背景:全球,肺癌是女性癌症死亡的第二大原因。本研究探讨了女性普遍存在的职业暴露之间的关联,还有肺癌.
方法:来自欧洲的10项肺癌病例对照研究的数据,加拿大,和新西兰在1988年至2008年之间进行的合并。3040例肺癌患者和4187例对照患者获得了终身职业史和包括吸烟在内的非职业因素信息。我们将每个报告的工作与加拿大工作暴露矩阵(CANJEM)联系起来,它提供了概率的估计,强度,以及在每个工作中接触每个选定代理的频率。对于这个分析,我们选择了15种试剂(清洁剂,杀生物剂,棉尘,合成纤维,甲醛,烹饪烟雾,有机溶剂,纤维素,来自石油的多环芳烃,氨,金属粉尘,烷烃C18+,铁化合物,异丙醇,和碳酸钙),在合并的研究人群中,终生暴露率至少为5%。对于每个特工来说,我们估计了每个研究中心的肺癌风险,根据暴露的持续时间,通过累积暴露,使用针对吸烟和其他协变量调整的单独逻辑回归模型。然后,我们使用随机效应荟萃分析来估计元赔率比。
结论:评估的药物均未显示与女性肺癌的一致和令人信服的关联。以下试剂在一些分析中显示出升高的比值比:金属粉尘,铁化合物,异丙醇,和有机溶剂。未来对女性职业性肺癌危险因素的研究应优先考虑这些药物。
BACKGROUND: Worldwide, lung cancer is the second leading cause of cancer death in women. The present study explored associations between occupational exposures that are prevalent among women, and lung cancer.
METHODS: Data from 10
case-control studies of lung cancer from Europe, Canada, and New Zealand conducted between 1988 and 2008 were combined. Lifetime occupational history and information on nonoccupational factors including smoking were available for 3040 incident lung cancer cases and 4187 controls. We linked each reported job to the Canadian Job-Exposure Matrix (CANJEM), which provided estimates of probability, intensity, and frequency of exposure to each selected agent in each job. For this analysis, we selected 15 agents (cleaning agents, biocides, cotton dust, synthetic fibers, formaldehyde, cooking fumes, organic solvents, cellulose, polycyclic aromatic hydrocarbons from petroleum, ammonia, metallic dust, alkanes C18+, iron compounds, isopropanol, and calcium carbonate) that had lifetime exposure prevalence of at least 5% in the combined study population. For each agent, we estimated lung cancer risk in each study center for ever-exposure, by duration of exposure, and by cumulative exposure, using separate logistic regression models adjusted for smoking and other covariates. We then estimated the meta-odds ratios using random-effects meta-analysis.
CONCLUSIONS: None of the agents assessed showed consistent and compelling associations with lung cancer among women. The following agents showed elevated odds ratio in some analyses: metallic dust, iron compounds, isopropanol, and organic solvents. Future research into occupational lung cancer risk factors among women should prioritize these agents.