Mannocci Alice, Lojodice Bruno, Boccia Antonio, La Torre Giuseppe
Dipartimento di Sanità Pubblica e Malattie Infettive, Università Sapienza di Roma, Italy.
Ig Sanita Pubbl. 2013 Mar-Apr;69(2):155-70.
Possible ill- health effects of exposures incurred by professional drivers have been reported by several studies with more or less statistically significant results, and continue to be debated in the medical literature. The aim of the present study was to review the existing literature regarding the association between working as a professional driver, mortality, cancer and cardio-vascular diseases.
The authors considered studies published until May 2012. The literature review was conducted by searching PubMed and EMBASE and using the following research entries: "professional drivers", "mortality", "cancer", "cardiovascular diseases", "health risks", "air-pollution" and "urban air".
Of 1,497 studies reviewed, 25 were included in the final analysis. Nine studies were found assessing mortality. Of these, one study indicated that professional drivers had a significantly increased risk for all- cause mortality compared to the general population (Standardised Mortality Ratio, SMR=1.15); five studies indicated a significantly higher risk of lung cancer mortality (SMR ranged 1.16 and 2.12). Seven studies evaluating cardio-vascular diseases focused on myocardial infarction. These reported a higher risk in professional drivers with respect to controls, with crude Odds Ratios (OR) between 1.66 and 3.3, Relative Risks (RR) ranging from 1.19 to 1.6. In five of the above studies, potential confounders were considered. Five of 11 studies reported a statistically significant increased risk of lung cancer in professional drivers with respect to the general population or to other workers, with ORs included between 1.21 and 1.85, and RRs between 1.2 and 1.4.
The reviewed studies had many limitations, such as poor exposure assessment and lack of information on relevant confounders. In addition, heterogeneity in the studies led to problems in summarizing the results. Despite this, study findings suggest the existence of an association between this professional activity and risk for lung cancer and cardiovascular diseases.
多项研究报告了职业司机接触某些物质可能对健康产生的不良影响，研究结果或多或少具有统计学意义，且在医学文献中仍存在争议。本研究的目的是回顾关于职业司机工作与死亡率、癌症和心血管疾病之间关联的现有文献。
作者纳入截至2012年5月发表的研究。通过检索PubMed和EMBASE进行文献综述，并使用以下检索词：“职业司机”、“死亡率”、“癌症”、“心血管疾病”、“健康风险”、“空气污染”和“城市空气”。
在1497项综述研究中，25项被纳入最终分析。发现有9项研究评估死亡率。其中，1项研究表明，与普通人群相比，职业司机全因死亡率风险显著增加（标准化死亡率比，SMR = 1.15）；5项研究表明肺癌死亡率风险显著更高（SMR范围为1.16至2.12）。7项评估心血管疾病的研究聚焦于心肌梗死。这些研究报告称，与对照组相比，职业司机风险更高，粗比值比（OR）在1.66至3.3之间，相对风险（RR）在1.19至1.6之间。在上述5项研究中考虑了潜在混杂因素。11项研究中有5项报告称，与普通人群或其他工人相比，职业司机患肺癌的风险在统计学上显著增加，OR在1.21至1.85之间，RR在1.2至1.4之间。
综述研究存在许多局限性，如暴露评估不佳以及缺乏相关混杂因素的信息。此外，研究的异质性导致结果总结存在问题。尽管如此，研究结果表明这种职业活动与肺癌和心血管疾病风险之间存在关联。
