Donato Francesca, Garzaro Giacomo, Pira Enrico, Boffetta Paolo
Department of Public Health Sciences and Pediatrics, Turin University, Turin, Italy.
Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, One Gustave L. Levy Place, Box 1130, New York, NY, 10029, USA.
Int Arch Occup Environ Health. 2016 Nov;89(8):1155-1168. doi: 10.1007/s00420-016-1167-x. Epub 2016 Sep 7.
To analyze overall and cause-specific mortality, especially from cancer, among cement production workers.
Results from some epidemiological studies suggested an increased risk of overall mortality and of stomach cancer associated with employment in the cement production, but the presence of a hazard and, if present, the magnitude of a risk have not been precisely quantified. We conducted a systematic review and meta-analysis of data on mortality from all causes, cardiovascular or respiratory diseases, and cancer among cement workers.
The literature search in PubMed and Scopus up to February 2016 and with appropriate keywords on mortality among cement workers revealed 188 articles which were screened. A total of 117 articles were reviewed in full text and 12 articles, referring to 11 study populations, were found to be relevant and of sufficient quality for further analysis. Meta-analyses were performed using a random-effects model.
Eight cohort studies, one proportionate mortality study, and two case-control studies were identified. The summary RRs were 0.89 [95 % confidence interval (CI) 0.76-1.01] for all-cause mortality, 0.94 (95 %, CI 0.80-1.08) for cancer mortality, 1.07 (95 % CI 0.79-1.35) for lung cancer mortality, and 0.93 (95 % CI 0.70-1.17) for stomach cancer mortality, respectively. Significant heterogeneity in results was observed among studies.
The present meta-analysis does not provide evidence of increased risk of overall mortality, as well as cancer, cardiovascular or respiratory mortality in relation to employment in cement production.
分析水泥生产工人的全因死亡率和特定病因死亡率,尤其是癌症死亡率。
一些流行病学研究结果表明,水泥生产行业的从业者全因死亡率及胃癌死亡率风险增加,但危害的存在以及(若存在)风险程度尚未得到精确量化。我们对水泥工人的全因、心血管或呼吸系统疾病以及癌症死亡率数据进行了系统综述和荟萃分析。
截至2016年2月,在PubMed和Scopus数据库中使用有关水泥工人死亡率的适当关键词进行文献检索,共筛选出188篇文章。对其中117篇文章进行了全文审阅,发现12篇文章(涉及11个研究人群)相关且质量足以进行进一步分析。采用随机效应模型进行荟萃分析。
确定了8项队列研究、1项比例死亡率研究和2项病例对照研究。全因死亡率的汇总相对危险度(RR)为0.89 [95%置信区间(CI)0.76 - 1.01],癌症死亡率为0.94(95%,CI 0.80 - 1.08),肺癌死亡率为1.07(95% CI 0.79 - 1.35),胃癌死亡率为0.93(95% CI 0.70 - 1.17)。各研究结果之间存在显著异质性。
本次荟萃分析未提供证据表明水泥生产行业从业者的全因死亡率、癌症死亡率、心血管或呼吸系统死亡率风险增加。