Wartenberg D
Department of Environmental and Community Medicine, University of Medicine and Dentistry of New Jersey-Robert Wood Johnson Medical School, Piscataway, USA.
Am J Public Health. 1998 Dec;88(12):1787-94. doi: 10.2105/ajph.88.12.1787.
This article uses meta-analysis methodology to examine the statistical consistency and importance of random variation among results of epidemiologic studies of residential magnetic field exposure and childhood leukemia.
A variety of meta-analytic statistical methods were applied to all available studies combined and on sub-groups of studies chosen by exposure characteristics. Sample sizes and fail-safe n's were calculated to determine the robustness of results and the potential role of publication bias.
Most studies show elevated but not statistically significant odds ratios. Results for exposures assessed by wire codes, distance, and/or historically reconstructed fields are relatively consistent, homogeneous, and positive, while those for direct magnetic field measurements are consistent, homogeneous, and marginally protective. Several unpublished studies, or a single unpublished study with several hundred subjects, would be needed to nullify the observed data.
The observed results identify a consistent risk that cannot be explained by random variation. The data supporting magnetic fields as the principal risk factor are suggestive but inconsistent. Additional studies using innovative designs that focus on highly exposed children offer the most hope of untangling this issue.
本文采用荟萃分析方法,检验居住磁场暴露与儿童白血病流行病学研究结果中随机变异的统计一致性和重要性。
将各种荟萃分析统计方法应用于所有可用研究的合并数据以及根据暴露特征选择的研究亚组。计算样本量和失效安全数,以确定结果的稳健性和发表偏倚的潜在作用。
大多数研究显示比值比升高,但无统计学显著性。通过电线编码、距离和/或历史重建磁场评估的暴露结果相对一致、同质且呈阳性,而直接磁场测量的结果一致、同质且具有轻微的保护作用。需要几项未发表的研究,或一项有数百名受试者的未发表研究,才能使观察到的数据无效。
观察到的结果表明存在一种无法用随机变异解释的一致风险。支持磁场作为主要危险因素的数据具有提示性,但不一致。采用创新设计、聚焦于高暴露儿童的更多研究最有希望解决这个问题。