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职业接触滑石粉会增加患肺癌的风险:一项职业队列研究的荟萃分析

Occupational Exposure to Talc Increases the Risk of Lung Cancer: A Meta-Analysis of Occupational Cohort Studies.

作者信息

Chang Che-Jui, Tu Yu-Kang, Chen Pau-Chung, Yang Hsiao-Yu

机构信息

Institute of Occupational Medicine and Industrial Hygiene, National Taiwan University College of Public Health, Taipei, Taiwan.

Department of Family Medicine, National Taiwan University Hospital, Taipei, Taiwan.

出版信息

Can Respir J. 2017;2017:1270608. doi: 10.1155/2017/1270608. Epub 2017 Aug 31.

Abstract

OBJECTIVE

Talc is widely used in industrial applications. Previous meta-analyses of carcinogenic effects associated with inhaled talc included publications before 2004, with a lack of data in China, the largest talc-producing country. The safety of workers exposed to talc was unclear due to limited evidence. The objective of this study was to reevaluate the association between inhaled talc and lung cancer.

SETTING PARTICIPANTS AND OUTCOME MEASURES

A meta-analysis was performed to calculate the meta-SMR of lung cancer. We searched the MEDLINE, EMBASE, CNKI, and Wanfang Data databases through March 2017. Data from observational studies were pooled using meta-analysis with random effects models.

RESULTS

Fourteen observational cohort studies (13 publications) were located via literature search. The heterogeneity of the included data was high (-squared = 72.9%). Pooling all the cohorts yielded a meta-SMR of 1.45 (95% CI: 1.22-1.72, < 0.0001) for lung cancer among the study subjects exposed to talc. Subgroup analysis for asbestos contamination showed no significant difference in lung cancer death between subjects exposed to talc with and without asbestos ( = 0.8680), indicating that this confounding factor may have no significance.

CONCLUSIONS

This study provides evidence that nonasbestiform talc might still increase the risk of lung cancer. Further epidemiological studies are required to evaluate the safety of workers with occupational talc exposure.

摘要

目的

滑石粉广泛应用于工业领域。先前关于吸入滑石粉致癌作用的荟萃分析纳入的是2004年以前的出版物,且缺乏来自中国(最大的滑石粉生产国)的数据。由于证据有限,接触滑石粉工人的安全性尚不明确。本研究的目的是重新评估吸入滑石粉与肺癌之间的关联。

设置参与者和结局指标

进行荟萃分析以计算肺癌的荟萃标准化死亡比(meta-SMR)。我们检索了截至2017年3月的MEDLINE、EMBASE、中国知网和万方数据数据库。使用随机效应模型的荟萃分析对观察性研究的数据进行汇总。

结果

通过文献检索找到14项观察性队列研究(13篇出版物)。纳入数据的异质性较高(I² = 72.9%)。汇总所有队列后,接触滑石粉的研究对象中肺癌的荟萃标准化死亡比为1.45(95%CI:1.22 - 1.72,P < 0.0001)。对石棉污染的亚组分析显示,接触滑石粉且有石棉污染与无石棉污染的受试者之间肺癌死亡无显著差异(P = 0.8680),表明该混杂因素可能无显著性意义。

结论

本研究提供了证据表明非石棉状滑石粉可能仍会增加肺癌风险。需要进一步的流行病学研究来评估职业接触滑石粉工人的安全性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/12be/5610800/d2be65035f76/CRJ2017-1270608.001.jpg

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