Morfeld Peter, Mundt Kenneth A, Dell Linda D, Sorahan Tom, McCunney Robert J
Institute and Policlinic for Occupational Medicine, Environmental Medicine and Preventive Research, University of Cologne, Cologne 50937, Germany.
Institute for Occupational Epidemiology and Risk Assessment of Evonik Industries, Essen 45128, Germany.
Int J Environ Res Public Health. 2016 Mar 9;13(3):302. doi: 10.3390/ijerph13030302.
Epidemiological studies have demonstrated associations between airborne environmental particle exposure and cardiac disease and mortality; however, few have examined such effects from poorly soluble particles of low toxicity such as manufactured carbon black (CB) particles in the work place. We combined standardised mortality ratio (SMR) and Cox proportional hazards results from cohort studies of US, UK and German CB production workers. Under a common protocol, we analysed mortality from all causes, heart disease (HD), ischemic heart disease (IHD) and acute myocardial infarction (AMI). Fixed and random effects (RE) meta-regression models were fit for employment duration, and for overall cumulative and lugged quantitative CB exposure estimates. Full cohort meta-SMRs (RE) were 1.01 (95% confidence interval (CI) 0.79-1.29) for HD; 1.02 (95% CI 0.80-1.30) for IHD, and 1.08 (95% CI 0.74-1.59) for AMI mortality. For all three outcomes, meta-SMRs were heterogeneous, increased with time since first and time since last exposure, and peaked after 25-29 or 10-14 years, respectively. Meta-Cox coefficients showed no association with lugged duration of exposure. A small but imprecise increased AMI mortality risk was suggested for cumulative exposure (RE-hazards ratio (HR) = 1.10 per 100 mg/m³-years; 95% CI 0.92-1.31), but not for lugged exposures. Our results do not demonstrate that airborne CB exposure increases all-cause or cardiac disease mortality.
流行病学研究已证明，暴露于空气中的环境颗粒物与心脏病及死亡率之间存在关联；然而，很少有研究考察低毒性难溶性颗粒物（如工作场所中的人造炭黑（CB）颗粒）的此类影响。我们综合了美国、英国和德国CB生产工人队列研究的标准化死亡率（SMR）和Cox比例风险结果。按照通用方案，我们分析了全因死亡率、心脏病（HD）、缺血性心脏病（IHD）和急性心肌梗死（AMI）。针对就业时长以及总体累积和滞后定量CB暴露估计值，拟合了固定效应和随机效应（RE）元回归模型。HD的全队列元SMR（RE）为1.01（95%置信区间（CI）0.79 - 1.29）；IHD为1.02（95%CI 0.80 - 1.30），AMI死亡率为1.08（95%CI 0.74 - 1.59）。对于所有这三个结果，元SMR具有异质性，随首次暴露后时间和末次暴露后时间增加，分别在25 - 29年或10 - 14年后达到峰值。元Cox系数显示与滞后暴露时长无关联。对于累积暴露，提示AMI死亡率风险有小幅但不精确的增加（RE - 风险比（HR） = 每100 mg/m³ - 年1.10；95%CI 0.92 - 1.31），但对于滞后暴露则不然。我们的结果并未证明暴露于空气中的CB会增加全因死亡率或心脏病死亡率。
