Kwak Kyeongmin, Kang Dongmug, Paek Domyung
Department of Occupational and Environmental Medicine, Korea University Ansan Hospital, Ansan, Republic of Korea.
Department of Occupational and Environmental Medicine, Pusan National University Yangsan Hospital, Yangsan, Republic of Korea.
Occup Environ Med. 2022 Mar;79(3):207-214. doi: 10.1136/oemed-2020-107222. Epub 2021 May 10.
Asbestos is a carcinogen associated with lung cancer, but few studies have examined the increased risk of lung cancer due to environmental asbestos exposure. We performed a systematic review and meta-analysis to evaluate the association between environmental asbestos exposure and lung cancer. We searched for articles on non-occupational or environmental asbestos exposure and lung cancer in PubMed, EMBASE, CINAHL and Web of Science databases. Our review included 15 studies, and except studies on ingestion exposure we performed a meta-analysis for 13 studies with respect to the type of exposure (neighbourhood and domestic/household exposure). Subgroup analyses and meta-regression were also performed. A significant increase in the risk of lung cancer was found for neighbourhood exposure (1.48, 95% CI 1.18 to 1.86), while the risk was not significantly increased for domestic/household exposure (1.04, 95% CI 0.85 to 1.27). With regard to neighbourhood exposure, naturally occurring asbestos and women were both associated with a higher risk of lung cancer; however, such an increase was not significantly greater compared with that associated with other sources of asbestos exposure and men. Although cautious interpretation is needed due to the large degree of heterogeneity and the small number of included studies, our findings imply that living near the source of asbestos increases the risk of lung cancer.
石棉是一种与肺癌相关的致癌物，但很少有研究探讨环境中石棉暴露导致肺癌风险增加的情况。我们进行了一项系统评价和荟萃分析，以评估环境石棉暴露与肺癌之间的关联。我们在PubMed、EMBASE、CINAHL和Web of Science数据库中检索了关于非职业性或环境性石棉暴露与肺癌的文章。我们的综述纳入了15项研究，除了关于摄入性暴露的研究外，我们对13项关于暴露类型（邻里和家庭/住户暴露）的研究进行了荟萃分析。还进行了亚组分析和荟萃回归。发现邻里暴露的肺癌风险显著增加（1.48，95%可信区间1.18至1.86），而家庭/住户暴露的风险未显著增加（1.04，95%可信区间0.85至1.27）。关于邻里暴露，天然存在的石棉和女性都与较高的肺癌风险相关；然而，与其他石棉暴露来源和男性相比，这种增加并没有显著更大。尽管由于高度的异质性和纳入研究数量较少，需要谨慎解释，但我们的研究结果表明，居住在石棉源附近会增加患肺癌的风险。
