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职业性暴露于农药与阻塞性肺部疾病风险的系统评价和荟萃分析。

Risk of obstructive pulmonary diseases and occupational exposure to pesticides: a systematic review and meta-analysis.

机构信息

Department of Occupational Health, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran.

Department of Social Medicine, Tehran University of Medical Sciences, Tehran, Iran.

出版信息

Public Health. 2019 Sep;174:31-41. doi: 10.1016/j.puhe.2019.05.024. Epub 2019 Jul 12.

DOI:10.1016/j.puhe.2019.05.024
PMID:31306887
Abstract

OBJECTIVE

This meta-analysis study was performed to examine the relationship between occupational exposure to pesticides and the risk of obstructive pulmonary diseases such as chronic obstructive pulmonary disease (COPD) and chronic bronchitis.

STUDY DESIGN

This is a systematic review and meta-analysis study.

METHODS

PubMed and Scopus databases were searched for English-language publications. Eight cohort studies and one case-control study were included in the pooled analysis.

RESULTS

These studies had a total of 101,353 participants from eleven different countries and were published between 2006 and 2018. The heterogeneity among the studies was high (P < 0.001, I = 68.7%). In a random-effects model meta-analysis, a pooled odds ratio (OR) analysis showed that there was a direct relationship between occupational exposure to the pesticides and obstructive pulmonary diseases (OR = 1.33, 95% confidence interval [CI]: 1.21-1.47). A positive significant relationship was also observed between exposure to the pesticides and risk of chronic bronchitis (OR = 1.27, 95% CI: 1.23-1.31). Also, there was a significant relationship between occupational exposure to the pesticides and an increased risk of COPD (OR = 1.44, 95% CI: 1.14-1.81). No evidence of publication bias was found among the studies according to the results of the Egger's test (P of bias = 0.157).

CONCLUSIONS

Findings of this study show that occupational exposure to pesticides can be associated with an increased risk of obstructive lung diseases including chronic bronchitis and COPD.

摘要

目的

本荟萃分析旨在研究职业性接触农药与阻塞性肺疾病(如慢性阻塞性肺疾病[COPD]和慢性支气管炎)风险之间的关系。

研究设计

这是一项系统性综述和荟萃分析研究。

方法

检索了 PubMed 和 Scopus 数据库中的英文文献。共有八项队列研究和一项病例对照研究纳入汇总分析。

结果

这些研究共纳入来自 11 个不同国家的 101353 名参与者,发表时间为 2006 年至 2018 年。研究之间的异质性很高(P<0.001,I=68.7%)。在随机效应模型荟萃分析中,汇总比值比(OR)分析显示,职业性接触农药与阻塞性肺疾病之间存在直接关系(OR=1.33,95%置信区间[CI]:1.21-1.47)。接触农药与慢性支气管炎风险之间也存在显著正相关关系(OR=1.27,95%CI:1.23-1.31)。此外,职业性接触农药与 COPD 风险增加之间也存在显著关系(OR=1.44,95%CI:1.14-1.81)。根据 Egger 检验的结果,研究之间未发现发表偏倚的证据(偏倚 P=0.157)。

结论

本研究结果表明,职业性接触农药可能与阻塞性肺部疾病(包括慢性支气管炎和 COPD)的风险增加有关。

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