Critical Literature Review on Exposure Assessment Methods for Metalworking Fluids in Epidemiological Cancer Study

금속가공유 노출과 암 발생위험역학조사에서 금속가공유 노출 평가 방법에 대한 고찰

  • Park, Donguk (Department of Environmental Health, Korea National Open University)
  • 박동욱 (한국방송통신대학교 환경보건학과)
  • Received : 2007.11.14
  • Accepted : 2007.12.03
  • Published : 2007.12.31


그 동안 많은 역학연구를 통해서 금속가공유(metalworking fluid, MWFs) 노출과 여러 조직에서 암 발생 위험과의 관계를 밝혔지만, 금속가공유 종류(비수용성, 수용성, 합성, 준합성)별로 구분된 위험은 아직 완전하게 규명되지 않았다. 역학조사에서 금속가공유 노출을 대체할 수 있는 인자(surrogate)로서 정성적(qualitative), 명목적(ordinal) 혹은 준정량적인(semi-quantitative) 변수들(금속가공유에 대한 노출 유무, 노출 정도: 높음, 낮음 등, 직업 유무, 근무기간 등)을 이용하여 금속가공유 노출을 평가하였다. 이러한 노출평가방법은 기본적으로 금속가공유 노출 강도(intensity)가 고려되지 않을 뿐만 아니라 노출 분류 오류(misclassification)도 항상 존재할 수 있어 금속가공유 노출은 물론이고 종류별 위험을 밝히기 어렵다. 일부 역학연구에서 금속가공유 종류별 누적 노출양(cumulative exposure level)과 암위험과의 관계를 밝혔다. 이러한 연구결과들은 모두 금속가공유 종류별로 과거노출을 추정할 수 있는 자료(정량적인 노출평가자료, 과거직업력, 취급했던 금속가공유 종류 등)가 잘 기록되어 있는 1개의 대규모 자동차공장에서 나온 것들이다. 따라서 금속가공유에 대한 노출자료가 부족하고 사용특성에 대한 기록이 없거나 부족한 일반 인구나 산업을 대상으로 한 역학연구에서는 금속가공유의 종류별 위험을 밝히는것은 불가능하다. 금속가공유 종류별로 과거 노출에 대한 확률(probability)을 추정하는데 일반적으로 활용할 수 있는 노출확률 메트릭스를 개발하는 것이 필요하다.


  1. Acquavella J. Occupational experience and mortality among a cohort of metal components manufacturing workers. Epidemiology 1993;4(5):428-434
  2. Agalliu I, Kriebel D, Quinn MM, Wegman DH, Eisen EA. Prostate cancer incidence on relation to time window of exposure to MWFs in the auto industry. Epidemiology 2005;16:664-670
  3. Bardin JA, Eisen EA, Tolbert PE, Hallock MF, Hammond SK, Woskie SR, Smith TJ, Monson RR. Mortality studies of machining fluid exposure in the automobile industry V: A casecontrol study of pancreatic cancer. Am J Ind Med 1997;32:240-247<240::AID-AJIM9>3.0.CO;2-0
  4. Bardin JA, Gore RJ, Wegman DH, Kriebel D, Woskie SR, Eisen EA. Registry-based case-control studies of lever and cancers of the biliary tract nested in a cohrt of autoworkers exposed to MWFs. Scan J Work Environ Health 2005;31(3):205-211
  5. Belletti I., Troschel L, Pisani P, Berrino F. Retrospective assessment of exposure by expert: the example of formaldehyde, solvents and mineral oils textile and metal workers. Int J Epidemiology 1993;22(6):S127-133
  6. Calvert GM. Cancer risks among workers exposed to metalworking fluids: a systematic review. Am J Ind Med 1998;33:282-292<282::AID-AJIM10>3.0.CO;2-W
  7. Coggon D, Inskip H. Mortality from scrotal cancer in metal machinists in England and Wales, 1979-80 and 1982-90. Occup Med 1996;46:1969-1970
  8. Decoufle P. Further analysis of cancer mortality patterns among workers exposed to cutting oil mists. J Natl Cancer Inst 1978;61(4):1025-1030
  9. Delzell E. Brown DA. Matthews R. Mortality among hourly motor vehicle manufacturing workers. J Occup Env Med 2003;45(8):813-830
  10. Eisen EA, Bardin J, Gore R. Exposure-response models based on extended follow-up of a cohort mortality study in the automobile industry. Scan J Work Environ Health 2001;27(4):240-249
  11. Eisen EA, Tolbert PE, Monson RR, Smith TJ. Mortality studies of machining fluid exposure in the automobile industry I: A standardized mortality ration analysis. Am J Ind Med 1992;22:809-824
  12. Eisen EA. Mortality studies of machining fluid exposure in the automobile industry. III: A case-control study of larynx cancer. Am J of Ind Med 1994;26:185-202
  13. Jarvholm B, Lillienberg L. Cancer morbidity among men exposed to oil mist in the metal industry. J Occup Med 1981;23(5):333-337
  14. Kauppinen TP. Development of a classification strategy of exposure for industry-based studies. Appl Occup Environ Hyg 1991;6(6):482-487
  15. Kazerouni N, Thomas TL, Petralia SA, Hayes RB. Mortality among workers exposed to cutting oil mist: Update of previous reports. Am J of Ind Med 2000;38:410-416<410::AID-AJIM6>3.0.CO;2-5
  16. Malloy EJ, Miller KL, Eisen EA. Rectal cancer and exposure to metalworking fluids in the automobile manufacturing industry. Occup Environ Med 2007;64:244-249
  17. NIOSH. Criteria for a recommended standard: Occupational exposure to metalworking fluids. U.S. 1998
  18. Park R, Krebs J, Mirer F. Mortality at an automotive stamping and assembly complex. Am J Ind Med 1994;26:449-463
  19. Park RM, Mirer FE. A survey of mortality at two automotive engine manufacturing plants. Am J Ind Med 1996;30(6):664-673<664::AID-AJIM3>3.0.CO;2-R
  20. Park RM. Causes of death among workers in a bearing manufacturing plant. Am J Ind Med 1988;13:569-580
  21. Park RM. Mortality at an automotive engine foundry and machining complex. J Occup Env Med 2001;43(5):483-493
  22. Russi M, Dubrow R, Flannery JT, Cullen MR., Mayne ST. Occupational exposure to machining fluids and laryngeal cancer risk: Contrasting results using two separate control groups. Am J Ind Med 1997;31:166-171<166::AID-AJIM5>3.0.CO;2-Y
  23. Savitz DA. Epidemiologic Evidence on the Carcinogenicity of Metalworking Fluids. Appl Occup Environ Hygiene 2003;18:913-920
  24. Schroeder JC, Tolbert PE, Eisen EA, Monson RR, Hallock MF, Smith TJ, Woskie SR, Hammond SK, Milton DK. Mortality studies of machining fluid exposure in the automobile industry IV; a case-control study of lung cancer.. Am J Ind Med 1997;31:525-533<525::AID-AJIM5>3.0.CO;2-S
  25. Silberstein M. Mortality among bearing plant workers exposed to metalworking fluids and abrasives. J Occup Med 1988;30(9):706-714
  26. Sullivan PA, Eisen EA, Woskie SR, Kriebel D, Wegman DH, Hallock MF, Hammond SK, Tolbert PE, Smith TJ, Monson RR. Mortality studies of MWFs exposure in the automobile industry V: A case-control study of esophageal cancer. Am J Ind Med 1998;34:36-48<36::AID-AJIM6>3.0.CO;2-O
  27. Thompson D, Kriebel D, Quinn MM, Wegman DH, Eisen EA. Occupational exposure to MWFs and risk of breast cancer among female autoworkers. Am J Ind Med 2005;47:153-160
  28. Tolbert PE, Eisen EA, Pothier LJ, Monson RR, Hallock MF, Smith TJ. Mortality studies of machining-fluid exposure in the automobile industry. II. Risks associated with specific fluid types. Scan J Work Environ Health 1992;18:351-360
  29. Vena JE. Mortality of workers in an automobile engine and parts manufacturing complex. Brit J Ind Med 1985;42:85-93
  30. Yassi A, Tate RB, Routledge M. Cancer incidence and mortality in workers employed at a transformer manufacturing plant: Update to a cohort study. Am J Ind Med 2003;44:58-62
  31. Zeka A, Eisen EA, Kriebel D, Gore R, Wegman DH. Risk of upper aerodigestive tract cancers in a case-cohort study of autoworkers exposed to metalworking fluids. Occup Environ Med 2004;61:426-443