职业性苯乙烯暴露与获得性色觉障碍：系统评价和荟萃分析。
Occupational styrene exposure and acquired dyschromatopsia: A systematic review and meta-analysis.
机构信息
Program in Liberal Medical Education, Brown University, Providence, Rhode Island.
Division of Ophthalmology, Alpert Medical School, Brown University, Providence, Rhode Island.
出版信息
Am J Ind Med. 2017 Nov;60(11):930-946. doi: 10.1002/ajim.22766. Epub 2017 Aug 24.
BACKGROUND
Styrene is a chemical used in the manufacture of plastic-based products worldwide. We systematically reviewed eligible studies of occupational styrene-induced dyschromatopsia, qualitatively synthesizing their findings and estimating the exposure effect through meta-analysis.
METHODS
PubMed, EMBASE, and Web of Science databases were queried for eligible studies. Using a random effects model, we compared measures of dyschromatopsia between exposed and non-exposed workers to calculate the standardized mean difference (Hedges'g). We also assessed between-study heterogeneity and publication bias.
RESULTS
Styrene-exposed subjects demonstrated poorer color vision than did the non-exposed (Hedges' g = 0.56; 95%CI: 0.37, 0.76; P < 0.0001). A non-significant Cochran's Q test result (Q = 23.2; P = 0.171) and an I of 32.2% (0.0%, 69.9%) indicated low-to-moderate between-study heterogeneity. Funnel plot and trim-and-fill analyses suggested publication bias.
CONCLUSIONS
This review confirms the hypothesis of occupational styrene-induced dyschromatopsia, suggesting a modest effect size with mild heterogeneity between studies.
背景
苯乙烯是一种在全球范围内用于制造塑料产品的化学物质。我们系统地回顾了职业性苯乙烯诱导的色觉障碍的合格研究，对其发现进行定性综合，并通过荟萃分析估计暴露效应。
方法
在 PubMed、EMBASE 和 Web of Science 数据库中检索合格的研究。我们使用随机效应模型比较暴露和非暴露工人的色觉障碍测量值，以计算标准化均数差（Hedges'g）。我们还评估了研究间的异质性和发表偏倚。
结果
苯乙烯暴露组的色觉比非暴露组差（Hedges'g=0.56；95%CI：0.37，0.76；P<0.0001）。Cochran's Q 检验结果不显著（Q=23.2；P=0.171），I 为 32.2%（0.0%，69.9%），表明研究间存在低至中度异质性。漏斗图和填充分析表明存在发表偏倚。
结论
本综述证实了职业性苯乙烯诱导的色觉障碍的假设，表明研究间存在适度的效应大小和轻度的异质性。
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