Collins J J, Esmen N A, Hall T A
Solutia Inc., St. Louis, MO 63141, USA.
Am J Ind Med. 2001 Mar;39(3):336-45. doi: 10.1002/1097-0274(200103)39:3<336::aid-ajim1022>3.0.co;2-k.
Most reviews on the carcinogenicity of formaldehyde have focused on cancers of the respiratory tract. Two recent studies have suggested that exposure to formaldehyde may increase the risk for pancreatic cancer.
We examine 14 epidemiology studies of workers exposed to formaldehyde where pancreatic cancer rates were reported and use meta-analytic techniques to summarize the findings. We also rank formaldehyde exposures for the industries in these studies.
We found a small increase of pancreatic cancer risk in the studies overall (meta Relative Risk [mRR] 1.1, 95%CI 1.0-1.3); however, this increased risk was limited to embalmers (mRR 1.3, 95%CI 1.0-1.6) and pathologists and anatomists (mRR 1.3, 95%CI 1.0-1.7). There was no increased risk among industrial workers (mRR 0.9, 95%CI 0.8-1.1) who on average had the highest formaldehyde exposures.
A small increased risk of pancreatic cancer from formaldehyde exposure cannot be ruled out from the studies examined. However, the null findings among industrial workers and the lack of biological plausibility would argue against formaldehyde as a cause. The increased risk of pancreatic cancer among embalmers, pathologists, and anatomists may be due to a diagnostic bias or to occupational exposures other than formaldehyde in these professions.
大多数关于甲醛致癌性的综述都集中在呼吸道癌症上。最近的两项研究表明，接触甲醛可能会增加患胰腺癌的风险。
我们审查了14项关于接触甲醛的工人的流行病学研究，这些研究报告了胰腺癌发病率，并使用荟萃分析技术总结研究结果。我们还对这些研究中各行业的甲醛暴露情况进行了排名。
我们发现，总体研究中胰腺癌风险略有增加（荟萃相对风险[mRR]为1.1，95%置信区间为1.0 - 1.3）；然而，这种风险增加仅限于尸体防腐师（mRR为1.3，95%置信区间为1.0 - 1.6）以及病理学家和解剖学家（mRR为1.3，95%置信区间为1.0 - 1.7）。在平均甲醛暴露量最高的产业工人中，风险并未增加（mRR为0.9，95%置信区间为0.8 - 1.1）。
在所审查的研究中，不能排除甲醛暴露导致胰腺癌风险略有增加的可能性。然而，产业工人的阴性结果以及缺乏生物学合理性表明甲醛不太可能是病因。尸体防腐师、病理学家和解剖学家中胰腺癌风险增加可能是由于诊断偏倚或这些职业中除甲醛之外的其他职业暴露所致。
