Turner Michelle C, Benke Geza, Bowman Joseph D, Figuerola Jordi, Fleming Sarah, Hours Martine, Kincl Laurel, Krewski Daniel, McLean Dave, Parent Marie-Elise, Richardson Lesley, Sadetzki Siegal, Schlaefer Klaus, Schlehofer Brigitte, Schüz Joachim, Siemiatycki Jack, Tongeren Martie van, Cardis Elisabeth
Barcelona Institute for Global Health (ISGlobal), Barcelona, Spain.
Universitat Pompeu Fabra (UPF), Barcelona, Spain.
Occup Environ Med. 2017 Nov;74(11):802-809. doi: 10.1136/oemed-2016-104080. Epub 2017 Jun 9.
In absence of clear evidence regarding possible effects of occupational chemical exposures on brain tumour aetiology, it is worthwhile to explore the hypothesis that such exposures might act on brain tumour risk in interaction with occupational exposure to extremely low frequency magnetic fields (ELF).
INTEROCC is a seven-country (Australia, Canada, France, Germany, Israel, New Zealand and UK), population-based, case-control study, based on the larger INTERPHONE study. Incident cases of primary glioma and meningioma were ascertained from 2000 to 2004. Job titles were coded into standard international occupational classifications and estimates of ELF and chemical exposures were assigned based on job-exposure matrices. Dichotomous indicators of cumulative ELF (≥50th vs <50th percentile, 1-4 year exposure time window) and chemical exposures (ever vs never, 5-year lag) were created. Interaction was assessed on both the additive and multiplicative scales.
A total of 1939 glioma cases, 1822 meningioma cases and 5404 controls were included in the analysis, using conditional logistic regression. There was no clear evidence for interactions between ELF and any of the chemical exposures assessed for either glioma or meningioma risk. For glioma, subjects in the low ELF/metal exposed group had a lower risk than would be predicted from marginal effects. Results were similar according to different exposure time windows, to cut-points of exposure or in exposed-only analyses.
There was no clear evidence for interactions between occupational ELF and chemical exposures in relation to glioma or meningioma risk observed. Further research with more refined estimates of occupational exposures is recommended.
鉴于缺乏关于职业化学暴露对脑肿瘤病因可能影响的明确证据，探讨此类暴露可能与职业暴露于极低频磁场（ELF）相互作用影响脑肿瘤风险这一假设是值得的。
INTEROCC是一项在七个国家（澳大利亚、加拿大、法国、德国、以色列、新西兰和英国）开展的基于人群的病例对照研究，以规模更大的INTERPHONE研究为基础。2000年至2004年确定了原发性胶质瘤和脑膜瘤的发病病例。将职位名称编码为标准国际职业分类，并根据工作暴露矩阵确定ELF和化学暴露的估计值。创建了累积ELF（≥第50百分位数与＜第50百分位数，1 - 4年暴露时间窗）和化学暴露（曾经暴露与从未暴露，5年滞后）的二分指标。在相加和相乘尺度上评估相互作用。
使用条件逻辑回归分析纳入了总共1939例胶质瘤病例、1822例脑膜瘤病例和5404例对照。没有明确证据表明ELF与评估的任何化学暴露之间在胶质瘤或脑膜瘤风险方面存在相互作用。对于胶质瘤，低ELF/金属暴露组的受试者风险低于根据边际效应预测的风险。根据不同的暴露时间窗、暴露切点或仅在暴露者分析中，结果相似。
未观察到职业ELF与化学暴露在胶质瘤或脑膜瘤风险方面存在相互作用的明确证据。建议进行更精确职业暴露估计的进一步研究。
