Diesel exhaust exposure and lung cancer
Diesel exhaust exposure and lung cancer
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DOI：
10.1097/00001648-199801000-00017
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发表时间：
1998-01-01
期刊：
影响因子：
5.4
通讯作者：
Smith, AH
中科院分区：
文献类型：
--
作者：
Bhatia, R;Lopipero, P;Smith, AH
我们在对29项已发表的队列和病例对照研究的荟萃分析中评估了柴油机废气职业暴露与肺癌之间的关系。在符合纳入标准的23项研究中，有21项观察到相对风险估计值大于1。通过研究精确度加权的合并效应测量表明，职业性暴露于柴油机废气导致肺癌的相对风险（RR）增加[RR = 1.33; 95%置信区间（CI）= 1.24-1.44]。病例中心亚分析（RR = 1.33; 95% CI 1.18-1.51）vs队列研究（RR = 1.33; 95% CI = 1.21-1.47）和控制吸烟的研究（RR = 1.35; 95% CI = 1.20-1.52）与未进行分析（RR = 1.33; 95% CI = 1.20-1.47）的结果与总体分析结果无差异。另一方面，使用内部比较的队列研究（RR = 1.33; 95%CI = 1.29-1.58）显示相对风险高于使用外部比较的队列研究（RR = 1.22; 95%CI = 1.04-1.44）。当我们根据暴露发生的职业环境对研究进行分层时，研究之间的异质性降低。一个积极的持续时间反应关系是显而易见的，在这些研究中，分层的就业时间。这项荟萃分析支持肺癌风险增加与柴油机废气暴露之间的因果关系。
We evaluated the relation between occupational exposure to diesel exhaust and cancer of the lung in a meta-analysis of 29 published cohort and case-control studies. Twenty-one of the 23 studies meeting the inclusion criteria hail observed relative risk estimates greater than one. Pooled effect measures weighted by study precision indicated an increased relative risk (RR) for lung cancer from occupational exposure to diesel exhaust [RR = 1.33; 95% confidence interval (CI) = 1.24-1.44]. Subanalysis of case-central (RR = 1.33; 95% CI 1.18-1.51) vs cohort studies (RR = 1.33; 95% CI = 1.21-1.47) and of studies that controlled for smoking (RR = 1.35; 95% CI = 1.20-1.52) vs those that did not (RR = 1.33; 95% CI = 1.20-1.47) produced results that did not differ from those of the overall analysis. On the other hand, cohort studies using internal comparisons (RR = 1.33; 95% CI = 1.29-1.58) showed higher relative risks than those using external comparisons (RR = 1.22; 95% CI = 1.04-1.44). Heterogeneity between studies was reduced when we stratified studies by the occupational setting in which exposure occurred. A positive duration-response relation was evident in those studies that were stratified by employment duration. This meta-analysis supports a causal association between increased risks for lung cancer and exposure to diesel exhaust.