Simning Adam, van Wijngaarden Edwin
Division of Epidemiology, Department of Community and Preventive Medicine, University of Rochester, Rochester, NY 14642, USA.
Occup Environ Med. 2007 Jul;64(7):432-8. doi: 10.1136/oem.2006.029223. Epub 2007 Jan 25.
This review assesses the epidemiological literature describing dentist mortality and cancer incidence risk. In the dental workplace a variety of hazards may have been historically present or currently exist which can impact dentists' long-term health, including their mortality and cancer incidence. The epidemiological literature of dentistry's health outcomes was reviewed with a focus on all cancers combined and cancers of the brain, lung, reproductive organs and skin. Relevant studies were identified using MEDLINE and NIOSHTIC through early 2006 and from references cited in the articles obtained from these databases. Dentist cancer mortality and incidence generally showed a favourable risk pattern for lung cancer and overall cancer occurrence. Nevertheless, several studies reported an increased risk for certain cancers, such as those of the skin and, to a lesser extent, the brain and female breast. These elevated risks may be related to social status or education level, or may alternatively represent the impact of hazards in the workplace. The evidence for an increased mortality or cancer incidence risk among dentists must be interpreted in light of methodological limitations of published studies. Future studies of dentists would benefit from the assessment of specific occupational exposures rather than relying on job title alone.
本综述评估了描述牙医死亡率和癌症发病风险的流行病学文献。在牙科工作场所,历史上可能一直存在或目前仍然存在各种危害,这些危害会影响牙医的长期健康,包括他们的死亡率和癌症发病率。对牙科健康结果的流行病学文献进行了综述,重点关注所有癌症合并以及脑癌、肺癌、生殖器官癌和皮肤癌。通过检索MEDLINE和NIOSHTIC数据库,截至2006年初,并从这些数据库中获取的文章所引用的参考文献中,识别出相关研究。牙医的癌症死亡率和发病率总体上显示出肺癌和总体癌症发生的风险模式较为有利。然而,几项研究报告称,某些癌症的风险增加,如皮肤癌,以及在较小程度上的脑癌和女性乳腺癌。这些升高的风险可能与社会地位或教育水平有关,或者可能代表工作场所危害的影响。必须根据已发表研究的方法学局限性来解释牙医中死亡率或癌症发病率增加风险的证据。未来对牙医的研究将受益于对特定职业暴露的评估,而不是仅依赖于工作头衔。