Department of Epidemiology, School of Public Health, University of Alabama at Birmingham, Birmingham, AL, USA.
Regul Toxicol Pharmacol. 2010 Nov;58(2):161-6. doi: 10.1016/j.yrtph.2010.08.013. Epub 2010 Aug 22.
This paper reviews and evaluates two recent epidemiologic studies of formaldehyde exposure and lymphohematopoietic cancers. One is an update of mortality in a retrospective cohort study of industrial workers and the other is a proportional mortality and case-control study among embalmers. Both studies included subjects with considerable exposure to formaldehyde and both are focused on the myeloid leukemias.
The principal epidemiologic methods and analyses used in the studies are described and evaluated. Additional measures of risk are presented.
Neither study reports a significant excess of mortality from any form of lymphohematopoietic cancer. However, both studies are interpreted by their authors as positive for an association between formaldehyde and the myeloid leukemias. This is based on weak and transitory associations seen in exposure-response analyses of relative risks. Issues are raised relating to the interpretation of these findings.
There is no statistically significant absolute excess mortality from any lymphohematopoietic cancer in either study. The study of industrial workers showed only a weak and transitory relationship between peak exposure to formaldehyde and the myeloid leukemias. Limited exposure-response relationships for the myeloid leukemias in the case-control study of embalmers apparently have not been analyzed for statistical significance. These limited exposure-response relationships do not provide clear evidence of a causal relationship between formaldehyde and the myeloid leukemias.
本文回顾并评估了两项近期有关甲醛暴露与淋巴血液系统癌症的流行病学研究。一项是对工业工人回顾性队列研究中死亡率的更新，另一项是对防腐人员的比例死亡率和病例对照研究。这两项研究都包括了大量接触甲醛的受试者，且都专注于髓系白血病。
描述并评估了研究中使用的主要流行病学方法和分析。还提出了其他风险衡量指标。
这两项研究均未报告任何形式的淋巴血液系统癌症死亡率显著增加。然而，这两项研究的作者都将其解释为甲醛与髓系白血病之间存在关联的阳性结果。这是基于相对风险暴露反应分析中观察到的微弱和短暂的关联。提出了与这些发现的解释有关的问题。
这两项研究均未发现任何淋巴血液系统癌症的绝对死亡率有统计学意义的增加。工业工人研究仅显示出甲醛暴露峰值与髓系白血病之间存在微弱和短暂的关系。在防腐人员的病例对照研究中，髓系白血病的有限暴露反应关系显然没有进行统计学意义的分析。这些有限的暴露反应关系并没有提供甲醛与髓系白血病之间存在因果关系的明确证据。
