Respiratory Health Division, National Institute for Occupational Safety and Health (NIOSH), Centers for Disease Control and Prevention (CDC), Morgantown, West Virginia.
Epidemic Intelligence Service, Center for Surveillance, Epidemiology and Laboratory Services, Centers for Disease Control and Prevention (CDC), Atlanta, Georgia.
Am J Ind Med. 2019 May;62(5):367-384. doi: 10.1002/ajim.22959. Epub 2019 Feb 18.
Non-malignant respiratory disease (NMRD) cases have occurred among rubber manufacturing workers. We examined exposure to rubber manufacturing emissions as a risk factor for NMRD.
From a systematic literature review, we identified case reports and assessed cross-sectional and mortality studies for strength of evidence of positive association (strong, intermediate, non-significant positive association, none) between exposure to rubber manufacturing emissions and NMRD-related morbidity and mortality, and conducted two meta-analyses.
We analyzed 62 articles. We identified 11 cases of NMRD. Nine (30%) of 30 cross-sectional studies and one (4%) of 26 mortality studies had strong evidence. The summary odds ratio and SMR for the cross-sectional and mortality meta-analyses were 3.83 (95% confidence interval [CI], 2.28-6.51) and 0.90 (95%CI, 0.82-0.99), respectively.
Available evidence supports rubber manufacturing emissions as a potential risk factor for NMRD-related morbidity. Further investigations with longer follow-up periods and inclusion of short-tenured workers could further define risks for NMRD and identify prevention strategies.
橡胶制造业工人中出现了非恶性呼吸道疾病（NMRD）病例。我们研究了橡胶制造业排放物暴露作为 NMRD 的风险因素。
从系统文献回顾中，我们确定了病例报告，并评估了横断面和死亡率研究，以确定暴露于橡胶制造业排放物与 NMRD 相关发病率和死亡率之间存在正关联（强、中等、非显著正关联、无）的证据强度（强、中、非显著正关联、无），并进行了两项荟萃分析。
我们分析了 62 篇文章。我们确定了 11 例 NMRD。30 项横断面研究中有 9 项（30%）和 26 项死亡率研究中有 1 项（4%）具有强有力的证据。横断面和死亡率荟萃分析的汇总优势比和 SMR 分别为 3.83（95%置信区间 [CI]，2.28-6.51）和 0.90（95%CI，0.82-0.99）。
现有证据支持橡胶制造业排放物作为 NMRD 相关发病率的潜在危险因素。进一步的研究需要更长的随访期，并纳入短期工作的工人，以进一步确定 NMRD 的风险，并确定预防策略。
