Damien M McElvenny, Ireny Iskandar, Sarah Daniels, Matthew Gittins, Martie van Tongeren
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引用次数: 0
Abstract
Objectives: The generic term man-made vitreous fibres (MMVFs) also known as man-made mineral fibres (MMMFs) denotes non-crystalline, fibrous inorganic material manufactured primarily from glass, rock, minerals, slag, glass, and processed inorganic oxides. The International Agency for Research on Cancer has classified rock (stone) wool, glass wool, and continuous glass filament as Group 3 (not classifiable for carcinogenicity). This study contains an updated systematic review and meta-analysis of respiratory health outcomes and MMMFs.
Methods: Cinahl, EMBASE, Medline, Web of Science, and OpenGrey were searched for epidemiological studies of occupational MMMF exposure and malignant and non-malignant respiratory diseases. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines were adopted for reporting. Meta-analyses were carried out separately for cohort and case-control studies.
Results: A total of 25 studies were identified for inclusion in the systematic review, with 19 of these (9 cohort; 10 case-control) providing risk estimates for the meta-analyses. Of the cohort studies, 3 were carried out in Sweden, 2 each in Canada and the United States, one in France, and one several European countries. The start of follow-up ranged from 1933 to 1975. The meta-RR for lung cancer from cohort studies (incidence or mortality) was 1.15 (95% CI: 1.01 to 1.32), for laryngeal cancer was 1.03 (95% CI: 0.78 to 1.37), and for non-malignant respiratory diseases (NMRD) mortality was 0.89 (95% CI: 0.66 to 1.22). Of the case-control studies, 9 examined lung cancer and one laryngeal cancer. Three of the lung cancer studies were carried out in France and one each in Germany, Russia, Canada, and China, with one in several European countries and one was a nested case-control study of several case cohorts from across the globe. The meta-OR for lung cancer from the case-control studies was 1.28 (95% CI: 1.10 to 1.50).
Conclusions: Our findings broadly agree with a previously published meta-analysis of respiratory system cancers, in that they were similar in terms of magnitude of relative risk. However, overall, our results suggest that exposure to MMMFs is associated with a small, but statistically significantly elevated risk for lung cancer, but not for laryngeal cancer or NMRDs. Given the heterogeneity between studies, and the possibility of residual confounding, further work is required to determine if this association is causal.
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About the Journal
Annals of Work Exposures and Health is dedicated to presenting advances in exposure science supporting the recognition, quantification, and control of exposures at work, and epidemiological studies on their effects on human health and well-being. A key question we apply to submission is, "Is this paper going to help readers better understand, quantify, and control conditions at work that adversely or positively affect health and well-being?"
We are interested in high quality scientific research addressing:
the quantification of work exposures, including chemical, biological, physical, biomechanical, and psychosocial, and the elements of work organization giving rise to such exposures;
the relationship between these exposures and the acute and chronic health consequences for those exposed and their families and communities;
populations at special risk of work-related exposures including women, under-represented minorities, immigrants, and other vulnerable groups such as temporary, contingent and informal sector workers;
the effectiveness of interventions addressing exposure and risk including production technologies, work process engineering, and personal protective systems;
policies and management approaches to reduce risk and improve health and well-being among workers, their families or communities;
methodologies and mechanisms that underlie the quantification and/or control of exposure and risk.
There is heavy pressure on space in the journal, and the above interests mean that we do not usually publish papers that simply report local conditions without generalizable results. We are also unlikely to publish reports on human health and well-being without information on the work exposure characteristics giving rise to the effects. We particularly welcome contributions from scientists based in, or addressing conditions in, developing economies that fall within the above scope.
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