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职业和环境接触多氯联苯与非霍奇金淋巴瘤风险:流行病学研究的系统评价和荟萃分析。

Occupational and environmental exposure to polychlorinated biphenyls and risk of non-Hodgkin lymphoma: a systematic review and meta-analysis of epidemiology studies.

机构信息

Department of Medicine and Surgery Specialties, Radiological Sciences and Public Health University of Brescia, Brescia.

Department of Public Health and Pediatric Sciences, University of Turin, Turin, Italy.

出版信息

Eur J Cancer Prev. 2019 Sep;28(5):441-450. doi: 10.1097/CEJ.0000000000000463.

DOI:10.1097/CEJ.0000000000000463
PMID:30234686
Abstract

We carryied out a meta-analysis of studies on exposure to polychlorinated biphenyls (PCBs) and risk of non-Hodgkin lymphoma (NHL). Through a systematic search of the literature, we identified relative risks (RRs) for PCB exposure and NHL risk in 30 populations (10 occupational exposure, seven high environmental exposure, 13 without special exposure). We performed random effects meta-analyses for exposure to all PCBs, specific PCB congeners and risk of all NHL and NHL subtypes. The meta-RR for studies of occupational exposure, high environmental exposure, and no special exposure were 0.94 [95% confidence interval (CI): 0.84-1.03], 1.05 (95% CI: 0.94-1.16), and 1.03 (95% CI: 0.72-1.34), respectively, and the cumulative meta-RR was 0.96 (95% CI: 0.85-1.07). No positive associations were found for exposure to specific congeners, nor for NHL subtypes. The meta-RR for an increase of 100 ppb serum or fat PCB level was 1.02 (95% CI: 1.00-1.04). There was weak indication of publication bias. Our meta-analysis found no association between PCB exposure and NHL risk, in particular in studies of occupational exposures. We detected a weak dose-response relation; the possibility of residual confounding and other sources of bias cannot be ruled out. PCBs are not likely to cause NHL in humans.

摘要

我们对多氯联苯(PCBs)暴露与非霍奇金淋巴瘤(NHL)风险的研究进行了荟萃分析。通过系统的文献检索,我们确定了 30 个人群(10 个职业暴露、7 个高环境暴露、13 个无特殊暴露)中 PCB 暴露与 NHL 风险的相对风险(RR)。我们对所有 PCBs、特定 PCB 同系物以及所有 NHL 和 NHL 亚型的风险进行了随机效应荟萃分析。职业暴露、高环境暴露和无特殊暴露研究的荟萃 RR 分别为 0.94(95%置信区间[CI]:0.84-1.03)、1.05(95% CI:0.94-1.16)和 1.03(95% CI:0.72-1.34),累积荟萃 RR 为 0.96(95% CI:0.85-1.07)。未发现特定同系物暴露或 NHL 亚型与 NHL 风险之间存在正相关关系。血清或脂肪 PCB 水平增加 100 ppb 的荟萃 RR 为 1.02(95% CI:1.00-1.04)。存在发表偏倚的微弱迹象。我们的荟萃分析发现,PCB 暴露与 NHL 风险之间没有关联,尤其是在职业暴露研究中。我们检测到了微弱的剂量-反应关系;不能排除残留混杂和其他来源的偏倚的可能性。PCBs 不太可能导致人类 NHL。

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