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接触多氯联苯和多氯二苯并呋喃后的死亡率:对两个高暴露队列的荟萃分析

Mortality after exposure to polychlorinated biphenyls and polychlorinated dibenzofurans: a meta-analysis of two highly exposed cohorts.

作者信息

Li Ming-Chieh, Chen Pau-Chung, Tsai Pei-Chien, Furue Masutaka, Onozuka Daisuke, Hagihara Akihito, Uchi Hiroshi, Yoshimura Takesumi, Guo Yue Leon

机构信息

Institute of Occupational Medicine and Industrial Hygiene, National Taiwan University (NTU), Taipei, Taiwan.

Department of Environmental and Occupational Medicine, NTU College of Medicine and NTU Hospital, Taipei, Taiwan.

出版信息

Int J Cancer. 2015 Sep 15;137(6):1427-32. doi: 10.1002/ijc.29504. Epub 2015 Mar 16.

Abstract

Both Yucheng and Yusho were events of accidental exposure to highly doses of polychlorinated biphenyls and dibenzofurans in Asian people. Mortality experiences caused by various diseases were reported in both cohorts with similar and dissimilar findings. We thus conducted a meta-analysis of two cohorts to reevaluate the effects of PCBs and PCDFs on major causes of mortalities. Two recently updated Yucheng and Yusho mortality studies were included. For selected diseases, standardized mortality ratios (SMR) and 95% confidence intervals (95% CI) were extracted. Meta-analyses were conducted using a random-effects model only when heterogeneity (I(2)  > 50% and/or p value <0.10 by the Q test) was not found. A total of 1,803 Yucheng subjects (male, N = 830; female, N = 973) with 48,751 person-years of follow-up and 1,664 Yusho subjects (male, N = 860; female, N = 804) with 50,773 person-years are included. An increase in all-cause mortality (pooled SMR=1.2, 95% CI: 1.1-1.3, I(2)  = 0.0%), all cancers (pooled SMR=1.3, 95% CI: 1.1-1.6, I(2)  = 0.0%), lung cancer (pooled SMR=1.7, 95% CI: 1.2-2.3, I(2) =0.0%), heart disease (pooled SMR=1.3, 95% CI: 1.0-1.7, I(2)  = 43.4%) and hepatic disease (pooled SMR=1.9, 95% CI: 1.3-2.8, I(2)  = 0.0%) were found in pooled males. Significant elevation from liver cancer was found in pooled females (pooled SMR=2.0, 95% CI: 1.1-3.6, I(2)  = 0.0%). This meta-analysis of Yucheng and Yusho cohorts showed similar elevation from all cancer, lung cancer, heart disease and hepatic disease mortalities in exposed men. Furthermore, a new finding of elevated liver cancer mortality in exposed women was identified.

摘要

“油症”和“米糠油事件”均为亚洲人群意外暴露于高剂量多氯联苯和二苯并呋喃的事件。两项队列研究均报告了由各种疾病导致的死亡情况,结果既有相似之处,也有不同之处。因此,我们对这两项队列研究进行了荟萃分析,以重新评估多氯联苯和多氯二苯并呋喃对主要死因的影响。纳入了两项最近更新的“油症”和“米糠油事件”死亡率研究。对于选定的疾病,提取了标准化死亡比(SMR)和95%置信区间(95%CI)。仅当未发现异质性(通过Q检验,I(2) >50%和/或p值<0.10)时,才使用随机效应模型进行荟萃分析。共纳入1803名“油症”受试者(男性830名,女性973名),随访人年数为48751人年;以及1664名“米糠油事件”受试者(男性860名,女性804名),随访人年数为50773人年。在汇总的男性中,全因死亡率(合并SMR = 1.2,95%CI:1.1 - 1.3,I(2) = 0.0%)、所有癌症(合并SMR = 1.3,95%CI:1.1 - 1.6,I(2) = 0.0%)、肺癌(合并SMR = 1.7,95%CI:1.2 - 2.3,I(2) = 0.0%)、心脏病(合并SMR = 1.3,95%CI:1.0 - 1.7,I(2) = 43.4%)和肝病(合并SMR = 1.9,95%CI:1.3 - 2.8,I(2) = 0.0%)均有所增加。在汇总的女性中,肝癌死亡率显著升高(合并SMR = 2.0,95%CI:1.1 - 3.6,I(2) = 0.0%)。这项对“油症”和“米糠油事件”队列的荟萃分析表明,暴露男性在所有癌症、肺癌、心脏病和肝病死亡率方面有类似程度的升高。此外,还发现了暴露女性肝癌死亡率升高这一新情况。

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