Wan Wenxin, Peters Susan, Portengen Lützen, Babigumira Ronnie, Stenehjem Jo Steinson, Richardson David, Vermeulen Roel
Institute for Risk Assessment Sciences, Utrecht University, Utrecht, the Netherlands.
Department of Research, Cancer Registry of Norway, Norwegian Institute of Public Health, Oslo, Norway.
Environ Health Perspect. 2024 Dec;132(12):126001. doi: 10.1289/EHP15086. Epub 2024 Dec 4.
Benzene is classified as carcinogenic to humans based on evidence that benzene causes acute myeloid leukemia. However, there is limited evidence that benzene causes lung cancer.
We performed a systematic review, quality assessment, and meta-analysis of published cohort and case-control studies on the association between occupational benzene exposure and lung cancer risk.
We reviewed the relevant human epidemiological studies from PubMed and Embase databases to 19 August 2024. Data extraction included study characteristics, effect estimates, and exposure assessment details. Two investigators independently evaluated study quality using the Newcastle-Ottawa scale (NOS) framework and exposure assessment quality based on criteria. Six risk of bias (ROB) domains were constructed from the NOS criteria to identify and quantify possible biases and their impacts on parameter estimates. Meta-analysis relative risk (pooled RR) and associated confidence intervals were calculated using random-effects models, and a flexible exposure-response meta-regression was fitted to assess the shape of the association. Subgroup analyses were conducted to explore the consistency of results.
Of 252 articles identified, 13 studies covering 366,975 participants (17,030 lung cancer cases) were included in our analysis. The meta-analysis of ever occupational benzene exposure showed an elevated risk of lung cancer (pooled ; 95% CI: 1.03, 1.27; ). Subgroup analyses revealed that larger pooled RRs in studies based on highly exposed groups had higher overall quality and better exposure assessments and included both males and females (as opposed to only males). A positive linear trend was observed in the exposure-response meta-analysis.
Our meta-analysis supports an association between occupational benzene exposure and an increased risk of lung cancer. https://doi.org/10.1289/EHP15086.
基于苯会导致急性髓系白血病的证据，苯被归类为对人类有致癌性。然而，关于苯会导致肺癌的证据有限。
我们对已发表的关于职业性苯暴露与肺癌风险之间关联的队列研究和病例对照研究进行了系统评价、质量评估和荟萃分析。
我们检索了截至2024年8月19日来自PubMed和Embase数据库的相关人类流行病学研究。数据提取包括研究特征、效应估计值和暴露评估细节。两名研究人员使用纽卡斯尔-渥太华量表（NOS）框架独立评估研究质量，并根据标准评估暴露评估质量。从NOS标准构建了六个偏倚风险（ROB）领域，以识别和量化可能的偏倚及其对参数估计的影响。使用随机效应模型计算荟萃分析相对风险（合并RR）和相关置信区间，并拟合灵活的暴露-反应荟萃回归以评估关联的形状。进行亚组分析以探讨结果的一致性。
在识别出的252篇文章中，我们的分析纳入了13项研究，涉及366,975名参与者（17,030例肺癌病例）。对曾经有职业性苯暴露的荟萃分析显示肺癌风险升高（合并RR = 1.15；95% CI：1.03，1.27；P = 0.01）。亚组分析显示，基于高暴露组的研究中较大的合并RR具有更高的总体质量和更好的暴露评估，并且包括男性和女性（而不是仅男性）。在暴露-反应荟萃分析中观察到正线性趋势。
我们的荟萃分析支持职业性苯暴露与肺癌风险增加之间存在关联。https://doi.org/10.1289/EHP15086 。
