Huss Anke, Peters Susan, Vermeulen Roel
Institute for Risk Assessment Sciences, Utrecht University, Utrecht, The Netherlands.
Department of Neurology, University Medical Centre Utrecht, Utrecht, The Netherlands.
Bioelectromagnetics. 2018 Feb;39(2):156-163. doi: 10.1002/bem.22104. Epub 2018 Jan 19.
We performed a meta-analysis to examine associations of occupational exposure to extremely-low frequency magnetic fields (ELF-MF) with amyotrophic lateral sclerosis (ALS). Epidemiologic studies were identified in EMBASE and MEDLINE, in reference lists and a specialist database. We included studies that reported risk estimates of ALS in association with occupational ELF-MF exposure. Summary relative risks (RR) or odds ratios (OR) were obtained with random effect meta-analysis, and analyses were stratified by type of exposure assessment. This was done to evaluate whether observed heterogeneity between studies could be explained with differences in the way the exposure had been determined. We included 20 studies in our meta-analysis. Overall, studies reported a slightly increased risk of ALS in those exposed to higher levels of ELF-MF compared to lower levels with a summary RR (sRR) of 1.14 (95% Confidence Interval [CI] 1.00-1.30) and for workers in electrical occupations (sRR 1.41, CI 1.05-1.92), but with large heterogeneity between studies (I > 70%). Self-reported exposure or occupations determined from death certificates did not show increased risks. Highest-longest types of exposure translated into increased risks of ALS if the studies had evaluated the whole occupational history, in contrast to evaluating only few points in time (e.g., from census records); sRR were 1.89 (CI 1.31-2.73, I 0%) and 1.06 (CI 0.75-1.57, I 76%), respectively. In this meta-analysis, we observed an increased risk of ALS in workers occupationally exposed to ELF-MF. Results of studies depended on the quality of the exposure assessment. Bioelectromagnetics. 39:156-163, 2018. © 2018 Wiley Periodicals, Inc.
我们进行了一项荟萃分析，以研究职业性接触极低频磁场（ELF-MF）与肌萎缩侧索硬化症（ALS）之间的关联。在EMBASE和MEDLINE数据库、参考文献列表以及一个专业数据库中检索了流行病学研究。我们纳入了报告了与职业性ELF-MF暴露相关的ALS风险估计值的研究。通过随机效应荟萃分析获得汇总相对风险（RR）或比值比（OR），并按暴露评估类型进行分层分析。这样做是为了评估研究之间观察到的异质性是否可以用暴露确定方式的差异来解释。我们的荟萃分析纳入了20项研究。总体而言，与低水平暴露相比，研究报告显示，暴露于高水平ELF-MF的人群患ALS的风险略有增加，汇总RR为1.14（95%置信区间[CI]1.00 - 1.30），电气行业工人的汇总RR为1.41（CI 1.05 - 1.92），但研究之间存在较大异质性（I²>70%）。自我报告的暴露或根据死亡证明确定的职业并未显示出风险增加。如果研究评估了整个职业史，与仅评估几个时间点（例如，根据人口普查记录）相比，最长时间的最高水平暴露会转化为ALS风险增加；汇总RR分别为1.89（CI 1.31 - 2.73，I² 0%）和1.06（CI 0.75 - 1.57，I² 76%）。在这项荟萃分析中，我们观察到职业性接触ELF-MF的工人患ALS的风险增加。研究结果取决于暴露评估的质量。《生物电磁学》。39:156 - 163，2018年。©2018威利期刊公司。
