Oddone Enrico, Modonesi Carlo, Gatta Gemma
Enrico Oddone, Department of Public Health, Experimental and Forensic Medicine, Occupational Medicine Unit, University of Pavia, 27100 Pavia, Italy.
World J Gastroenterol. 2014 Sep 21;20(35):12431-44. doi: 10.3748/wjg.v20.i35.12431.
A traditional belief widespread across the biomedical community was that dietary habits and genetic predisposition were the basic factors causing colorectal cancer. In more recent times, however, a growing evidence has shown that other determinants can be very important in increasing (or reducing) incidence of this malignancy. The hypothesis that environmental and occupational risk factors are associated with colorectal cancer is gaining ground, and high risks of colorectal cancer have been reported among workers in some industrial branches. The aim of this study was to investigate the epidemiologic relationship between colorectal cancer and occupational exposures to several industrial activities, by means of a scientific literature review and meta-analysis. This work pointed out increased risks of colorectal cancer for labourers occupied in industries with a wide use of chemical compounds, such as leather (RR = 1.70, 95%CI: 1.24-2.34), basic metals (RR = 1.32, 95%CI: 1.07-1.65), plastic and rubber manufacturing (RR = 1.30, 95%CI: 0.98-1.71 and RR = 1.27, 95%CI: 0.92-1.76, respectively), besides workers in the sector of repair and installation of machinery exposed to asbestos (RR = 1.40, 95%CI: 1.07-1.84). Based on our results, the estimated crude excess risk fraction attributable to occupational exposure ranged from about 11% to about 15%. However, homogeneous pattern of association between colorectal cancer and industrial branches did not emerge from this review.
生物医学界普遍存在的一种传统观念是，饮食习惯和遗传易感性是导致结直肠癌的基本因素。然而，近年来，越来越多的证据表明，其他决定因素在增加（或降低）这种恶性肿瘤的发病率方面可能非常重要。环境和职业风险因素与结直肠癌有关的假说越来越有说服力，并且在一些工业部门的工人中报告了结直肠癌的高风险。本研究的目的是通过科学文献综述和荟萃分析，调查结直肠癌与几种工业活动的职业暴露之间的流行病学关系。这项工作指出，从事广泛使用化合物行业的劳动者患结直肠癌的风险增加，如皮革行业（相对风险RR = 1.70，95%置信区间CI：1.24 - 2.34）、基本金属行业（RR = 1.32，95%CI：1.07 - 1.65）、塑料和橡胶制造业（RR分别为1.30，95%CI：0.98 - 1.71和RR = 1.27，95%CI：0.92 - 1.76），此外还有接触石棉的机械维修和安装部门的工人（RR = 1.40，95%CI：1.07 - 1.84）。根据我们的结果，归因于职业暴露的估计粗超额风险分数约为11%至15%。然而，本次综述并未发现结直肠癌与工业部门之间存在均匀的关联模式。
