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职业性铅暴露与肾癌的病例对照研究。

Case-control investigation of occupational lead exposure and kidney cancer.

机构信息

Occupational and Environmental Epidemiology Branch, Division of Cancer Epidemiology Genetics, National Cancer Institute, Bethesda, Maryland, USA.

Stewart Exposure Assessments, LLC, Arlington, Texas, USA.

出版信息

Occup Environ Med. 2019 Jul;76(7):433-440. doi: 10.1136/oemed-2018-105327. Epub 2019 Feb 13.

Abstract

OBJECTIVES

Lead is a suspected carcinogen that has been inconsistently associated with kidney cancer. To clarify this relationship, we conducted an analysis of occupational lead exposure within a population-based study of kidney cancer using detailed exposure assessment methods.

METHODS

Study participants (1217 cases and 1235 controls), enrolled between 2002 and 2007, provided information on their occupational histories and, for selected lead-related occupations, answered questions regarding workplace tasks, and use of protective equipment. Industrial hygienists used this information to develop several estimates of occupational lead exposure, including probability, duration and cumulative exposure. Unconditional logistic regression was used to compute ORs and 95% CIs for different exposure metrics, with unexposed subjects serving as the reference group. Analyses were also conducted stratifying on several factors, including for subjects of European ancestry only, single nucleotide polymorphisms in (rs1805313, rs1800435, rs8177796, rs2761016), a gene involved in lead toxicokinetics.

RESULTS

In our study, cumulative occupational lead exposure was not associated with kidney cancer (OR 0.9, 95% CI 0.7 to 1.3 for highest quartile vs unexposed; p=0.80). Other lead exposure metrics were similarly null. We observed no evidence of effect modification for the evaluated variants (subjects of European ancestry only, 662 cases and 561 controls) and most stratifying factors, although lead exposure was associated with increased risk among never smokers.

CONCLUSIONS

The findings of this study do not offer clear support for an association between occupational lead exposure and kidney cancer.

摘要

目的

铅是一种可疑的致癌物质,其与肾癌的关系一直存在争议。为了澄清这种关系,我们在一项基于人群的肾癌研究中,使用详细的暴露评估方法,对职业性铅暴露与肾癌的关系进行了分析。

方法

研究对象(1217 例病例和 1235 例对照)于 2002 年至 2007 年间入组,提供了职业史信息,对于某些与铅有关的职业,还回答了关于工作场所任务和使用防护设备的问题。工业卫生学家利用这些信息,开发了几种职业性铅暴露的估计方法,包括概率、持续时间和累积暴露。采用非条件逻辑回归,计算了不同暴露指标的比值比(OR)和 95%置信区间(CI),以未暴露人群为参照组。还进行了分层分析,包括仅针对欧洲血统的人群、涉及铅毒代动力学的基因(rs1805313、rs1800435、rs8177796、rs2761016)中的单核苷酸多态性。

结果

在我们的研究中,累积职业性铅暴露与肾癌无关(最高四分位数与未暴露相比,OR 0.9,95%CI 0.7 至 1.3;p=0.80)。其他铅暴露指标也同样无关联。在所评估的 基因(仅欧洲血统人群,662 例病例和 561 例对照)和大多数分层因素中,未观察到效应修饰的证据,但铅暴露与从不吸烟者的肾癌风险增加有关。

结论

这项研究的结果并未明确支持职业性铅暴露与肾癌之间存在关联。

相似文献

1
Case-control investigation of occupational lead exposure and kidney cancer.职业性铅暴露与肾癌的病例对照研究。
Occup Environ Med. 2019 Jul;76(7):433-440. doi: 10.1136/oemed-2018-105327. Epub 2019 Feb 13.

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