Department of Health Studies, University of Chicago, Chicago, Illinois, USA.
Occup Environ Med. 2014 May;71(5):366-80. doi: 10.1136/oemed-2013-101929. Epub 2014 Mar 6.
Numerous occupational and environmental exposures have been shown to disrupt thyroid hormones, but much less is known about their relationships with thyroid cancer. Here we review the epidemiology studies of occupations and occupational exposures and thyroid cancer incidence to provide insight into preventable risk factors for thyroid cancer. The published literature was searched using the Web of Knowledge database for all articles through August 2013 that had in their text 'occupation' 'job' 'employment' or 'work' and 'thyroid cancer'. After excluding 10 mortality studies and 4 studies with less than 5 exposed incident cases, we summarised the findings of 30 articles that examined thyroid cancer incidence in relation to occupations or occupational exposure. The studies were grouped by exposure/occupation category, study design and exposure assessment approach. Where available, gender-stratified results are reported. The most studied (19 of 30 studies) and the most consistent associations were observed for radiation-exposed workers and healthcare occupations. Suggestive, but inconsistent, associations were observed in studies of pesticide-exposed workers and agricultural occupations. Findings for other exposures and occupation groups were largely null. The majority of studies had few exposed cases and assessed exposure based on occupation or industry category, self-report, or generic (population-based) job exposure matrices. The suggestive, but inconsistent findings for many of the occupational exposures reviewed here indicate that more studies with larger numbers of cases and better exposure assessment are necessary, particularly for exposures known to disrupt thyroid homeostasis.
许多职业和环境暴露已被证明会干扰甲状腺激素，但对它们与甲状腺癌的关系却知之甚少。在这里，我们回顾了职业和职业暴露与甲状腺癌发病率的流行病学研究，以深入了解甲状腺癌的可预防风险因素。通过 Web of Knowledge 数据库搜索了截至 2013 年 8 月的所有文献，这些文献的文本中包含“职业”、“工作”、“就业”或“工作”以及“甲状腺癌”。排除了 10 项死亡率研究和 4 项暴露于少于 5 例的研究后，我们总结了 30 项研究的结果，这些研究检查了职业或职业暴露与甲状腺癌发病率之间的关系。这些研究按暴露/职业类别、研究设计和暴露评估方法进行分组。在有性别分层结果的情况下，报告了这些结果。辐射暴露工人和医疗保健职业的研究（30 项研究中的 19 项）最多，结果也最一致。在农药暴露工人和农业职业的研究中观察到了提示性但不一致的关联。其他暴露和职业群体的研究结果则主要为阴性。大多数研究的暴露病例较少，并且根据职业或行业类别、自我报告或通用（基于人群）工作暴露矩阵来评估暴露。这里回顾的许多职业暴露的提示性但不一致的发现表明，需要进行更多具有更大数量病例和更好暴露评估的研究，特别是对于已知会破坏甲状腺内稳态的暴露。
