Service of Medical Oncology, Santiago de Compostela University Hospital, Santiago de Compostela, Spain.
Department of Preventive Medicine and Public Health, University of Santiago de Compostela, Santiago de Compostela, Spain.
J Expo Sci Environ Epidemiol. 2024 May;34(3):457-464. doi: 10.1038/s41370-023-00538-w. Epub 2023 Apr 3.
Occupational exposure role on small cell lung cancer (SCLC) onset has been little studied. Wood dust has been recognized as a human carcinogen, and many occupations have high wood-dust exposure. The aim of this study was therefore to perform a systematic review and meta-analysis of the scientific literature to summarize and analyse the risks of wood dust-related occupations on development of SCLC, taking tobacco use into account.
We conducted a literature search of PubMed, EMBASE, Web of Science and Cochrane using a predefined strategy and including case-control and cohort studies assessing occupational exposure to wood dust or wood dust-related occupations. To perform the meta-analysis, the odds ratio (OR) and 95% confidence interval (CI) of each of the studies were extracted. A random-effects model was fitted using the DerSimonian Laird method. Sensitivity and subgroup analyses were performed. Quality was assessed using the Office and Health Assessment and Translation (OHAT) for human and animal studies instrument.
Eleven studies with a total of 2,368 SCLC cases and 357,179 controls were included. Overall, exposure to wood dust significantly increases risk of SCLC (RR = 1.41, 95% CI 1.11-1.80), with low heterogeneity between studies (I2 = 40%). The association was maintained in studies conducted on males (RR = 1.41, 95% CI 1.12-1.78) but not in those conducted on females/both sexes (RR = 1.37, 95% CI 0.35-3.44). Sensitivity analysis showed that none of the studies significantly modified the results.
Our results support that exposure to wood-dust can increase the risk of SCLC. Although the level of evidence is low, there are strong arguments to recommend the implementation of effective control measures to reduce exposure in occupational settings, as a means of preventing SCLC.
The results of this study support that exposure to wood-dust can increase the risk of developing small cell lung cancer. Determining the impact of occupational exposure on workers is essential to improve their individual protection and prevention. There is a strong case for recommending the implementation of control measures to reduce occupational exposure to wood dust, specifically for highly exposed occupations such as carpenters and sawmills, in order to prevent small cell lung cancer.
职业暴露在小细胞肺癌（SCLC）发病中的作用研究较少。木尘已被确认为人类致癌物，许多职业存在高木尘暴露。因此，本研究旨在通过系统综述和荟萃分析科学文献，总结和分析与木尘相关职业暴露与 SCLC 发展之间的风险，同时考虑吸烟因素。
我们使用预定义的策略在 PubMed、EMBASE、Web of Science 和 Cochrane 中进行文献检索，包括评估职业性接触木尘或与木尘相关职业暴露与 SCLC 关系的病例对照和队列研究。为了进行荟萃分析，提取了每项研究的比值比（OR）和 95%置信区间（CI）。使用 DerSimonian Laird 方法拟合随机效应模型。进行敏感性和亚组分析。使用人类和动物研究的 Office 和 Health Assessment and Translation（OHAT）工具评估质量。
共纳入 11 项研究，总计 2368 例 SCLC 病例和 357179 例对照。总体而言，暴露于木尘显著增加 SCLC 发病风险（RR=1.41，95%CI 1.11-1.80），研究间异质性较低（I2=40%）。该关联在仅纳入男性的研究中（RR=1.41，95%CI 1.12-1.78）中仍然存在，但在纳入男性和女性/所有性别（RR=1.37，95%CI 0.35-3.44）的研究中不存在。敏感性分析表明，没有一项研究显著改变了结果。
我们的结果支持木尘暴露可增加 SCLC 发病风险。尽管证据水平较低，但有充分理由建议实施有效的控制措施以减少职业环境中的暴露，作为预防 SCLC 的手段。
本研究结果支持木尘暴露可增加患小细胞肺癌的风险。确定职业暴露对工人的影响对于改善他们的个体保护和预防至关重要。强烈建议实施控制措施以减少木尘的职业暴露，特别是针对木匠和锯木厂等高暴露职业，以预防小细胞肺癌。
