Department of Clinical Epidemiology, First Affiliated Hospital, China Medical University, Shenyang 110001, China.
Medical Oncology Department of Thoracic Cancer (2), Cancer Hospital of China Medical University, Liaoning Cancer Hospital & Institute, No. 44, Xiaoheyan Road, Dadong District, Shenyang, 110042 Liaoning Province, China.
Biomed Res Int. 2021 Mar 8;2021:6624799. doi: 10.1155/2021/6624799. eCollection 2021.
Evidence on the carcinogenicity of coalmine dust in occupational settings is still conflicting. Therefore, we conducted this research to evaluate the mortality risk of lung cancer for coalminers exposed to occupational dust when compared to population with no or low dust exposure.
Databases of PubMed and Chinese National Knowledge Infrastructure as well as reference lists were searched updated to September 18, 2020. The enrolled articles should report lung cancer mortality risk for coalminers exposed to occupational dust. Basic information was extracted such as the author and publication year, area and ethnicity, the type and estimates of outcome, duration of follow-up, and the study design. The checklists from Agency for Healthcare Research and Quality and the Newcastle-Ottawa Scale were used for the assessment of quality and bias risk for descriptive studies, cohort studies, and case control studies, respectively. The overall relative risks were calculated while Begg's and Egger's tests and sensitivity analysis were performed to explore potential heterogeneity sources. Metaregression and subgroup analyses were also conducted to give more detailed information for the correlation between dust exposure and lung cancer mortality.
A total of 19 articles with 22 different studies (descriptive study, case control study, and cohort study) including 8909 observed deaths from 1964 to 2017 were enrolled with a significant heterogeneity ( = 95%, < 0.001). The pooled relative risk of mortality from lung cancer was 1.16 (1.03-1.30) for coalminers. Results of metaregression analysis indicated that the high heterogeneity among these enrolled studies might be caused by the ethnicity differences ( = 0.011). Subgroup analysis also indicated that the pooled estimate for Asian population in China was 4.94 (3.95-6.17) with = 39.3% and = 0.192. All these results suggested that exposure to occupational dust would significantly increase the mortality risk of lung cancer, especially for Asian population in China, which should be measured and controlled more strictly. . This systematic review and meta-analysis provides high-quality evidence that exposure to occupational dust might increase the mortality risk of lung cancer, especially for Asian populations in China. The magnitude of this effect is of major public health importance in view of the ubiquitous existence of coalmining industry in China and even in the world. However, these pooled estimates should be interpreted cautiously because of the high heterogeneity among these publications. . This study was supported by the National Key Research and Development Program of China (Grant No. 2016YFC1302501).
职业环境中煤尘的致癌性证据仍存在争议。因此，我们进行了这项研究，以评估与无或低尘暴露人群相比，接触职业粉尘的矿工患肺癌的死亡风险。
检索了 PubMed 和中国国家知识基础设施数据库的数据库，并更新至 2020 年 9 月 18 日。纳入的文章应报告接触职业粉尘的矿工患肺癌的死亡风险。提取了作者和出版年份、地区和种族、结局类型和估计值、随访时间和研究设计等基本信息。使用美国医疗保健研究与质量局和纽卡斯尔-渥太华量表检查表分别评估描述性研究、队列研究和病例对照研究的质量和偏倚风险。计算了总的相对风险，并进行了 Begg 和 Egger 检验以及敏感性分析，以探讨潜在的异质性来源。还进行了荟萃回归和亚组分析，以提供有关粉尘暴露与肺癌死亡率之间相关性的更详细信息。
共纳入 19 篇文章，涉及 22 项不同的研究（描述性研究、病例对照研究和队列研究），包括 1964 年至 2017 年观察到的 8909 例死亡，异质性显著（ = 95%， < 0.001）。矿工患肺癌的死亡率的合并相对风险为 1.16（1.03-1.30）。荟萃回归分析结果表明，这些纳入研究之间的高度异质性可能是由种族差异引起的（ = 0.011）。亚组分析还表明，来自中国的亚洲人群的合并估计值为 4.94（3.95-6.17）， = 39.3%， = 0.192。所有这些结果表明，接触职业粉尘会显著增加肺癌的死亡风险，特别是对来自中国的亚洲人群，应更严格地进行测量和控制。。本系统评价和荟萃分析提供了高质量的证据，表明接触职业粉尘可能会增加肺癌的死亡风险，特别是对来自中国的亚洲人群。鉴于中国乃至世界范围内煤炭开采行业的普遍存在，这种影响的程度具有重要的公共卫生意义。然而，由于这些出版物之间存在高度异质性，因此应谨慎解释这些汇总估计值。。本研究得到了中国国家重点研发计划（Grant No. 2016YFC1302501）的支持。
