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环境/职业氡暴露与非肺部恶性肿瘤风险:流行病学证据综述。

Environmental/Occupational Exposure to Radon and Non-Pulmonary Neoplasm Risk: A Review of Epidemiologic Evidence.

机构信息

Department of Medicine and Surgery, University of Parma, 43126 Parma, Italy.

Centre for Research in Toxicology (CERT), University of Parma, Via A. Gramsci 14, 43126 Parma, Italy.

出版信息

Int J Environ Res Public Health. 2021 Oct 5;18(19):10466. doi: 10.3390/ijerph181910466.

Abstract

Although Radon (Rn) is a known agent for lung cancer, the link between Rn exposure and other non-pulmonary neoplasms remains unclear. The aim of this review is to investigate the role of Rn in the development of tumors other than lung cancer in both occupational and environmental exposure. Particularly, our attention has been focused on leukemia and tumors related to brain and central nervous system (CNS), skin, stomach, kidney, and breast. The epidemiologic literature has been systematically reviewed focusing on workers, general population, and pediatric population. A weak increase in leukemia risk due to Rn exposure was found, but bias and confounding factors cannot be ruled out. The results of studies conducted on stomach cancer are mixed, although with some prevalence for a positive association with Rn exposure. In the case of brain and CNS cancer and skin cancer, results are inconclusive, while no association was found for breast and kidney cancers. Overall, the available evidence does not support a conclusion that a causal association has been established between Rn exposure and the risk of other non-pulmonary neoplasms mainly due to the limited number and heterogeneity of existing studies. To confirm this result, a statistical analysis should be necessary, even if it is now not applicable for the few studies available.

摘要

虽然氡(Rn)是肺癌的已知致病因素,但 Rn 暴露与其他非肺部肿瘤之间的联系仍不清楚。本综述的目的是研究 Rn 在职业和环境暴露中除肺癌以外的肿瘤发展中的作用。特别关注的是白血病以及与脑和中枢神经系统(CNS)、皮肤、胃、肾和乳房相关的肿瘤。我们系统性地回顾了职业人群、一般人群和儿童人群的流行病学文献。发现 Rn 暴露会导致白血病风险略有增加,但不能排除偏倚和混杂因素的影响。关于胃癌的研究结果存在差异,但有一些研究结果表明与 Rn 暴露呈正相关。在脑和中枢神经系统癌症以及皮肤癌方面,结果尚无定论,而乳腺癌和肾癌与 Rn 暴露无关。总体而言,现有证据并不支持 Rn 暴露与其他非肺部肿瘤风险之间存在因果关系的结论,主要是因为现有研究的数量有限且存在异质性。为了证实这一结果,即使对于现有少数研究来说不适用,也需要进行统计分析。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/cace/8508162/bb17667c5ec8/ijerph-18-10466-g001.jpg

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