职业性苯暴露与人类肺癌研究：系统回顾和荟萃分析。

IF 10.1 1区环境科学与生态学 Q1 ENVIRONMENTAL SCIENCES

Environmental Health Perspectives Pub Date : 2024-12-01 Epub Date: 2024-12-04 DOI:10.1289/EHP15086

Wenxin Wan, Susan Peters, Lützen Portengen, Ronnie Babigumira, Jo Steinson Stenehjem, David Richardson, Roel Vermeulen

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引用次数: 0

摘要

背景：基于苯引起急性髓性白血病的证据，苯被列为人类致癌物。然而，苯导致肺癌的证据有限。目的：我们对已发表的关于职业性苯暴露与肺癌风险之间关系的队列研究和病例对照研究进行了系统回顾、质量评估和荟萃分析。方法：回顾PubMed和Embase数据库截至2024年8月19日的相关人类流行病学研究。数据提取包括研究特征、效应估计和暴露评估细节。两名研究者使用纽卡斯尔-渥太华量表（NOS）框架和基于先验标准的暴露评估质量独立评估研究质量。根据NOS标准构建6个偏倚风险域（ROB），以识别和量化可能的偏倚及其对参数估计的影响。使用随机效应模型计算meta分析相对风险（合并RR）和相关置信区间，并拟合灵活的暴露-反应meta回归来评估关联的形状。进行亚组分析以探讨结果的一致性。结果：在鉴定的252篇文章中，13项研究包括366,975名参与者（17,030例肺癌病例）被纳入我们的分析。所有职业苯暴露的荟萃分析显示肺癌风险升高(合并RR=1.14；95% ci: 1.03, 1.27；我²= 72)。亚组分析显示，在基于高暴露组的研究中，更大的汇总rr具有更高的总体质量和更好的暴露评估，并且包括男性和女性（而不仅仅是男性）。在暴露-反应荟萃分析中观察到正线性趋势。讨论：我们的荟萃分析支持职业性苯暴露与肺癌风险增加之间的关联。https://doi.org/10.1289/EHP15086。

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Occupational Benzene Exposure and Lung Cancer in Human Studies: A Systematic Review and Meta-Analysis.

Background: Benzene is classified as carcinogenic to humans based on evidence that benzene causes acute myeloid leukemia. However, there is limited evidence that benzene causes lung cancer.

Objectives: We performed a systematic review, quality assessment, and meta-analysis of published cohort and case-control studies on the association between occupational benzene exposure and lung cancer risk.

Methods: We reviewed the relevant human epidemiological studies from PubMed and Embase databases to 19 August 2024. Data extraction included study characteristics, effect estimates, and exposure assessment details. Two investigators independently evaluated study quality using the Newcastle-Ottawa scale (NOS) framework and exposure assessment quality based on a priori criteria. Six risk of bias (ROB) domains were constructed from the NOS criteria to identify and quantify possible biases and their impacts on parameter estimates. Meta-analysis relative risk (pooled RR) and associated confidence intervals were calculated using random-effects models, and a flexible exposure-response meta-regression was fitted to assess the shape of the association. Subgroup analyses were conducted to explore the consistency of results.

Results: Of 252 articles identified, 13 studies covering 366,975 participants (17,030 lung cancer cases) were included in our analysis. The meta-analysis of ever occupational benzene exposure showed an elevated risk of lung cancer (pooled $RR = 1.14$ ; 95% CI: 1.03, 1.27; $I ² = 72$ ). Subgroup analyses revealed that larger pooled RRs in studies based on highly exposed groups had higher overall quality and better exposure assessments and included both males and females (as opposed to only males). A positive linear trend was observed in the exposure-response meta-analysis.

Discussion: Our meta-analysis supports an association between occupational benzene exposure and an increased risk of lung cancer. https://doi.org/10.1289/EHP15086.

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来源期刊

Environmental Health Perspectives 环境科学-公共卫生、环境卫生与职业卫生

CiteScore

14.40

自引率

2.90%

发文量

388

审稿时长

6 months

期刊介绍： Environmental Health Perspectives (EHP) is a monthly peer-reviewed journal supported by the National Institute of Environmental Health Sciences, part of the National Institutes of Health under the U.S. Department of Health and Human Services. Its mission is to facilitate discussions on the connections between the environment and human health by publishing top-notch research and news. EHP ranks third in Public, Environmental, and Occupational Health, fourth in Toxicology, and fifth in Environmental Sciences.