Department of Occupational and Environmental Medicine, School of Medicine, Örebro University, 701 82 Örebro, Sweden.
Department of Statistics, Örebro University, 701 82 Örebro, Sweden.
Int J Environ Res Public Health. 2019 Jan 26;16(3):337. doi: 10.3390/ijerph16030337.
To carry out an integrated and stratified meta-analysis on occupational exposure to electromagnetic fields (EMFs), metals and pesticides and its effects on amyotrophic lateral sclerosis (ALS) and Parkinson's and Alzheimer's disease, and investigate the possibility of publication bias. : In the current study, we updated our recently published meta-analyses on occupational exposures in relation to ALS, Alzheimer's and Parkinson's disease. Based on 66 original publications of good scientific epidemiological standard, according to the Meta-analysis of Observational Studies in Epidemiology (MOOSE) and the Grading of Recommendations, Assessment, Development and Evaluations (GRADE) guidelines, we analysed subgroups by carrying out stratified meta-analyses on publication year, statistical precision of the relative risk (RR) estimates, inspection of the funnel plots and test of bias. : Based on 19 studies the weighted RR for occupational exposure to EMFs was 1.26 (95% confidence interval (CI) 1.07⁻1.50) for ALS, 1.33 (95% CI 1.07⁻1.64) for Alzheimer's disease and 1.02 (95% CI 0.83⁻1.26) for Parkinson's disease. Thirty-one studies concerned occupational exposure to pesticides and the weighted RR was 1.35 (95% CI 1.02⁻1.79) for ALS, 1.50 (95% CI 0.98⁻2.29) for Alzheimer's disease and 1.66 (95% CI 1.42⁻1.94) for Parkinson's disease. Finally, 14 studies concerned occupational exposure to metals and only exposure to lead (five studies) involved an elevated risk for ALS or Parkinson's disease and the weighted RR was 1.57 (95% CI 1.11⁻2.20). The weighted RR for all the non-lead exposures was 0.97 (95% CI 0.88⁻1.06). : Exposure to pesticides increased the risk of getting the mentioned neurodegenerative diseases by at least 50%. Exposure to lead was only studied for ALS and Parkinson's disease and involved 50% increased risk. Occupational exposure to EMFs seemed to involve some 10% increase in risk for ALS and Alzheimer's disease only.
开展了一项关于职业暴露于电磁场（EMF）、金属和农药及其对肌萎缩侧索硬化症（ALS）、帕金森病和阿尔茨海默病影响的综合分层荟萃分析，并调查了出版偏倚的可能性。在当前研究中，我们更新了最近发表的关于与 ALS、阿尔茨海默病和帕金森病相关的职业暴露的荟萃分析。基于 66 项具有良好科学流行病学标准的原始出版物，根据观察性研究的荟萃分析（MOOSE）和推荐评估、发展和评估分级（GRADE）指南，我们根据出版年份、相对风险（RR）估计的统计精度、漏斗图检查和偏倚检验进行分层荟萃分析亚组分析。基于 19 项研究，职业接触电磁场与 ALS 的加权 RR 为 1.26（95%置信区间（CI）1.07⁻1.50），与阿尔茨海默病的加权 RR 为 1.33（95% CI 1.07⁻1.64），与帕金森病的加权 RR 为 1.02（95% CI 0.83⁻1.26）。31 项研究涉及职业性农药接触，加权 RR 为 1.35（95% CI 1.02⁻1.79），与 ALS 的加权 RR 为 1.50（95% CI 0.98⁻2.29），与阿尔茨海默病的加权 RR 为 1.66（95% CI 1.42⁻1.94），与帕金森病的加权 RR 为 1.66（95% CI 1.42⁻1.94）。最后，14 项研究涉及职业性金属接触，只有铅（5 项研究）暴露与 ALS 或帕金森病的风险增加有关，加权 RR 为 1.57（95% CI 1.11⁻2.20）。所有非铅接触的加权 RR 为 0.97（95% CI 0.88⁻1.06）。接触农药会使上述神经退行性疾病的风险至少增加 50%。只有铅的接触与 ALS 和帕金森病有关，涉及风险增加 50%。职业接触电磁场似乎只使 ALS 和阿尔茨海默病的风险增加了约 10%。
