An evidence-based assessment for the association between long-term exposure to outdoor air pollution and the risk of lung cancer
An evidence-based assessment for the association between long-term exposure to outdoor air pollution and the risk of lung cancer
复制标题
对长期暴露于室外空气污染与肺癌风险之间关系的循证评估
DOI：
10.1097/cej.0000000000000158
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发表时间：
2016-05-01
影响因子：
2.4
通讯作者：
Wang, Ling
中科院分区：
文献类型：
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作者：
Yang, Wan-Shui;Zhao, Hao;Wang, Ling
尽管室外空气污染已被确定为人类致癌物，但与室外空气污染相关的肺癌相对风险 (RR) 和 95% 置信区间 (CI) 的大小仍不确定。在全球范围内，我们使用荟萃分析方法量化了与长期暴露于室外空气污染相关的肺癌风险。检索了两个数据库（PubMed 和 Web of Science）截至 2014 年 5 月 31 日的相关队列研究，分析中总共确定了 21 项队列研究。细颗粒物 (PM2.5) 增加，肺癌死亡率或发病风险增加 7.23 (95% CI: 1.48–13.31)%/10 &mgr;m3，二氧化氮 (NO2) 增加 13.17 (95% CI: 5.57–21.30)%/十亿分之一 (ppb)，0.81 (95% CI: 氮氧化物 (NOx) 增加 0.14–1.49)%/10 ppb，二氧化硫 (SO2) 增加 14.76 (95% CI: 1.04–30.34)%/10 ppb。当分析仅限于从不吸烟者或具有高方法学质量的研究时，这些正相关性仍然存在，并且没有显示出性别差异。此外，在从不吸烟者中，细颗粒物与肺癌的关联性更强（每 10 &mgr;m3 的 RR=1.18，95% CI：1.06-1.32）。一氧化碳和臭氧没有关联。我们的研究表明，长期暴露于 PM2.5、NO2、NOx 和 SO2 可能与肺癌风险增加有关。尽管 RR 的幅度相对较小，但我们的发现如果得到验证，可能具有公共卫生重要性，因为全球很大一部分人口暴露在空气污染中。
Although outdoor air pollution has been identified as carcinogenic to humans, the magnitude of the relative risk (RR) and the 95% confidence interval (CI) for lung cancer in relation to outdoor air pollution remain uncertain. On a global scale, we quantified the risk of lung cancer associated with long-term exposure to outdoor air pollution using a meta-analytic approach. Relevant cohort studies from two databases (PubMed and Web of Science) through 31 May 2014 were searched, and a total of 21 cohort studies were identified in the analysis. The risk of lung cancer mortality or morbidity increased 7.23 (95% CI: 1.48–13.31)%/10 &mgr;g/m3 increase in fine particles (PM2.5), 13.17 (95% CI: 5.57–21.30)%/10 parts per billion (ppb) increase in nitrogen dioxide (NO2), 0.81 (95% CI: 0.14–1.49)%/10 ppb increase in nitrogen oxides (NOx), and 14.76 (95% CI: 1.04–30.34)%/10 ppb increase in sulfur dioxide (SO2). These positive associations remained when analysis was restricted to never-smokers or studies with high methodological quality, and showed no difference by sex. In addition, the association of fine particles with lung cancer was suggestively stronger among never-smokers (RR per each 10 &mgr;g/m3=1.18, 95% CI: 1.06–1.32). There was a null association for carbon monoxide and ozone. Our study indicated that long-term exposure to PM2.5, NO2, NOx, and SO2 may be associated with an increased risk of lung cancer. Although the magnitude of the RR is relatively small, our finding, if validated, may be of public health importance because a large proportion of the population is exposed to air pollution globally.