occupational carcinogens

职业性致癌物
  • 文章类型: Journal Article
    目的:本研究旨在从各种流行病学角度分析职业性肿瘤的全球负担。
    方法:在这项横断面研究中,我们使用来自GBD2019和世界银行数据库的数据进行了二次分析,以评估职业性致癌物所致肿瘤的负担及其分布特征.
    方法:基于GBD2019和世界银行数据库,我们分析了职业性肿瘤的全球负担,包括年龄周期队列模型,分解分析,健康不平等分析,和面板模型。所有分析均在R(4.0.3版)和Joinpoint(4.9.1版)中进行。
    结果:职业性致癌物引起的肿瘤负担的绝对数量在过去30年中持续上升。2019年,职业性肿瘤在全球范围内导致333,867[95%不确定区间(UI):263,491至404,641]死亡率和6,964,775(95%UI:5,467,884至8,580,431)残疾调整寿命年(DALYs)。格陵兰,摩纳哥,荷兰,安道尔承受了最大的负担。社会人口指数较高的国家的负担较高。老年人的年龄效应显著,1925年出生队列的队列效应最高.人口增长是死亡率(89%)和DALY(111%)变化的最重要驱动因素。此外,城市人口比例与疾病负担显著正相关,人均GDP与疾病负担呈负相关。
    结论:职业性肿瘤的负担在不同地点和人群中分布不均。迫切需要合理分配医疗资源。
    OBJECTIVE: The study aimed to analyze the global burden of occupational neoplasms from various epidemiological perspectives.
    METHODS: In this cross-sectional study, secondary analyses were conducted to assess the burden of neoplasms attributable to occupational carcinogens and their distribution characteristics using data from GBD 2019 and the World Bank database.
    METHODS: Based on the GBD 2019 and the World Bank database, we analyzed the global burden of occupational neoplasms including the age-period-cohort model, decomposition analysis, health inequality analysis, and panel model. All analyses were conducted in R (version 4.0.3) and Joinpoint (version 4.9.1).
    RESULTS: The absolute number of neoplasms burden attributable to occupational carcinogens has continued to rise over 30 years. In 2019, occupational neoplasms caused 333,867 [95% uncertainty interval (UI): 263,491 to 404,641] mortalities and 6,964,775 (95% UI: 5,467,884 to 8,580,431) disability-adjusted life years (DALYs) globally. Greenland, Monaco, the Netherlands, and Andorra suffered the highest burden. The burden was higher in countries with a higher sociodemographic index. The age effect was prominent in the elderly, and the 1925 birth cohort had the highest cohort effect. Population growth was the most significant driver of the mortalities (89%) and DALYs (111%) change. Moreover, the proportion of urban population was significantly positively associated with the disease burden, while GDP per capita was negatively correlated with the disease burden.
    CONCLUSIONS: The burden of occupational neoplasms was unevenly distributed across locations and populations. The need for rational allocation of healthcare resources was urgent.
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  • 文章类型: Journal Article
    职业相关癌症是一个重大的全球健康问题。与职业有关的癌症比例最大的是气管,支气管,肺癌(TBL)。本研究旨在探讨与TBL癌症相关的职业性致癌物的地理和时间趋势。
    可归因于职业性致癌物的TBL癌症数据来自2019年全球疾病负担研究。死亡人数和年龄标准化率(ASR),残疾调整寿命年(DALYs),并按地理位置对相应的平均年变化百分比(AAPC)进行了评估和分层,社会人口统计学指数(SDI)五分位数,年龄,和性爱。
    全球,由职业性致癌物引起的TBL癌症的死亡和DALYs的ASR呈下降趋势(AAPC=-0.69%,-1.01%),而在低点观察到增加,中低端,和中间的SDI五分位数。尽管2019年男性分别占死亡人数和DALYs的82.4%和81.5%,女性ASR呈上升趋势(AAPC=0.33%,0.02%)。职业接触石棉,二氧化硅和柴油发动机废气是年龄标准化的TBL癌症死亡和DALY的三大原因。在过去的三十年里,职业性石棉和二氧化硅暴露导致的年龄标准化TBL癌症死亡和DALYs百分比下降了18.24、6.71和20.52%,全球4.00%,但在SDI较低的地区显著增加,而由职业性柴油机废气暴露引起的负担在全球范围内增加了32.76%,为37.23%。
    职业暴露仍然是TBL癌症的重要危险因素。职业性致癌物引起的TBL癌症负担表现出明显的异质性,在较高的SDI地区降低,但在较低的SDI地区增加。男性的负担明显高于女性,但是雌性呈增长趋势。职业接触石棉是造成负担的主要原因。因此,因地制宜的有效预防和控制措施是必要的。
    Occupational-related cancers are a substantial global health issue. The largest proportion of occupational-related cancers is tracheal, bronchus, and lung (TBL) cancer. This study aimed to explore the geographical and temporal trends in occupational carcinogens related to TBL cancer.
    Data on TBL cancer attributable to occupational carcinogens were collected from the Global Burden of Disease Study 2019. Numbers and age-standardized rates (ASRs) of deaths, disability-adjusted life years (DALYs), and corresponding average annual percentage change (AAPC) were evaluated and stratified by geographic location, socio-demographic index (SDI) quintiles, age, and sex.
    Globally, ASRs of deaths and DALYs in TBL cancer attributable to occupational carcinogens showed a downward trend (AAPC = - 0.69%, - 1.01%) while increases were observed in the low, low-middle, and middle SDI quintiles. Although males accounted for 82.4% and 81.5% of deaths and DALYs in 2019, respectively, it showed an upward trend of ASRs in females (AAPC = 0.33%, 0.02%). Occupational exposure to asbestos, silica and diesel engine exhaust were the top three causes of age-standardized TBL cancer deaths and DALYs. Over the past three decades, the percentage of age-standardized TBL cancer deaths and DALYs attributable to occupational asbestos and silica exposure decreased by 18.24, 6.71 and 20.52%, 4.00% globally, but increased significantly in lower SDI regions, while the burden attributable to occupational diesel engine exhaust exposure increased by 32.76, 37.23% worldwide.
    Occupational exposure remains an important risk factor for TBL cancer. The burden of TBL cancer attributable to occupational carcinogens showed obvious heterogeneity which decreased in higher SDI but increased in lower SDI regions. The burden of males was significantly higher than females, but the females showed an increasing trend. Occupational exposure to asbestos was the main causes of the burden. Therefore, effective prevention and control measures tailored to local conditions are necessary.
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  • 文章类型: Systematic Review
    吸烟和饮酒等社会习惯是众所周知的口腔和口咽鳞状细胞癌(OSCC/OPSCC)的病原体。人乳头瘤病毒(HPV)是OPSCC的已知病原体。然而,我们经常遇到没有可识别风险因素的患者。越来越多的证据表明职业性致癌物在口腔癌的发病机理中的作用。因此,这项研究的目的是确定与口腔癌有关的任何职业性致癌物。我们使用PubMed对文献进行了系统的回顾,EMBASE,还有Medline,以及对在地区病房接受治疗超过25年的患者的回顾性回顾。职业是根据英国2020年分类标准进行分类的。使用卡方检验完成数据分析。共有17篇论文符合纳入审查标准。在我们的回顾性研究中,共确定了874名患者,其中31%是蓝领工人。32.8%是白领,20.2%是失业/家庭主妇,16%的工人从事其他职业。大多数蓝领工人都在建筑行业,并且最大程度地暴露于碳氢化合物和废气中。口腔和口咽SCC的病因是多因素的,对职业性致癌物的作用尚无共识。我们展示了我们的患者队列,并讨论了似乎使他们容易受到OSCC和OPSCC的职业暴露。需要进一步的多中心研究,以使我们能够充分了解口腔癌的发病机理,并帮助我们向相关组织提供信息,目的是减少与职业有关的癌症的发病率。
    Social habits such as smoking and drinking alcohol are well-known causative agents for oral and oropharyngeal squamous cell carcinoma (OSCC/OPSCC). Human papillomavirus (HPV) is a known causative agent for OPSCC. However, we often encounter patients with no identifiable risk factors. There is growing evidence of the role of occupational carcinogens in the pathogenesis of oral cancer. The aim of this study therefore was to identify any occupational carcinogens linked to oral cancer. We carried out a systematic review of the literature using PubMed, EMBASE, and Medline, along with a retrospective review of patients treated in a regional unit over 25 years. Occupations were classified based on the UK Standard of Classification 2020. Data analysis was completed using the chi-squared test. A total of 17 papers met the inclusion criteria for review. In our retrospective study a total of 874 patients were identified of whom 31% were blue-collar workers, 32.8% were white-collar workers, 20.2% were unemployed/housewives, and 16% workers in other occupations. The majority of blue-collar workers were in the construction industry and had maximum exposure to hydrocarbons and exhaust fumes. The aetiology of oral and oropharyngeal SCC is multifactorial and there is no consensus on the role of occupational carcinogens. We showcase our patient cohort and discuss the occupational exposures that appear to make them susceptible to OSCC and OPSCC. Further multicentre studies are required to enable us to understand fully the pathogenesis of oral cancer and help us to inform relevant organisations, the aim being to reduce the incidence of occupation-related cancer.
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