Occupational-related exposure to diesel exhaust and risk of leukemia: systematic review and meta-analysis of cohort studies

IF 2.6 3区医学 Q2 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH

International Archives of Occupational and Environmental Health Pub Date : 2023-12-24 DOI:10.1007/s00420-023-02034-y

Darshi Shah, Vincent DeStefano, Giulia Collatuzzo, Federica Teglia, Paolo Boffetta

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引用次数: 0

Abstract

Purpose

Diesel exhaust (DE) is an established lung carcinogen. The association with leukemia is not well established. We conducted a systematic review and meta-analysis of cohort studies to determine the association between occupational DE exposure and risk of leukemia.

Methods

A systematic literature review was performed to identify all cohort studies on occupational exposure to DE and associated risk of leukemia. STROBE guidelines and PECOS criteria were followed. Meta-analyses with fixed effects (and random-effects model in cases of high heterogeneity) were performed to calculate summary relative risks (RR) and 95% confidence intervals (CI), including subgroup analyses by outcome (mortality or incidence), sex, geographic region, industry type, and study quality. Study quality was assessed using the the Joanna Briggs Institute (JBI) critical appraisal checklist for cohort studies.

Results

Of the 30 studies retained, 20 (8 from North America, 12 from Europe) reported a total of 33 estimates of the risk of leukemia. Overall, the relative risk (RR) of leukemia was 1.01 (95% CI = 0.97–1.05, I² = 21.2%, n = 33); corresponding results for leukemia incidence and mortality were RR = 1.02 (95% CI = 0.98–1.06, I² = 27.9%, n = 19) and RR = 0.91 (95% CI = 0.81–1.02, I² = 0.0%, n = 15), respectively. The main results were confirmed in analyses by sex and geographic area. A statistically significant association was detected for miners (RR = 1.58, 95% CI = 1.15–2.15, I² = 77.0%, n = 2) but not for other occupational groups. Publication bias was not detected (p = 0.7).

Conclusion

Our results did not indicate an association between occupational DE exposure and leukemia, with the possible exception of miners. Residual confounding cannot be excluded.

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与职业相关的柴油废气暴露和白血病风险：队列研究的系统回顾和荟萃分析

目的柴油废气（DE）是一种公认的肺致癌物。但其与白血病的关系尚未得到充分证实。我们对队列研究进行了系统性回顾和荟萃分析，以确定职业性柴油废气暴露与白血病风险之间的关联。方法我们进行了系统性文献回顾，以确定所有有关职业性柴油废气暴露和相关白血病风险的队列研究。研究遵循了 STROBE 指南和 PECOS 标准。采用固定效应进行 Meta 分析（异质性较高时采用随机效应模型），以计算汇总相对风险 (RR) 和 95% 置信区间 (CI)，包括按结果（死亡率或发病率）、性别、地理区域、行业类型和研究质量进行亚组分析。研究质量采用乔安娜-布里格斯研究所 (Joanna Briggs Institute, JBI) 的队列研究关键评估清单进行评估。总体而言，白血病的相对风险 (RR) 为 1.01 (95% CI = 0.97-1.05, I2 = 21.2%, n = 33)；白血病发病率和死亡率的相应结果分别为 RR = 1.02 (95% CI = 0.98-1.06, I2 = 27.9%, n = 19) 和 RR = 0.91 (95% CI = 0.81-1.02, I2 = 0.0%, n = 15)。按性别和地理区域进行的分析证实了主要结果。矿工（RR = 1.58，95% CI = 1.15-2.15，I2 = 77.0%，n = 2）与此有统计学意义，而其他职业群体则没有。结论我们的研究结果并未表明职业性 DE 暴露与白血病之间存在关联，但矿工可能是个例外。不能排除残余混杂因素。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

International Archives of Occupational and Environmental Health 医学-公共卫生、环境卫生与职业卫生

CiteScore

5.60

自引率

6.70%

发文量

127

审稿时长

3 months

期刊介绍： International Archives of Occupational and Environmental Health publishes Editorials, Review Articles, Original Articles, and Letters to the Editor. It welcomes any manuscripts dealing with occupational or ambient environmental problems, with a special interest in research at the interface of occupational health and clinical medicine. The scope ranges from Biological Monitoring to Dermatology, from Fibers and Dust to Human Toxicology, from Nanomaterials and Ultra-fine Dust to Night- and Shift Work, from Psycho-mental Distress and Burnout to Vibrations. A complete list of topics can be found on the right-hand side under For authors and editors. In addition, all papers should be based on present-day standards and relate to: -Clinical and epidemiological studies on morbidity and mortality -Clinical epidemiological studies on the parameters relevant to the estimation of health risks -Human experimental studies on environmental health effects. Animal experiments are only acceptable if relevant to pathogenic aspects. -Methods for studying the topics mentioned above.