PDF(Pubmed)
Abstract：
UNASSIGNED: While much research has been done to identify individual workplace lung carcinogens, little is known about joint effects on risk when workers are exposed to multiple agents.
UNASSIGNED: We investigated the pairwise joint effects of occupational exposures to asbestos, respirable crystalline silica, metals (i.e., nickel, chromium-VI), and polycyclic aromatic hydrocarbons (PAH) on lung cancer risk, overall and by major histologic subtype, while accounting for cigarette smoking.
UNASSIGNED: In the international 14-center SYNERGY project, occupational exposures were assigned to 16,901 lung cancer cases and 20,965 control subjects using a quantitative job-exposure matrix (SYN-JEM). Odds ratios (ORs) and 95% confidence intervals (CIs) were computed for ever vs. never exposure using logistic regression models stratified by sex and adjusted for study center, age, and smoking habits. Joint effects among pairs of agents were assessed on multiplicative and additive scales, the latter by calculating the relative excess risk due to interaction (RERI).
UNASSIGNED: All pairwise joint effects of lung carcinogens in men were associated with an increased risk of lung cancer. However, asbestos/metals and metals/PAH resulted in less than additive effects; while the chromium-VI/silica pair showed marginally synergistic effect in relation to adenocarcinoma (RERI: 0.24; CI: 0.02, 0.46; p = 0.05). In women, several pairwise joint effects were observed for small cell lung cancer including exposure to PAH/silica (OR = 5.12; CI: 1.77, 8.48), and to asbestos/silica (OR = 4.32; CI: 1.35, 7.29), where exposure to PAH/silica resulted in a synergistic effect (RERI: 3.45; CI: 0.10, 6.8).
UNASSIGNED: Small or no deviation from additive or multiplicative effects was observed, but co-exposure to the selected lung carcinogens resulted generally in higher risk than exposure to individual agents, highlighting the importance to reduce and control exposure to carcinogens in workplaces and the general environment. https://doi.org/10.1289/EHP13380.
UNASSIGNED: We investigated the pairwise joint effects of occupational exposures to asbestos, respirable crystalline silica, metals (i.e., nickel, chromium-VI), and polycyclic aromatic hydrocarbons (PAH) on lung cancer risk, overall and by major histologic subtype, while accounting for cigarette smoking.
UNASSIGNED: In the international 14-center SYNERGY project, occupational exposures were assigned to 16,901 lung cancer cases and 20,965 control subjects using a quantitative job-exposure matrix (SYN-JEM). Odds ratios (ORs) and 95% confidence intervals (CIs) were computed for ever vs. never exposure using logistic regression models stratified by sex and adjusted for study center, age, and smoking habits. Joint effects among pairs of agents were assessed on multiplicative and additive scales, the latter by calculating the relative excess risk due to interaction (RERI).
UNASSIGNED: All pairwise joint effects of lung carcinogens in men were associated with an increased risk of lung cancer. However, asbestos/metals and metals/PAH resulted in less than additive effects; while the chromium-VI/silica pair showed marginally synergistic effect in relation to adenocarcinoma (RERI: 0.24; CI: 0.02, 0.46; p = 0.05). In women, several pairwise joint effects were observed for small cell lung cancer including exposure to PAH/silica (OR = 5.12; CI: 1.77, 8.48), and to asbestos/silica (OR = 4.32; CI: 1.35, 7.29), where exposure to PAH/silica resulted in a synergistic effect (RERI: 3.45; CI: 0.10, 6.8).
UNASSIGNED: Small or no deviation from additive or multiplicative effects was observed, but co-exposure to the selected lung carcinogens resulted generally in higher risk than exposure to individual agents, highlighting the importance to reduce and control exposure to carcinogens in workplaces and the general environment. https://doi.org/10.1289/EHP13380.
摘要：
■虽然已经做了很多研究来确定个体工作场所的肺部致癌物，当工人接触多种药物时，对风险的联合影响知之甚少。
■我们调查了职业性接触石棉的成对联合效应，可吸入结晶二氧化硅，金属(即，镍,铬-VI)，和多环芳烃（PAH）对肺癌的风险，总体和主要组织学亚型，同时考虑吸烟。
■在国际14中心SYNERGY项目中，使用定量工作暴露矩阵(SYN-JEM)将职业暴露分配至16,901例肺癌病例和20,965例对照受试者.计算赔率比(OR)和95%置信区间(CI)从未暴露，使用按性别分层并针对研究中心进行调整的逻辑回归模型，年龄,和吸烟习惯。在乘法和加法尺度上评估了成对药物之间的联合作用，后者通过计算相互作用导致的相对超额风险(RERI)。
■男性肺部致癌物的所有成对联合作用均与肺癌风险增加相关。然而,石棉/金属和金属/PAH产生的累加效应小于累加效应；而铬-VI/二氧化硅对与腺癌相关的协同作用（RERI：0.24；CI：0.02，0.46；p=0.05）。在女性中，对于小细胞肺癌，观察到几种成对联合效应，包括暴露于PAH/二氧化硅（OR=5.12；CI：1.77，8.48），和石棉/二氧化硅(OR=4.32；CI：1.35，7.29)，其中暴露于PAH/二氧化硅导致协同效应(RERI:3.45;CI:0.10,6.8)。
■观察到与加法或乘法效应的偏差很小或没有偏差，但是共同暴露于选定的肺部致癌物通常导致比暴露于单独药物更高的风险，强调减少和控制工作场所和一般环境中致癌物接触的重要性。https://doi.org/10.1289/EHP13380.
■我们调查了职业性接触石棉的成对联合效应，可吸入结晶二氧化硅，金属(即，镍,铬-VI)，和多环芳烃（PAH）对肺癌的风险，总体和主要组织学亚型，同时考虑吸烟。
■在国际14中心SYNERGY项目中，使用定量工作暴露矩阵(SYN-JEM)将职业暴露分配至16,901例肺癌病例和20,965例对照受试者.计算赔率比(OR)和95%置信区间(CI)从未暴露，使用按性别分层并针对研究中心进行调整的逻辑回归模型，年龄,和吸烟习惯。在乘法和加法尺度上评估了成对药物之间的联合作用，后者通过计算相互作用导致的相对超额风险(RERI)。
■男性肺部致癌物的所有成对联合作用均与肺癌风险增加相关。然而,石棉/金属和金属/PAH产生的累加效应小于累加效应；而铬-VI/二氧化硅对与腺癌相关的协同作用（RERI：0.24；CI：0.02，0.46；p=0.05）。在女性中，对于小细胞肺癌，观察到几种成对联合效应，包括暴露于PAH/二氧化硅（OR=5.12；CI：1.77，8.48），和石棉/二氧化硅(OR=4.32；CI：1.35，7.29)，其中暴露于PAH/二氧化硅导致协同效应(RERI:3.45;CI:0.10,6.8)。
■观察到与加法或乘法效应的偏差很小或没有偏差，但是共同暴露于选定的肺部致癌物通常导致比暴露于单独药物更高的风险，强调减少和控制工作场所和一般环境中致癌物接触的重要性。https://doi.org/10.1289/EHP13380.
