全球职业性三氯乙烯（TCE）暴露相关性肾癌的流行趋势和预测：来自 1990 年至 2021 年全球疾病负担（GBD）研究的洞察及 2050 年预测。

Global trends and projections of occupational trichloroethylene (TCE) exposure-associated kidney cancer: Insights of the Global Burden of Disease (GBD) Study 2021 from 1990 to 2021 and prediction to 2050.

机构信息

Department of Urology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang 325035, China; Key Laboratory of Novel Nuclide Technologies on Precision Diagnosis and Treatment & Clinical Transformation of Wenzhou City, Wenzhou, Zhejiang 325035, China; Institute of Urology, Wenzhou Medical University, Wenzhou, Zhejiang 325035, China; Translational Medicine Laboratory, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang 325035, China.

Department of Wound Repair, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang 325035, China.

出版信息

Ecotoxicol Environ Saf. 2024 Nov 15;287:117252. doi: 10.1016/j.ecoenv.2024.117252. Epub 2024 Nov 6.

DOI:10.1016/j.ecoenv.2024.117252

PMID:39504875

Abstract

BACKGROUND

Exposure to trichloroethylene (TCE) in occupations is associated with an increased risk of kidney cancer (KC). However, there is a lack of comprehensive study on the global burden of occupational exposure to TCE-related KC.

METHODS

Epidemiological data on occupational TCE exposure-associated KC from 1990 to 2021 were obtained from Global Burden of Disease (GBD) 2021 study, including death counts and disability-adjusted life years (DALYs). Global burden of this disease was stratified by genders, age, socio-demographic index (SDI) quintiles, GBD subcontinental regions, and countries. The estimated annual percentage change (EAPC) was calculated to illustrate trends over the last 32 years, and forecasts were conducted to predict the disease burden until 2050.

RESULTS

In 2021, the global age-standardized death rate (ASDR) of occupational TCE exposure-related KC was 0.0009 (95 %UI: 0.0002-0.0016) per 100,000 persons, and the age-standardized DALY rate (ASDAR) was 0.0284 (95 %UI: 0.0062-0.0522) per 100,000 individuals. The disease showed significant heterogeneity by sex and age, with males bearing a notably higher burden, and the burden being concentrated in the 50-79 year-old group. Major burdens were focused in middle to high-middle SDI regions, especially in Southern Latin America (Uruguay, Argentina, and Chile). Over 32 years, the burden of occupational TCE exposure-associated KC has gradually increased, with projections indicating continued growth to 2050, particularly among males and individuals aged 50-79. Regions like high-middle SDI areas, North America, High-income North America, Southern Sub-Saharan Africa, saw the most significant increases. Correlation analyses indicated a positive association between ASDR and ASDAR with SDI, while EAPC showed a notable negative correlation with SDI. Decomposition analyses reveals three global population determinants that positively contributed to the increase in deaths, but negatively impacted DALYs.

CONCLUSION

This study highlights a significant rising trend of occupational TCE exposure-associated KC from 1990 to 2021 and projected to 2050, with an emphasis on the disease burden in men, elderly population, and middle to high-middle SDI regions, underscoring the impact of occupational TCE exposure on KC.

摘要

背景

职业性接触三氯乙烯（TCE）与肾癌（KC）风险增加有关。然而，目前缺乏关于职业性接触 TCE 相关 KC 的全球负担的综合研究。

方法

从 2021 年全球疾病负担（GBD）研究中获取了 1990 年至 2021 年职业性 TCE 暴露相关 KC 的流行病学数据，包括死亡人数和伤残调整生命年（DALYs）。按性别、年龄、社会人口指数（SDI）五分位数、GBD 次区域和国家对该疾病的全球负担进行分层。使用估计年度百分比变化（EAPC）来说明过去 32 年的趋势，并进行预测以预测 2050 年之前的疾病负担。

结果

2021 年，职业性 TCE 暴露相关 KC 的全球年龄标准化死亡率（ASDR）为每 10 万人 0.0009（95%UI：0.0002-0.0016），年龄标准化伤残调整生命年率（ASDAR）为每 10 万人 0.0284（95%UI：0.0062-0.0522）。该疾病在性别和年龄方面存在显著异质性，男性负担明显更高，且负担集中在 50-79 岁年龄组。主要负担集中在中高 SDI 地区，特别是在南拉丁美洲（乌拉圭、阿根廷和智利）。在过去 32 年中，职业性 TCE 暴露相关 KC 的负担逐渐增加，预计到 2050 年仍将持续增长，尤其是男性和 50-79 岁人群。中高 SDI 地区、北美、高收入北美、南非南部等地区增幅最大。相关分析表明，ASDR 和 ASDAR 与 SDI 呈正相关，而 EAPC 与 SDI 呈显著负相关。分解分析表明，全球人口的三个决定因素对死亡人数的增加有正向贡献，但对 DALYs 有负向影响。