Critical review of the epidemiology literature on the potential cancer risks of methylene chloride
Critical review of the epidemiology literature on the potential cancer risks of methylene chloride
复制标题
关于二氯甲烷潜在癌症风险的流行病学文献的批判性回顾
DOI：
10.1007/s004200050396
复制
发表时间：
1999
影响因子：
3
通讯作者：
D. Mundt
中科院分区：
文献类型：
--
作者：
L. Dell;K. Mundt;M. McDonald;Joseph P. Tritschler II;D. Mundt
目的：严格审查和总结迄今为止发表的关于二氯甲烷对人类致癌性的流行病学证据。方法：审查论文通过 Medline（国家医学图书馆）确定，仅限于流行病学研究。研究使用三个类别进行分类。主要研究重点关注主要暴露于二氯甲烷的职业群体中二氯甲烷与癌症之间的关联。二次研究先验地将二氯甲烷确定为潜在的感兴趣暴露，研究人员要么描述二氯甲烷暴露特征，要么分别描述二氯甲烷暴露工人的结果。三级研究评估了最低程度暴露于二氯甲烷或假定暴露但没有暴露估计或单独分类的群体。结果：尽管对可能暴露于高浓度二氯甲烷的大量职业工人进行了多项研究，但在任何部位都没有明显的强有力或一致的发现。据报道，胰腺癌、肝癌、胆道癌、乳腺癌和脑癌之间存在零星且微弱的关联。尽管这些研究总体上不能排除与二氯甲烷暴露相关的任何癌症风险的可能性，但它们确实支持没有实质性癌症风险的结论。结论：对已建立的队列的持续随访可能会阐明迄今为止报告的少数且不一致的关系；然而，与二氯甲烷暴露相关的风险（如果有的话）似乎很小，并且仅限于罕见的癌症。额外队列研究对于评估与二氯甲烷暴露相关的癌症风险的有用性将在很大程度上取决于相关暴露期是否已经过去以及暴露特征（例如峰值或间歇暴露或强度）是否可以改善。
Objective:To critically review and summarize the epidemiological evidence published to date on the carcinogenicity of methylene chloride to humans.Methods:Papers for review were identified through Medline (National Library of Medicine) and were limited to epidemiology studies. Studies were classified using three categories.Primary studiesfocused on the association between methylene chloride and cancer among occupational cohorts primarily exposed to methylene chloride.Secondary studiesidentified methylene chloride a priori as a potential exposure of interest, and the investigators either characterized the methylene chloride exposure or described results for the methylene chloride-exposed workers separately.Tertiary studiesevaluated cohorts either minimally exposed to methylene chloride or presumed exposed but for which no exposure estimation or separate classification was made.Results:No strong or consistent finding for any site of cancer was apparent despite several studies of large occupational cohorts of workers potentially exposed to high concentrations of methylene chloride. Sporadic and weak associations were reported for cancers of the pancreas, liver and biliary passages, breast, and brain. Although these studies collectively cannot rule out the possibility of any cancer risk associated with methylene chloride exposure, they do support a conclusion of no substantive cancer risk.Conclusions:Continued follow-up of the established cohorts may elucidate the few and inconsistent relationships reported to date; however, it appears likely that risks associated with methylene chloride exposure, if any, are small and limited to rare cancers. The usefulness of additional cohort studies for the evaluation of cancer risks associated with methylene chloride exposure will depend largely on whether the relevant exposure period has passed and whether exposure characterization (e.g., peak or intermittent exposure or intensity) can be improved.