Institut de Radioprotection et de Sûreté Nucléaire (IRSN), PSE-SANTE/SESANE/LEPID, Fontenay-aux-Roses, France.
Front Public Health. 2024 Sep 25;12:1439355. doi: 10.3389/fpubh.2024.1439355. eCollection 2024.
To date, lung cancer is the only well-established health effect associated with radon exposure in humans. To summarize available evidence on other potential health effects of radon exposure, we performed a comprehensive qualitative and quantitative synthesis of the available literature on radon exposure and health effects other than lung cancer, in both occupational and general populations.
Eligible studies published from January 1990 to March 2023, in English and French languages, were identified in PubMed, ScienceDirect, Scopus, ScieLo and HAL. In the meta-analysis, we estimated average weighted standardized incidence ratios (metaSIR), standardized mortality ratios (metaSMR), and risk ratio (metaRR) per 100 unit (Bq/m or Working level Month) increase in radon exposure concentration by combining estimates from the eligible studies using the random-effect inverse variance method. DerSimonian & Laird estimator was used to estimate the between-study variance. For each health outcome, analyses were performed separately for mine workers, children, and adults in the general population.
A total of 129 studies were included in the systematic review and 40 distinct studies in the meta-analysis. For most of these health outcomes, the results of the meta-analyses showed no statistically significant association, and heterogeneity was only present among occupational studies, especially between those included in the metaSIR or metaSMR analyses. However, the estimated exposure-risk associations were positive and close to the statistical significance threshold for: lymphohematological cancer incidence in children (metaRR = 1.01; 95%CI: 1.00-1.03; = 0.08); malignant melanoma mortality among adults in the general population (metaRR = 1.10; 95%CI: 0.99-1.21; = 0.07); liver cancer mortality among mine workers (metaRR = 1.04; 95%CI: 1.00-1.10; = 0.06); intestine and rectal cancer mortality combined among mine workers (metaRR = 1.02; 95%CI: 1.00-1.04; = 0.06).
Although none of the exposure-risk associations estimated in the meta-analyses reached statistical significance, the hypothesis that radon may have other health effects apart from lung cancer could not be ruled-out and call for additional research. Larger and well-designed studies are needed to further investigate this question.
https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42023474542, ID: CRD42023474542.
迄今为止，肺癌是唯一被证实与人类氡暴露有关的健康影响。为了总结氡暴露与肺癌以外的其他潜在健康影响的现有证据，我们对 1990 年 1 月至 2023 年 3 月期间发表的关于氡暴露与职业和一般人群中除肺癌以外的健康影响的可用文献进行了全面的定性和定量综合分析。
在 PubMed、ScienceDirect、Scopus、ScieLo 和 HAL 中，确定了从 1990 年 1 月至 2023 年 3 月发表的英语和法语的合格研究。在荟萃分析中，我们通过使用随机效应逆方差法结合合格研究中的估计值，估计了每增加 100 单位（Bq/m 或工作水平月）氡暴露浓度的平均加权标准化发病率比（metaSIR）、标准化死亡率比（metaSMR）和风险比（metaRR）。使用 DerSimonian 和 Laird 估计值来估计研究间的方差。对于每个健康结果，分别对矿工、儿童和一般人群中的成年人进行了分析。
共纳入 129 项系统评价研究和 40 项荟萃分析研究。对于大多数这些健康结果，荟萃分析的结果没有显示出统计学上的显著关联，而且异质性仅存在于职业研究中，特别是在纳入 metaSIR 或 metaSMR 分析的研究中。然而，对于以下健康结果，估计的暴露风险关联呈阳性且接近统计学意义的阈值：儿童淋巴血液系统癌症发病率（metaRR=1.01；95%CI：1.00-1.03；=0.08）；一般人群中成年人恶性黑色素瘤死亡率（metaRR=1.10；95%CI：0.99-1.21；=0.07）；矿工肝癌死亡率（metaRR=1.04；95%CI：1.00-1.10；=0.06）；矿工肠和直肠癌死亡率合并（metaRR=1.02；95%CI：1.00-1.04；=0.06）。
尽管荟萃分析中估计的暴露风险关联均未达到统计学意义，但不能排除氡可能除了肺癌之外还有其他健康影响的假设，需要进一步研究。需要更大和设计良好的研究来进一步调查这个问题。
https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42023474542，ID：CRD42023474542。
