PDF(Pubmed)
Abstract：
OBJECTIVE: Etiological factors of testicular germ cell tumors (TGCT) remain largely unknown, but a causal role of occupational exposures to solvents has been suggested. Previous studies analyzing these exposures reported discordant results, potentially related to exposure assessment methods. The aim of this study was to investigate the role of occupational exposure to solvents on the risk of developing TGCT among young men.
METHODS: This study examined occupational exposures to solvents and TGCT risk based on the lifetime work histories of 454 cases and 670 controls, aged 18-45 years, of the French national TESTIS case-control study. Solvent exposure was estimated using: (i) exposure assignment by job-exposure matrix (JEM) and (ii) JEM combined with self-reported exposure data from specific questionnaires (SQ) and expert assessment (EA). Odds ratios (OR) and 95% confidence intervals (CI) were estimated using conditional logistic regression models.
RESULTS: Both approaches (JEM and JEM+SQ+EA) showed a consistent association between TGCT and trichloroethylene exposure (exposed versus not exposed; JEM=OR 1.80 [95% confidence interval (CI) 1.12-2.90] and JEM+SQ+EA= OR 2.59 (95% CI 1.42-4.72). Both approaches also observed positive associations with ketone esters and fuels & petroleum-based solvents.
CONCLUSIONS: The results suggest that some organic solvents might be involved in the pathogenesis of TGCT among occupationally exposed men. The combined use of JEM+SQ+EA seemed to limit misclassification by considering individual exposure variability and is, therefore, an appealing approach to assess occupational exposures in epidemiological studies.
METHODS: This study examined occupational exposures to solvents and TGCT risk based on the lifetime work histories of 454 cases and 670 controls, aged 18-45 years, of the French national TESTIS case-control study. Solvent exposure was estimated using: (i) exposure assignment by job-exposure matrix (JEM) and (ii) JEM combined with self-reported exposure data from specific questionnaires (SQ) and expert assessment (EA). Odds ratios (OR) and 95% confidence intervals (CI) were estimated using conditional logistic regression models.
RESULTS: Both approaches (JEM and JEM+SQ+EA) showed a consistent association between TGCT and trichloroethylene exposure (exposed versus not exposed; JEM=OR 1.80 [95% confidence interval (CI) 1.12-2.90] and JEM+SQ+EA= OR 2.59 (95% CI 1.42-4.72). Both approaches also observed positive associations with ketone esters and fuels & petroleum-based solvents.
CONCLUSIONS: The results suggest that some organic solvents might be involved in the pathogenesis of TGCT among occupationally exposed men. The combined use of JEM+SQ+EA seemed to limit misclassification by considering individual exposure variability and is, therefore, an appealing approach to assess occupational exposures in epidemiological studies.
摘要：
目的：睾丸生殖细胞肿瘤（TGCT）的病因因素尚不清楚，但是已经提出了职业暴露于溶剂的因果关系。先前分析这些暴露的研究报告了不一致的结果，可能与暴露评估方法有关。这项研究的目的是调查职业暴露于溶剂对年轻男性患TGCT风险的作用。
方法：本研究基于454例病例和670例对照的终生工作史，调查了职业溶剂暴露和TGCT风险。18-45岁,法国国家TESTIS病例对照研究。使用以下方法估算溶剂暴露：（i）按工作暴露矩阵（JEM）进行的暴露分配和（ii）JEM结合来自特定问卷（SQ）和专家评估（EA）的自我报告暴露数据。使用条件逻辑回归模型估计赔率（OR）和95％置信区间（CI）。
结果：两种方法（JEM和JEMSQ+EA）均显示TGCT与三氯乙烯暴露（暴露与未暴露；JEM=OR1.80[95％置信区间（CI）1.12-2.90]和JEMSQ+EA=OR2.59（95％CI1.42-4.72）之间的一致关联。两种方法还观察到与酮酯和燃料和石油基溶剂的正相关。
结论：结果表明，某些有机溶剂可能参与了职业暴露男性TGCT的发病机制。JEM+SQ+EA的组合使用似乎通过考虑个体暴露变异性来限制错误分类，并且是，因此,在流行病学研究中评估职业暴露的一种有吸引力的方法。
方法：本研究基于454例病例和670例对照的终生工作史，调查了职业溶剂暴露和TGCT风险。18-45岁,法国国家TESTIS病例对照研究。使用以下方法估算溶剂暴露：（i）按工作暴露矩阵（JEM）进行的暴露分配和（ii）JEM结合来自特定问卷（SQ）和专家评估（EA）的自我报告暴露数据。使用条件逻辑回归模型估计赔率（OR）和95％置信区间（CI）。
结果：两种方法（JEM和JEMSQ+EA）均显示TGCT与三氯乙烯暴露（暴露与未暴露；JEM=OR1.80[95％置信区间（CI）1.12-2.90]和JEMSQ+EA=OR2.59（95％CI1.42-4.72）之间的一致关联。两种方法还观察到与酮酯和燃料和石油基溶剂的正相关。
结论：结果表明，某些有机溶剂可能参与了职业暴露男性TGCT的发病机制。JEM+SQ+EA的组合使用似乎通过考虑个体暴露变异性来限制错误分类，并且是，因此,在流行病学研究中评估职业暴露的一种有吸引力的方法。
