Moura Luiza Taciana Rodrigues de, Bedor Cheila Nataly Galindo, Lopez Rossana Veronica Mendoza, Santana Vilma Sousa, Rocha Talita Máira Bueno da Silveira da, Wünsch Filho Victor, Curado Maria Paula
Universidade Federal do Vale do São Francisco, Petrolina, PE, Brazil.
Centro de Investigação Translacional em Oncologia, Instituto do Câncer do Estado de São Paulo, São Paulo, SP, Brasil.
Rev Bras Epidemiol. 2020;23:e200022. doi: 10.1590/1980-549720200022. Epub 2020 May 11.
To update findings of observational analytical studies on the association between occupational exposure to organophosphates and hematologic malignancies.
Systematic literature review, including cohort and case-control studies, without limitation of publication time, in Portuguese and English. The articles were traced from June 2017 to July 2019 in PubMed, MEDLINE, LILACS, Web of Science, and Scopus databases. The qualitative bias risk assessment was performed using the Newcastle-Ottawa Scale and the Downs and Black Checklist. Results were presented according to the Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA).
Seventeen studies evaluated as good/high methodological quality were eligible. Exposure to diazinon (1 cohort), phonophos (1 cohort), dichlorvos, crotoxiphos and famphur (1 case control) was associated with leukemia, while exposure to organophosphate was associated to lymphomas (6 case control); the risk of non-Hodgkin's lymphoma was higher in those exposed to diazinon (1 control case) and malathion (3 control case) than non-exposed ones. Multiple myeloma occurred more commonly in organophosphate exposed than in non-exposed individuals (1 case-control).
Occupational exposure to organophosphates increases the risk of hematologic malignancies, especially among individuals with longer exposure periods. Worker monitoring and exposure control measures are recommended.
更新关于职业性接触有机磷酸酯与血液系统恶性肿瘤之间关联的观察性分析研究结果。
进行系统的文献综述，包括队列研究和病例对照研究，不限发表时间，语言限定为葡萄牙语和英语。于2017年6月至2019年7月在PubMed、MEDLINE、LILACS、科学网和Scopus数据库中检索文章。使用纽卡斯尔-渥太华量表和唐斯-布莱克清单进行定性偏倚风险评估。结果根据系统评价和Meta分析的首选报告项目（PRISMA）呈现。
17项评估为方法学质量良好/高的研究符合要求。接触二嗪农（1项队列研究）、丰索磷（1项队列研究）、敌敌畏、巴毒磷和伐灭磷（1项病例对照研究）与白血病有关，而接触有机磷酸酯与淋巴瘤有关（6项病例对照研究）；接触二嗪农（1项病例对照研究）和马拉硫磷（3项病例对照研究）的人群中非霍奇金淋巴瘤的风险高于未接触者。多发性骨髓瘤在接触有机磷酸酯的个体中比未接触者更常见（1项病例对照研究）。
职业性接触有机磷酸酯会增加血液系统恶性肿瘤的风险，尤其是接触时间较长的个体。建议对工人进行监测并采取接触控制措施。
