Occupational and Environmental Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Department of Health and Human Services, Bethesda, Maryland 20852, USA.
Occup Environ Med. 2013 Aug;70(8):591-9. doi: 10.1136/oemed-2012-101212. Epub 2013 May 30.
The carcinogenic potential of trichloroethylene (TCE) continues to generate much controversy, even after the US Environmental Protection Agency raised its classification to 'carcinogenic to humans'. We conducted a meta-analysis of published cohort and case-control studies exploring occupational TCE exposure in relation to five different lymphatic and haematopoietic cancers: non-Hodgkin's lymphoma (NHL, N=24), Hodgkin's lymphoma (HL, N=13), multiple myeloma (MM, N=11), leukaemia (N=12) and chronic/small lymphocytic leukaemia (CLL/SLL, N=7). Studies published between 1950 and 2011 were identified through a PubMed Medline search. All studies included in analyses were classified as those that assessed either occupational TCE exposure specifically ('TCE-exposure' studies) or a broader classification of all chlorinated solvents ('chlorinated solvent-exposure' studies). A significantly raised summary estimate for NHL was seen for all cohort and case-control 'TCE-exposure' studies combined (N=19; relative risk (RR)=1.32, 95% CI 1.14 to 1.54; I(2)=25.20; p-heterogeneity=0.12) and for cohort 'TCE-exposure' studies (N=10; RR=1.52, 95% CI 1.29 to 1.79; I(2)=7.09; p-heterogeneity=0.63). A non-significant but raised summary estimate was seen for NHL case-control 'TCE-exposure' studies. No significant association with NHL risk was detected overall for any 'chlorinated solvent-exposure' studies. Summary estimates for occupational TCE exposure were not associated with risk of HL, MM, leukaemia or CLL/SLL. Our updated meta-analysis of NHL, which incorporates new analytical results from three cohort and four case-control studies, supports an association between occupational TCE exposure and NHL.
三氯乙烯（TCE）的致癌潜能仍存在诸多争议，即便美国环保署已将其归为“人类致癌物”。我们对已发表的队列研究和病例对照研究进行了荟萃分析，旨在探讨职业性 TCE 暴露与五种不同的淋巴造血系统癌症之间的关系：非霍奇金淋巴瘤（NHL，N=24）、霍奇金淋巴瘤（HL，N=13）、多发性骨髓瘤（MM，N=11）、白血病（N=12）和慢性/小淋巴细胞白血病（CLL/SLL，N=7）。通过 PubMed Medline 搜索，确定了 1950 年至 2011 年期间发表的研究。所有纳入分析的研究都被归类为专门评估职业性 TCE 暴露的研究（“TCE 暴露”研究）或更广泛的所有氯化溶剂暴露的研究（“氯化溶剂暴露”研究）。综合所有队列和病例对照“TCE 暴露”研究（N=19；相对风险（RR）=1.32，95%置信区间 1.14-1.54；I(2)=25.20；p 异质性=0.12）和队列“TCE 暴露”研究（N=10；RR=1.52，95%置信区间 1.29-1.79；I(2)=7.09；p 异质性=0.63），均观察到 NHL 的汇总估计值显著升高。病例对照“TCE 暴露”研究中 NHL 的汇总估计值略有升高，但无统计学意义。总体而言，任何“氯化溶剂暴露”研究均与 NHL 风险无显著相关性。职业性 TCE 暴露与 HL、MM、白血病或 CLL/SLL 的风险均无显著关联。我们对 NHL 的更新荟萃分析，纳入了三项队列研究和四项病例对照研究的新分析结果，支持职业性 TCE 暴露与 NHL 之间存在关联。
