Department of Sociology, University of Warwick, Coventry, CV4 7AL, UK.
Centre for Environmental Health and Sustainability, University of Leicester, Leicester, LE1 7HA, UK.
Environ Health. 2020 May 19;19(1):53. doi: 10.1186/s12940-020-00582-1.
The petrochemical industry is a major source of hazardous and toxic air pollutants that are recognised to have mutagenic and carcinogenic properties. A wealth of occupational epidemiology literature exists around the petrochemical industry, with adverse haematological effects identified in employees exposed to 'low' concentrations of aromatic hydrocarbons (benzene, toluene, ethylbenzene, and xylene). Releases from the petrochemical industry are also thought to increase the risk of cancer incidence in fenceline communities. However, this emerging and at times inconclusive evidence base remains fragmented. The present study's aim was to conduct a systematic review and meta-analysis of epidemiological studies investigating the association between incidences of haematological malignancy and residential exposure to the petrochemical industry.
Epidemiological studies reporting the risk of haematological malignancies (Leukaemia, Hodgkin's lymphoma, Non-Hodgkin's lymphoma, and Multiple myeloma) were included where the following criteria were met: (i) Cancer incidence is diagnosed by a medical professional and coded in accordance to the International Classification of Diseases; (ii) A clear definition of fenceline communities is provided, indicating the proximity between exposed residents and petrochemical activities; and (iii) Exposure is representative of normal operating conditions, not emergency events. Two investigators independently extracted information on study characteristics and outcomes in accordance with PRISMA and MOOSE guidelines. Relative risks and their 95% confidence intervals were pooled across studies for the four categories of haematological malignancy, using a random effects meta-analysis.
The systematic review identified 16 unique studies, which collectively record the incidence of haematological malignancies across 187,585 residents living close to a petrochemical operation. Residents from fenceline communities, less than 5 km from a petrochemical facility (refinery or manufacturer of commercial chemicals), had a 30% higher risk of developing Leukaemia than residents from communities with no petrochemical activity. Meanwhile, the association between exposure and rarer forms of haematological malignancy remains uncertain, with further research required.
The risk of developing Leukaemia appears higher in individuals living near a petrochemical facility. This highlights the need for further policy to regulate the release of carcinogens by industry.
石化工业是危险和有毒空气污染物的主要来源,这些污染物已被证实具有致突变和致癌特性。围绕石化工业,已经有大量职业流行病学文献,其中暴露于“低”浓度芳香烃(苯、甲苯、乙苯和二甲苯)的员工出现血液学不良效应。石化工业的排放物也被认为会增加围栏社区癌症发病率。然而,这一新兴且有时结论不明确的证据基础仍然存在碎片化。本研究旨在对调查血液系统恶性肿瘤与石化工业住宅暴露之间关联的流行病学研究进行系统回顾和荟萃分析。
本研究纳入了报告血液系统恶性肿瘤(白血病、霍奇金淋巴瘤、非霍奇金淋巴瘤和多发性骨髓瘤)风险的流行病学研究,符合以下标准:(i)癌症发病率由医疗专业人员诊断,并按照国际疾病分类进行编码;(ii)提供了明确的围栏社区定义,表明暴露居民与石化活动的接近程度;(iii)暴露代表正常运行条件,而不是紧急情况。两名研究人员根据 PRISMA 和 MOOSE 指南独立提取研究特征和结局信息。使用随机效应荟萃分析,对四种血液系统恶性肿瘤的研究进行汇总,得出相对风险及其 95%置信区间。
系统综述确定了 16 项独特的研究,这些研究共同记录了居住在靠近石化作业的 187585 名居民的血液系统恶性肿瘤发病率。与没有石化活动的社区的居民相比,距离石化设施(炼油厂或商用化学品制造商)不到 5 公里的围栏社区居民患白血病的风险高出 30%。而暴露与更罕见的血液系统恶性肿瘤之间的关联仍不确定,需要进一步研究。
居住在石化设施附近的个体患白血病的风险似乎更高。这凸显了需要进一步制定政策来规范行业致癌物质的排放。