Parent Marie-Elise, Turner Michelle C, Lavoué Jérôme, Richard Hugues, Figuerola Jordi, Kincl Laurel, Richardson Lesley, Benke Geza, Blettner Maria, Fleming Sarah, Hours Martine, Krewski Daniel, McLean David, Sadetzki Siegal, Schlaefer Klaus, Schlehofer Brigitte, Schüz Joachim, Siemiatycki Jack, van Tongeren Martie, Cardis Elisabeth
Epidemiology and Biostatistics Unit, INRS-Institut Armand-Frappier, Université du Québec, 531, Boul. Des Prairies, Laval, Quebec, H7V 1B7, Canada.
School of Public Health, University of Montreal, Montreal, Canada.
Environ Health. 2017 Aug 25;16(1):90. doi: 10.1186/s12940-017-0300-y.
Brain tumor etiology is poorly understood. Based on their ability to pass through the blood-brain barrier, it has been hypothesized that exposure to metals may increase the risk of brain cancer. Results from the few epidemiological studies on this issue are limited and inconsistent.
We investigated the relationship between glioma risk and occupational exposure to five metals - lead, cadmium, nickel, chromium and iron- as well as to welding fumes, using data from the seven-country INTEROCC study. A total of 1800 incident glioma cases and 5160 controls aged 30-69 years were included in the analysis. Lifetime occupational exposure to the agents was assessed using the INTEROCC JEM, a modified version of the Finnish job exposure matrix FINJEM.
In general, cases had a slightly higher prevalence of exposure to the various metals and welding fumes than did controls, with the prevalence among ever exposed ranging between 1.7 and 2.2% for cadmium to 10.2 and 13.6% for iron among controls and cases, respectively. However, in multivariable logistic regression analyses, there was no association between ever exposure to any of the agents and risk of glioma with odds ratios (95% confidence intervals) ranging from 0.8 (0.7-1.0) for lead to 1.1 (0.7-1.6) for cadmium. Results were consistent across models considering cumulative exposure or duration, as well as in all sensitivity analyses conducted.
Findings from this large-scale international study provide no evidence for an association between occupational exposure to any of the metals under scrutiny or welding fumes, and risk of glioma.
脑肿瘤的病因尚不清楚。基于金属能够穿过血脑屏障的能力，有人提出接触金属可能会增加患脑癌的风险。关于这个问题的少数流行病学研究结果有限且不一致。
我们利用七国职业暴露与癌症研究（INTEROCC）的数据，调查了神经胶质瘤风险与职业接触五种金属（铅、镉、镍、铬和铁）以及焊接烟雾之间的关系。分析纳入了1800例年龄在30至69岁之间的新发神经胶质瘤病例和5160名对照。使用INTEROCC工作环境暴露矩阵（JEM）评估终生职业暴露情况，该矩阵是芬兰工作暴露矩阵（FINJEM）的修改版本。
总体而言，病例接触各种金属和焊接烟雾的患病率略高于对照，在曾经接触过的人群中，镉的患病率在对照和病例中分别为1.7%至2.2%，铁的患病率分别为10.2%至13.6%。然而，在多变量逻辑回归分析中，接触任何一种物质与神经胶质瘤风险之间均无关联，铅的比值比（95%置信区间）为0.8（0.7 - 1.0），镉为1.1（0.7 - 1.6）。在考虑累积暴露或暴露持续时间的模型中以及所有敏感性分析中，结果均一致。
这项大规模国际研究的结果没有提供证据表明职业接触任何一种受审查的金属或焊接烟雾与神经胶质瘤风险之间存在关联。
