Wong O, Raabe G K
Applied Health Sciences, Inc., San Mateo, California, 94401, USA.
Regul Toxicol Pharmacol. 2000 Aug;32(1):78-98. doi: 10.1006/rtph.2000.1410.
In 1989 we published a critical review of cancer epidemiology in petroleum workers, which included as a component of the review a meta-analysis by cancer site. Subsequently we have completed three additional reviews and meta-analyses on cell-type-specific leukemias (1995), multiple myeloma (1997), and non-Hodgkin's lymphoma (2000). The objective of the present investigation was to update our 1989 review and meta-analysis of nonlymphohematopoietic cancers in cohort studies of petroleum workers. Included in the present investigation were cohort studies of petroleum workers from the United States, the United Kingdom, Canada, Australia, Finland, Sweden, and Italy. Individual studies were reviewed with regard to specific cancer sites. For each cancer of interest, risk ratios from the individual studies were presented. In some studies, subcohort analyses stratified by exposure parameters such as length of employment, job category, and hire year were also reported. These subcohort or stratified analyses were reviewed and the results of these analyses were taken into consideration in our interpretation. In addition to the qualitative review of individual studies, a meta-analysis was performed to combine data from individual cohort studies of petroleum workers. The primary purpose of the meta-analysis was to provide a summary measure of risk for each cancer site. Based on a review and meta-analyses of cohort studies of more than 350,000 petroleum workers in the United States, the United Kingdom, Canada, Australia, Finland, Sweden, and Italy, we concluded that there was no increased mortality from digestive cancers (stomach, large intestine, liver, or pancreas), lung cancer, bladder cancer, kidney cancer, or brain cancer. The summary standardized mortality ratios for these cancer sites were all below unity. Significant increases of melanoma mortality were reported in some small groups of refinery workers in the United Kingdom and upstream operation workers in Canada, but no responsible agent(s) had been identified. The observed mortality from skin cancer in all other studies was similar to the expected. In particular, no significant increase of skin cancer mortality was reported in any of the U.S. studies. Elevated mortality from prostate cancer was noted in short-term workers at a U.S. refinery and in short-term workers employed in certain crafts at U.S. crude oil operations. However, the absence of an upward trend by length of employment in these workers argued against an association between exposure to petroleum products and prostate cancer. For all petroleum workers as a whole, mortality from prostate cancer was as expected.
1989年，我们发表了一篇关于石油工人癌症流行病学的批判性综述，其中包括按癌症部位进行的荟萃分析。随后，我们又完成了另外三项关于特定细胞类型白血病（1995年）、多发性骨髓瘤（1997年）和非霍奇金淋巴瘤（2000年）的综述和荟萃分析。本研究的目的是更新我们1989年对石油工人队列研究中非淋巴造血系统癌症的综述和荟萃分析。本研究纳入了来自美国、英国、加拿大、澳大利亚、芬兰、瑞典和意大利的石油工人队列研究。针对特定癌症部位对各项研究进行了审查。对于每种感兴趣的癌症，列出了各项研究的风险比。在一些研究中，还报告了按就业时长、工作类别和入职年份等暴露参数分层的亚队列分析。对这些亚队列或分层分析进行了审查，并在我们的解读中考虑了这些分析的结果。除了对各项研究进行定性审查外，还进行了荟萃分析，以合并石油工人个体队列研究的数据。荟萃分析的主要目的是为每个癌症部位提供风险的汇总衡量指标。基于对美国、英国、加拿大、澳大利亚、芬兰、瑞典和意大利35万多名石油工人队列研究的审查和荟萃分析，我们得出结论，消化系统癌症（胃癌、大肠癌、肝癌或胰腺癌）、肺癌、膀胱癌、肾癌或脑癌的死亡率没有增加。这些癌症部位的汇总标准化死亡率均低于1。在英国的一些小炼油工人群体和加拿大的上游作业工人中，报告了黑色素瘤死亡率显著增加，但尚未确定责任因素。在所有其他研究中观察到的皮肤癌死亡率与预期相似。特别是，美国的任何一项研究中均未报告皮肤癌死亡率显著增加。在美国一家炼油厂的短期工人以及美国原油作业某些工种的短期工人中，注意到前列腺癌死亡率升高。然而，这些工人的死亡率并未随就业时长呈上升趋势，这表明石油产品暴露与前列腺癌之间不存在关联。对于全体石油工人而言，前列腺癌死亡率与预期相符。
