Monash Centre for Occupational and Environmental Health, Monash University, Melbourne, VIC, Australia.
Department of Surgery, Liverpool Hospital, Liverpool, NSW, Australia.
Ann Work Expo Health. 2021 Apr 22;65(3):255-265. doi: 10.1093/annweh/wxaa114.
An estimated 125 million workers are exposed to asbestos worldwide. Asbestos is classified by the International Agency for Research on Cancer as a Group 1 carcinogen. The association between occupational asbestos exposure and kidney cancer is not well established however. This study aimed to determine the mortality and incidence of kidney cancer in workers who have been exposed to asbestos. We performed a systematic review and meta-analysis to evaluate the association between occupational asbestos exposure and kidney cancer.
Medline, EMBASE, and Web of Science were searched according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines for articles on occupational asbestos exposure and kidney cancer. The studies reported the standardized mortality ratio (SMR) or standardized incidence ratio (SIR) of kidney cancer in workers exposed to asbestos. SMRs or SIRs with its 95% confidence interval (CI) were pooled using a fixed-effect model.
Forty-nine cohort studies involving 335 492 workers were selected for analysis. These studies included 468 kidney cancer deaths and 160 incident cases. The overall pooled-SMR of kidney cancer was 0.95 (95% CI: 0.86-1.05), with no significant heterogeneity (PQ = 0.09, I2 = 24.87%). The overall pooled-SIR of kidney cancer was 0.95 (95% CI: 0.79-1.11), with no significant heterogeneity (PQ = 0.68, I2 = 0.00%). Subgroup analysis did not find any increased association with occupational asbestos exposure. There was no evidence of publication bias with Egger's test P values of 0.08 for mortality studies and 0.99 for incidence studies.
This systematic review and meta-analysis did not show evidence of association between occupational asbestos exposure and kidney cancer mortality or incidence.
全球估计有 1.25 亿工人接触石棉。国际癌症研究机构将石棉归类为第 1 组致癌物。然而，职业性石棉暴露与肾癌之间的关联尚未得到很好的确定。本研究旨在确定暴露于石棉的工人中肾癌的死亡率和发病率。我们进行了系统评价和荟萃分析，以评估职业性石棉暴露与肾癌之间的关联。
根据系统评价和荟萃分析的首选报告项目（PRISMA）指南，在 Medline、EMBASE 和 Web of Science 上搜索有关职业性石棉暴露和肾癌的文章。报告了暴露于石棉的工人中肾癌的标准化死亡率比（SMR）或标准化发病率比（SIR）的研究。使用固定效应模型汇总 SMR 或 SIR 及其 95%置信区间（CI）。
选择了 49 项队列研究进行分析，涉及 335492 名工人。这些研究包括 468 例肾癌死亡和 160 例发病病例。肾癌的总体汇总 SMR 为 0.95（95%CI：0.86-1.05），无显著异质性（PQ = 0.09，I2 = 24.87%）。肾癌的总体汇总 SIR 为 0.95（95%CI：0.79-1.11），无显著异质性（PQ = 0.68，I2 = 0.00%）。亚组分析未发现与职业性石棉暴露有任何增加的关联。Egger 检验的发表偏倚 P 值分别为 0.08 用于死亡率研究和 0.99 用于发病率研究，均无统计学意义。
本系统评价和荟萃分析未显示职业性石棉暴露与肾癌死亡率或发病率之间存在关联的证据。
