Department of Medicine, University of Alberta, Edmonton, AB, Canada.
Department of Obstetrics & Gynecology, University of Alberta, Edmonton, AB, Canada.
Environ Res. 2022 Nov;214(Pt 4):114152. doi: 10.1016/j.envres.2022.114152. Epub 2022 Aug 27.
The present systematic review aimed to evaluate the associations between welding fumes exposure and changes in oxidative stress [superoxide dismutase (SOD) and malondialdehyde (MDA)] and DNA damage [8-hydroxy-2'-deoxyguanosine (8-OHdG) and DNA-protein crosslink (DPC)] markers in professional welders (PROSPERO CRD42022298115). Six electronic bibliographic databases were searched from inception through September 2021 to identify observational epidemiological studies evaluating the association between welding fumes exposures and changes in oxidative stress and DNA damage in professional welders. Two reviewers independently assessed the risk of bias and certainty of the evidence. A narrative synthesis of results was conducted using the Synthesis Without Meta-analysis (SWiM) method. Pooled mean differences with 95% confidence intervals were calculated in a random-effects meta-analysis for the outcomes of interest in the review. From 450 studies identified through the search strategy, 14 observational epidemiological studies were included in the review. Most studies reported significantly higher welding fumes levels in welders than in controls. The narrative synthesis results of SOD showed a significant difference between welders and controls, while the meta-analysis results of MDA did not show a significant difference between the studied groups (MD = 0.26; 95% CI, -0.03, 0.55). The meta-analysis results of 8-OHdG (MD = 9.38; 95% CI, 0.55-18.21) and DPC (MD = 1.07; 95% CI, 0.14-2) revealed significantly differences between the studied groups. The included studies were at high risk of exclusion and confounding bias. The certainty of the evidence for oxidative stress and DNA damage results were very low and moderate, respectively. Exposure to welding fumes and metal particles is associated with DNA damage in professional welders, and 8-OHdG and DPC might be considered reliable markers to assess DNA damage resulting from exposure to welding fumes. We recommend, however, that the evaluation of oxidative stress resulting from welding fumes exposure not be solely based on MDA and SOD.
本系统评价旨在评估职业焊工(PROSPERO CRD42022298115)暴露于焊接烟尘与氧化应激标志物(超氧化物歧化酶[SOD]和丙二醛[MDA])及 DNA 损伤标志物(8-羟基-2'-脱氧鸟苷[8-OHdG]和 DNA-蛋白质交联[DPC])变化之间的关联。通过对从开始到 2021 年 9 月的六个电子文献数据库进行检索,以确定评估职业焊工暴露于焊接烟尘与氧化应激和 DNA 损伤变化之间关联的观察性流行病学研究。两位审阅者独立评估了偏倚风险和证据的确定性。采用无荟萃分析的综合方法(Synthesis Without Meta-analysis,SWiM)对结果进行叙述性综合。对综述中感兴趣的结局,使用随机效应荟萃分析计算了汇总均数差值及其 95%置信区间。通过搜索策略,从 450 项研究中筛选出 14 项观察性流行病学研究。大多数研究报告焊工的焊接烟尘水平明显高于对照组。SOD 的叙述性综合结果表明,焊工与对照组之间存在显著差异,而 MDA 的荟萃分析结果则显示两组间无显著差异(MD=0.26;95%CI,-0.03,0.55)。8-OHdG(MD=9.38;95%CI,0.55-18.21)和 DPC(MD=1.07;95%CI,0.14-2)的荟萃分析结果表明两组间存在显著差异。纳入的研究存在很高的排除偏倚和混杂偏倚风险。氧化应激和 DNA 损伤结果的证据确定性分别为极低和中度。职业焊工暴露于焊接烟尘和金属颗粒与 DNA 损伤相关,8-OHdG 和 DPC 可能被认为是评估因暴露于焊接烟尘而导致的 DNA 损伤的可靠标志物。但是,我们建议评估因焊接烟尘暴露而产生的氧化应激,不能仅仅基于 MDA 和 SOD。