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Vol. 9. Núm. 50.
Páginas 287-294 (septiembre - octubre 1995)
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Vol. 9. Núm. 50.
Páginas 287-294 (septiembre - octubre 1995)
Open Access
Mortalidad en trabajadores de la siderurgia del país vasco*
Mortality among Steelworkers in the Basque Country, Spain
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Félix Urbaneja Arrúe1,**, Juan José Aurrekoetxea Agirre2, Victor Echenagusía Capelastegui3
1 Unidad de Salud Laboral. Departamento de Sanidad del Gobierno Vasco. Bilbao
2 Unidad de Salud Laboral. Departamento de Sanidad del Gobierno Vasco. San Sebastián
3 Servicio Médico de Altos Hornos de Vizcaya S.A. Sestao
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La mayor parte de los estudios de mortalidad en trabajadores de la industria siderúrgica constata una frecuencia más elevada de muerte por cáncer, fundamentalmente por cáncer de pulmóny, en menor medida, por cáncer digestivo y genitourinario. En España no disponemos de tasas de mortalidad por ocupación o actividad que permitan contrastar esos datos. Para hacer una primera evaluación del riesgo de muerte asociado al trabajo en siderurgia, se realizó un estudio de la mortalidad proporcional en los trabajadores activos y retirados de la siderurgia integral «Altos Hornos de Vizcaya» muertos durante el periodo de 1986–1993. Los 1553 sujetos que componían la muestra del estudio se obtuvieron del registro de mortalidad de la compañía de seguros. Se comparó la causa de la muerte con la de la población general de la Comunidad Autónoma del País Vasco mediante el cálculo de la Razón de Mortalidad Proporcional y la OR de Mortalidad ajustadas por edad.

Se encontró un exceso de muertes por cáncer en general (OR = 1.26; IC: 1,11–1,42), por cáncer de estómago (OR = 1,50; IC: 1,14–1,98) y por cáncer renal (OR= 1,89; IC: 1,14–3,14) que coinciden con los hallazgos de otros autores. No se observó una mortalidad significativamente mayor de la esperada por cáncer de pulmón (OR = 1,13; IC: 0,91–1,40), cáncer de vejiga (OR = 1,13; IC: 0,74–1,72) y enfermedad respiratoria crónica (OR = 0,94; IC: 0,73–1,20). Llama la atención el exceso de muertes por cáncer hepático (OR = 1,56; IC: 1,06–2,28) y por cáncer de localizatión no especificada (OR = 1,85; IC: 1,45–2,36). Esto último puede ser debido a sesgos de ciasificación que afectan al estudio. En sentido contrario, estos mismos sesgos y otros sesgos de selectión que se discuten, podrían estar subestimando la mortalidad por cáncer de pulmón. El exceso de muertes por cáncer de estómago y de riñón hallado permite plantear la hipótesis de una relación causal con determinados agentes cancerígenos, no bien identificados, existentes en el medio de trabajo de una siderurgia.

Palabras clave:
Siderurgia
Mortalidad
Cáncer
Summary

Most of mortality studies among steelworkers pointed out an increased frequency on cancer mortality, above all by lung cancer, and, in a lower proportion, by cancers of digestive and genitourinary systems. In Spain mortality rates are not published by occupation and economic activity to contrast these observations. It was carried out a proportionate mortality study among active or retired workers from an steel mill, Altos Hornos de Vizcaya, died from 1986 to 1993, to make a preliminary death risk assessment associated with job in the steel industry. A sample of 1553 men was drawn from the mortality register of a private Insurance Company. Death causes within the sample and in general population of the Autonomous Community of the Basque Country were compared using a proportionate analysis. Mortality odds ratios (OR) were also computed.

The results show an excess of cancer mortality (OR = 1.26, IC: 1.11–1.42), stomach cancer (OR = 1.50, IC: 1.14–1.98) and renal cancer (OR = 1.89; IC: 1.14–3.14) as it has been stated by other authors. It has not been found an increased mortality risk from lung cancer (OR = 1.13, IC: 0.91–1.40), bladder cancer (OR = 1.13, IC: 0.74–1.72) and chronic respiratory disease (OR = 0.94, IC: 0.73–1.20). There is also an excess of liver cancer (OR = 1.56, IC: 1.06–2.28) and cancer of non specified location (OR = 1.85, IC: 1.45–2.36). This can be due to classification bias that affects the study. On the other hand, these and other selection bias, discussed in this paper, could underestimate the lung cancer mortality. We can not conclude that, among the workers of the study, the mortality from several kind of cancer is not associated to occupational exposure. Furthermore, this excess of stomach and kidney cancer mortality may lead us to pose the hypotnesis of cause-effect relationship with some not well identified carcinogens present at the steel working place.

Key words:
Steelworkers
Mortality
Cancer
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Este trabajo contó con una ayuda económica dentro del programa de investigación de la CECA (CEE).

Copyright © 1995. Sociedad Española de Salud Pública y Administración Sanitaria
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