichlorohydrin [106-89-8] (Vol. 11, Suppl. 7, Vol. 71; 1999)
(NB: Overall evaluation upgraded from 2B to 2A with supporting evidence from other relevant data)

Ethyl carbamate (urethane) [51-79-6] (Vol. 7, Suppl. 7, Vol. 96; in preparation)
(NB: Overall evaluation upgraded from 2B to 2A based on mechanistic and other relevant data)

Ethylene dibromide [106-93-4] (Vol. 15, Suppl. 7, Vol. 71; 1999)
(NB: Overall evaluation upgraded from 2B to 2A with supporting evidence from other relevant data)

N-Ethyl-N-nitrosourea [759-73-9] (Vol. 17, Suppl.7; 1987)
(NB: Overall evaluation upgraded from 2B to 2A with supporting evidence from other relevant data)

Etoposide [33419-42-0] (Vol. 76; 2000)
(NB: Overall evaluation upgraded from 2B to 2A with supporting evidence from other relevant data)

Glycidol [556-52-5] (Vol. 77; 2000)
(NB: Overall evaluation upgraded from 2B to 2A with supporting evidence from other relevant data)

Indium phosphide [22398-80-7] (Vol. 86; 2006)
(NB: Overall evaluation upgraded from 2B to 2A)

IQ (2-Amino-3-methylimidazo[4,5-f]quinoline) [76180-96-6] (Vol. 56; 1993)
(NB: Overall evaluation upgraded from 2B to 2A with supporting evidence from other relevant data)

Kaposi's sarcoma herpesvirus/human herpesvirus 8 (Vol. 70; 1997)

Lead compounds, inorganic (Vol. 87; 2006)

5-Methoxypsoralen [484-20-8] (Vol. 40, Suppl. 7; 1987)
(NB: Overall evaluation upgraded from 2B to 2A with supporting evidence from other relevant data)

Methyl methanesulfonate [66-27-3] (Vol. 7, Suppl. 7, Vol. 71; 1999)
(NB: Overall evaluation upgraded from 2B to 2A with supporting evidence from other relevant data)

N-Methyl-N´-nitro-N-nitrosoguanidine(MNNG) [70-25-7] (Vol. 4, Suppl. 7; 1987)
(NB: Overall evaluation upgraded from 2B to 2A with supporting evidence from other relevant data)

N-Methyl-N-nitrosourea [684-93-5] (Vol. 17, Suppl.7; 1987)
(NB: Overall evaluation upgraded from 2B to 2A with supporting evidence from other relevant data)

Nitrate or nitrite (ingested) under conditions that result in endogenous nitrosation (Vol. 94; in preparation)

Nitrogen mustard [51-75-2] (Vol. 9, Suppl. 7; 1987)

N-Nitrosodiethylamine [55-18-5] (Vol. 17, Suppl. 7; 1987)
(NB: Overall evaluation upgraded from 2B to 2A with supporting evidence from other relevant data)

N-Nitrosodimethylamine [62-75-9] (Vol. 17, Suppl. 7; 1987)
(NB: Overall evaluation upgraded from 2B to 2A with supporting evidence from other relevant data)

Phenacetin [62-44-2] (Vol. 24, Suppl. 7; 1987)

Procarbazine hydrochloride [366-70-1] (Vol. 26, Suppl. 7; 1987)
(NB: Overall evaluation upgraded from 2B to 2A with supporting evidence from other relevant data)

Styrene-7,8-oxide [96-09-3] (Vol. 60; 1994)
(NB: Overall evaluation upgraded from 2B to 2A with supporting evidence from other relevant data)

Teniposide [29767-20-2] (Vol. 76; 2000)
(NB: Overall evaluation upgraded from 2B to 2A with supporting evidence from other relevant data)

Tetrachloroethylene [127-18-4] (Vol. 63; 1995)

Trichloroethylene [79-01-6] (Vol. 63; 1995)

1,2,3-Trichloropropane [96-18-4] (Vol. 63; 1995)

Tris(2,3-dibromopropyl) phosphate [126-72-7] (Vol. 20, Suppl. 7, Vol. 71;1999)
(NB: Overall evaluation upgraded from 2B to 2A with supporting evidence from other relevant data)

Ultraviolet radiation A (Vol. 55; 1992)
(NB: Overall evaluation upgraded from 2B to 2A with supporting evidence from other relevant data)

Ultraviolet radiation B (Vol. 55; 1992)
(NB: Overall evaluation upgraded from 2B to 2A with supporting evidence from other relevant data)

Ultraviolet radiation C (Vol. 55; 1992)
(NB: Overall evaluation upgraded from 2B to 2A with supporting evidence from other relevant data)

[Urethane: see Ethyl carbamate]

Vinyl bromide [593-60-2] (Vol. 39, Suppl. 7, Vol. 71, Vol. 97; in preparation)
(NB: (1) Overall evaluation upgraded from 2B to 2A based on mechanistic and other relevant data;
(2) For practical purposes, vinyl bromide should be considered to act similarly to the human carcinogen vinyl chloride.)

Vinyl fluoride [75-02-5] (Vol. 63; 1995)
(NB: (1) Overall evaluation upgraded from 2B to 2A based on mechanistic and other relevant data;
(2) For practical purposes, vinyl fluoride should be considered to act similarly to the human carcinogen vinyl chloride.)

Mixtures

Creosotes [8001-58-9] (Vol. 35, Suppl. 7, Vol. 92; in preparation)

Diesel engine exhaust (Vol. 46; 1989)

High-temperature frying, emissions from (Vol. 95; in preparation)

Hot mate (Vol. 51; 1991)

Household combustion of biomass fuel (primarily wood), indoor emissions from (Vol. 95; in preparation)

Non-arsenical insecticides (occupational exposures in spraying and application of) (Vol. 53; 1991)

Polychlorinated biphenyls [1336-36-3] (Vol. 18, Suppl. 7; 1987)

Exposure circumstances

Art glass, glass containers and pressed ware (manufacture of) (Vol. 58; 1993)

Carbon electrode manufacture (Vol. 92; in preparation)

Cobalt metal with tungsten carbide (Vol. 86; 2006)

Hairdresser or barber (occupational exposure as a) (Vol. 57, Vol. 99; in preparation)

Petroleum refining (occupational exposures in) (Vol. 45; 1989)

Shiftwork that involves circadian disruption (Vol. 98; in preparation)

Sunlamps and sunbeds (use of) (Vol. 55; 1992)

＊本日、Wikipediaで国際がん研究機関の項をみましたが、そこにこのリストの和訳がありましたが、ちょっと古いようで、上のリストで載っていないものがあります。

＊余談ですが、美容師、理容師の環境は、発ガンリスク２Ａなのです。