Lung Cancer and Exposure to Nitrogen Dioxide and Traffic: A Systematic Review and Meta-Analysis.
Lung Cancer and Exposure to Nitrogen Dioxide and Traffic: A Systematic Review and Meta-Analysis.
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DOI：
10.1289/ehp.1408882
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发表时间：
2015-11
影响因子：
10.4
通讯作者：
Loomis D
中科院分区：
文献类型：
--
作者：
Hamra GB;Laden F;Cohen AJ;Raaschou-Nielsen O;Brauer M;Loomis D
暴露于与交通有关的空气污染物是一个重要的公共卫生问题。在这里，我们提出了一个系统的审查和荟萃分析的研究，检查氮氧化物（NOx）的措施和各种措施的交通相关的空气污染暴露与肺癌的关系。我们对暴露于二氧化氮（NO2）和NOx及其与肺癌的相关性的研究进行了随机效应荟萃分析。我们确定了20项符合纳入标准的研究，并提供了必要的信息来估计暴露于测量的NO2每增加10 μg/m3的肺癌变化。此外，我们定性评估了与肺癌相关的道路距离和交通量之间的关联证据。与NO2暴露量增加10 μg/m3相关的肺癌变化的荟萃估计值为4%（95% CI：1%，8%）。与NOx增加10 μg/m3相关的肺癌变化的荟萃估计值相似，且略精确，为3%（95% CI：1%，5%）。NO2荟萃估计值对不同的混杂调整集以及使用的暴露评估技术具有稳健性。修整和填充分析表明，如果存在发表偏倚，则总体荟萃估计值偏离零值。交通量和道路距离的森林图在很大程度上表明肺癌风险略有增加。我们发现了一致的证据表明NO2与肺癌之间的关系，NO2作为交通源空气污染暴露的代表。与住宅靠近道路和氮氧化物有关的肺癌研究也表明风险增加，这可能部分归因于空气污染暴露。国际癌症研究机构最近将室外空气污染和颗粒物列为致癌物质（第1组）。这些荟萃分析支持这一结论，特别注意交通源空气污染。Hamra GB，Laden F，Cohen AJ，Raaschou-Nielsen O，Brauer M，卢米斯D. 2015.肺癌与暴露于二氧化氮和交通：系统回顾和荟萃分析。环境健康展望123：1107-1112; http：dx.doi.org/10.1289/ehp.1408882
Exposure to traffic-related air pollutants is an important public health issue. Here, we present a systematic review and meta-analysis of research examining the relationship of measures of nitrogen oxides (NOx) and of various measures of traffic-related air pollution exposure with lung cancer. We conducted random-effects meta-analyses of studies examining exposure to nitrogen dioxide (NO2) and NOx and its association with lung cancer. We identified 20 studies that met inclusion criteria and provided information necessary to estimate the change in lung cancer per 10-μg/m3 increase in exposure to measured NO2. Further, we qualitatively assessed the evidence of association between distance to roadways and traffic volume associated with lung cancer. The meta-estimate for the change in lung cancer associated with a 10-μg/m3 increase in exposure to NO2 was 4% (95% CI: 1%, 8%). The meta-estimate for change in lung cancer associated with a 10-μg/m3 increase in NOx was similar and slightly more precise, 3% (95% CI: 1%, 5%). The NO2 meta-estimate was robust to different confounding adjustment sets as well as the exposure assessment techniques used. Trim-and-fill analyses suggest that if publication bias exists, the overall meta-estimate is biased away from the null. Forest plots for measures of traffic volume and distance to roadways largely suggest a modest increase in lung cancer risk. We found consistent evidence of a relationship between NO2, as a proxy for traffic-sourced air pollution exposure, with lung cancer. Studies of lung cancer related to residential proximity to roadways and NOx also suggest increased risk, which may be attributable partly to air pollution exposure. The International Agency for Research on Cancer recently classified outdoor air pollution and particulate matter as carcinogenic (Group 1). These meta-analyses support this conclusion, drawing particular attention to traffic-sourced air pollution. Hamra GB, Laden F, Cohen AJ, Raaschou-Nielsen O, Brauer M, Loomis D. 2015. Lung cancer and exposure to nitrogen dioxide and traffic: a systematic review and meta-analysis. Environ Health Perspect 123:1107–1112; http://dx.doi.org/10.1289/ehp.1408882