Occupational and environmental risk factors for chronic rhinosinusitis: a systematic review.
Occupational and environmental risk factors for chronic rhinosinusitis: a systematic review.
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DOI：
10.1002/alr.21573
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发表时间：
2015-11
影响因子：
6.4
通讯作者：
Schwartz BS
中科院分区：
文献类型：
--
作者：
Sundaresan AS;Hirsch AG;Storm M;Tan BK;Kennedy TL;Greene JS;Kern RC;Schwartz BS
慢性鼻窦炎（CRS）是一种常见的致残性副鼻窦疾病，其病因可能是多因素的，可能包括危险的职业和环境暴露。我们完成了对职业和环境文献的系统回顾，以评估危险暴露可能在CRS中发挥作用的证据质量。我们在PubMed检索了有关CRS的研究和以下暴露类别：职业、就业、工作、工业、空气污染、农业、农业、环境、化学品、道路、灾难或交通。我们从六个主要领域的最后一组文章中提取信息：研究设计；人口;风险评估;暴露评估;CRS定义;和结果。我们从1080篇手稿中鉴定出41篇文章：37篇职业风险论文，1篇环境风险论文，3篇研究两类暴露的论文。41项研究中没有一项使用与当前诊断指南一致的CRS定义。暴露评估通常依赖于自我报告或基于就业行业的暴露二元测量。使用定义CRS的通用方法，仅对农民的谷物、乳制品和养猪业进行了不止一项研究评估，但这些环境中的就业并不总是与CRS相关。其他多重暴露不符合报告关联的质量标准，或者没有被一个以上的研究评估。目前的文献状况允许我们对危险职业或环境暴露在CRS中的作用做出很少的结论，在疾病发生和进展的潜在可改变风险因素方面留下了关键的知识空白。
Chronic rhinosinusitis (CRS) is a prevalent and disabling paranasal sinus disease, with a likely multi-factorial etiology potentially including hazardous occupational and environmental exposures. We completed a systematic review of the occupational and environmental literature to evaluate the quality of evidence of the role that hazardous exposures might play in CRS. We searched PubMed for studies of CRS and following exposure categories: occupation, employment, work, industry, air pollution, agriculture, farming, environment, chemicals, roadways, disaster, or traffic. We abstracted information from the final set of articles across six primary domains: study design; population; exposures evaluated; exposure assessment; CRS definition; and results. We identified 41 articles from 1080 manuscripts: 37 occupational risk papers, 1 environmental risk paper, and 3 papers studying both categories of exposures. None of the 41 studies used a CRS definition consistent with current diagnostic guidelines. Exposure assessment was generally dependent on self-report or binary measurements of exposure based on industry of employment. Only grain, dairy and swine operations among farmers were evaluated by more than one study using a common approach to defining CRS, but employment in these settings was not consistently associated with CRS. The multiple other exposures did not meet quality standards for reporting associations or were not evaluated by more than one study. The current state of the literature allows us to make very few conclusions about the role of hazardous occupational or environmental exposures in CRS, leaving a critical knowledge gap regarding potentially modifiable risk factors for disease onset and progression.