Occupational exposure to hexavalent chromium and cancers of the gastrointestinal tract: A meta-analysis
Occupational exposure to hexavalent chromium and cancers of the gastrointestinal tract: A meta-analysis
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DOI：
10.1016/j.canep.2010.03.013
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发表时间：
2010-08-01
影响因子：
2.6
通讯作者：
Proctor, Deborah M.
中科院分区：
文献类型：
--
作者：
Gatto, Nicole M.;Kelsh, Michael A.;Proctor, Deborah M.
简介 我们对职业接触 Cr(VI) 的工人中的口腔癌、食道癌、胃癌、小肠癌、结肠癌和直肠癌进行了系统的文献回顾和荟萃分析。方法使用 PubMed，确定了 1950 年至 2009 年发表的评估 Cr(VI) 接触与胃肠道癌症之间关系的研究。从符合特定纳入标准的 32 项研究中提取了效果和变异性的测量，并使用随机效应模型和逆方差计算了荟萃分析总结相对风险测量结果 元标准化死亡率 (SMR) 为：口腔癌 [1 02 (95% CI = 077-1 34))、食道癌 [1.17 (95% CI = 090-1 51)]、胃癌 [1 09(95% CI = 0.93-1 28)]、结肠癌 [0 89 (95% CI = 0 701) 12)1 和直肠 [1 17(95% CI = 098-1 39)1 对研究中包含的更高暴露亚组或基于地理区域或公认的 Cr(VI) 暴露行业（焊接、镀铬、铬酸盐生产和颜料生产）的亚组进行的分析并未导致meta-SMR 升高，但美国队列中食道癌除外[meta-SMR = 1 49 (95% Cl) = 1 06-2 09)] 然而，这一发现基于仅四项研究的子组，其中一项是 PMR 研究，评估了社会经济地位 (SES)、饮食和/或吸烟或健康工人效应 (HWE) 造成的限制的潜在混杂因素，而吸烟、饮食和 SES 可能是导致元 SMR 向上偏差的重要因素。 HWE 不太可能对总结结果产生显着影响 三项报告小肠癌的研究均未观察到风险显着增加 讨论 这些荟萃分析和文献综述表明，接触 Cr(VI) 的工人患胃肠道癌症的风险并不比一般人群更大 (C) 2010 Elsevier Ltd 保留所有权利
Introduction We conducted a systematic literature review and meta-analysis of oral cavity, esophageal, stomach, small intestine, colon, and rectal cancers among workers occupationally exposed to Cr(VI) Methods Using PubMed, studies published from 1950 to 2009 evaluating the relationship between Cr(VI) exposure and GI cancers were identified Measures of effect and variability were extracted from 32 studies meeting specific inclusion criteria, and meta-analysis summary relative risk measures were calculated using random effects models and inverse variance weighting methods Results Meta-standardized mortality ratios (SMRs) were, for cancer of the oral cavity [1 02 (95% CI = 077-1 34)), esophagus [1.17 (95% CI = 090-1 51)], stomach [1 09(95% CI = 0.93-1 28)], colon [0 89 (95% Cl = 0 701 12)1, and rectum [1 17(95% CI = 098-1 39)1 Analyses of more highly exposed subgroups included in the studies or subgroups based on geographic region or by industry with recognized Cr(VI) exposures (welding, chrome plating, chromate production, and pigment production) did not result in elevated meta-SMRs except for esophageal cancer among US cohorts [meta-SMR = 1 49 (95% Cl = 1 06-2 09)] However, that finding was based on a subgroup of only four studies, one of which was a PMR study Potential confounding by socioeconomic status (SES), diet and/or smoking, or limitations due to the healthy-worker effect (HWE) were evaluated, and while smoking, diet and SES may be important factors that may have upwardly biased the meta-SMRs. HWE is not likely to have significantly affected the summary results None of three studies reporting small intestine cancers observed a statistically significant increased risk Discussion These meta-analyses and literature review indicate that Cr(VI)exposed workers are not at a greater risk of GI cancers than the general population (C) 2010 Elsevier Ltd All rights reserved