中文摘要：

目的：探讨云南省大姚县低剂量青石棉相关暴露与当地恶性肿瘤死亡的关联,为制定当地恶性肿瘤的防治策略提供依据。方法：对大姚县部分青石棉污染区的农村居民进行27年回顾性队列（1984年2月至2011年4日）研究。结果：观察队列共1 249人,随访总人年数为28 848.27人年,其中443人死亡,占全部随访对象的35.47%。队列中有121人死于恶性肿瘤,总死亡率为1 535.64/10万人年。居恶性肿瘤死因顺位首位的是肝癌,共29例,粗死亡率为100.53/10万人年（标化死亡率为51.22/10万人年）;居第2位的是肺部恶性肿瘤（不含胸膜间皮瘤）,共27例,粗死亡率为93.59/10万人年（标化死亡率为41.05/10万人年）;居第3位的是胸膜间皮瘤,共26例,粗死亡率为90.13/10万人年（标化死亡率为54.36/10万人年）。肠癌与胃癌死亡率分别为45.06/10万人年（标化死亡率为23.68/10万人年）和41.60/10万人年（标化死亡率为18.27/10万人年）。多因素分析显示,当地主要青石棉暴露因素（生产石棉炉、使用石棉炉数量、石棉修路和居住时间）均与恶性肿瘤死亡相关。而且男性的相对危险度高于女性。结论：消化道恶性肿瘤已成为严重危害大姚县居民健康的首位癌种,以肝癌、肠癌及胃癌为主,青石棉相关暴露是当地恶性肿瘤高发的主要危险因素。

英文摘要：

Objective：To explore the association between environmental low-dose exposure to crocidolite and malignancy,so as to provide the epidemiologic evidence for malignancy prevention. Methods：A 27-year（February,1984 to January,2011） retrospective cohort study was conducted to evaluate the mortality of the major malignancy in the crocidolite-contaminated area in Dayao county,Yunnan province. Results：There were 1 249 subjects（575 males and 674 females） in the retrospective cohort and 28 848.27 person-years were observed totally.In this cohort,443 person were died,which accounted for 35.4% of the total subjects.Furthermore,121 person were died from cancer,the total mortality was 1535.64 per 100 000 person-years.Hepatic carcinoma（29 cases） was the first cause of tumor death and the mortality was 100.53 per 100 000 person-years（the standarized mortality rate is 51.22 per 100 000 person-years）.Lung cancer（27 cases,not including pleura mesothelioma） was the second cause of tumor death and the mortality was 93.59 per 100 000 person-years（the standarized mortality rate is 41.5 per 100 000 person-years）.The third cause was pleura mesothelioma,which contained 26 cases,the mortality was 90.13 per 100 000 person-years（the standarized mortality rate is 54.36 per 100 000 person-years）.Gastric cancer and intestinal cancer mortality were 45.06 per 100 000 person-years（the standarized mortality rate is 23.68 per 100 000 person-years） and 18.27 per 100 000 person-years（the standarized mortality rate is 54.36 per 100 000 person-years）.Multiple regression analysis showed that the exposure factors（producing asbestos stove,using asbestos stove,building the road with asbestos and the time of living in contaminated areas） were associated with the occurrence of malignancy in Dayao county.Meanwhile,the relative risk was higher among the male residents. Conclusions：Liver,lung,stomach,colon cancer,pleural mesothelioma and other malignant tumors are higher than those in Yunnan and the national average