接触沥青和沥青烟与癌症风险：一项更新的系统评价和荟萃分析。

Cancer Risk Associated With Exposure to Bitumen and Bitumen Fumes: An Updated Systematic Review and Meta-Analysis.

机构信息

Health Sciences, Ramboll Environment and Health, Amherst, Mass (Dr Mundt, Ms Dell, Ms Crawford, Dr Sax), and Icahn School of Medicine at Mount Sinai, New York, NY (Dr Boffetta).

出版信息

J Occup Environ Med. 2018 Jan;60(1):e6-e54. doi: 10.1097/JOM.0000000000001202.

DOI:10.1097/JOM.0000000000001202

PMID:29111990

Abstract

OBJECTIVE

To evaluate whether cancer risks are increased among bitumen (asphalt) workers.

METHODS

Systematic review and meta-analysis of cancer risks (lung, upper aerodigestive tract (UADT), esophagus, bladder, kidney, stomach, and skin) and bitumen exposure. Certainty in the epidemiological evidence that bitumen-exposed workers experience increased cancer risks was rated using Grading of Recommendations Assessment, Development and Evaluation criteria.

RESULTS

After excluding lower-quality studies, lung cancer risks were not increased among bitumen-exposed workers (meta-relative risk [RR] 0.94, 95% CI 0.74 to 1.20, eight studies). Increased risks of UADT and stomach cancers were observed (meta-RR 1.31, 95% CI 1.03 to 1.67, 10 studies and meta-RR 1.29, 95% CI 1.03 to 1.62, seven studies, respectively).

CONCLUSIONS

Except for lung cancer, evidence for increased cancer risks among bitumen-exposed workers was judged to be of low certainty, due to inadequate exposure characterization and unmeasured confounders (coal tar exposure, smoking, and alcohol consumption).

摘要

目的

评估沥青（沥青）工人的癌症风险是否增加。

方法

对癌症风险（肺癌、上呼吸道（UADT）、食管、膀胱、肾脏、胃和皮肤）和沥青暴露的系统评价和荟萃分析。使用评估、制定和评估标准（Grading of Recommendations Assessment, Development and Evaluation criteria）对沥青暴露工人经历增加的癌症风险的流行病学证据的确定性进行评级。

结果

在排除低质量研究后，沥青暴露工人的肺癌风险并未增加（meta-相对风险 [RR] 0.94，95% CI 0.74 至 1.20，八项研究）。观察到 UADT 和胃癌风险增加（meta-RR 1.31，95% CI 1.03 至 1.67，十项研究和 meta-RR 1.29，95% CI 1.03 至 1.62，七项研究）。