肺癌是世界上最常见的癌症之一。由于暴露于各种致癌物,肺癌的发病率较高可能与石化工业园区(PIC)的住宅附近有关。尽管以前的流行病学研究结果仍无定论.因为居住不平等造成的疾病负担是公共卫生和社会关注的问题,这项研究分析了已发表的数据,以估计与居住地靠近PIC相关的肺癌发病率.
我们对选定的符合以下标准的流行病学研究进行了荟萃分析:肺癌发病率由国际疾病分类编码;暴露组明确定义为居住在PIC附近的居民;置信区间可从原始文章获得或可计算。我们进一步应用了人口归因因子(PAF)方法来估计22个欧盟(EU)国家因居住在PIC附近而造成的疾病负担。
荟萃分析包括6项研究,共有466,066名居民居住在六个国家的PIC附近。居住在PIC附近的居民患肺癌的风险比居住在更远的地方的居民高19%(95%CI=1.06-1.32)。按性别,女性(RR=1.29;95%CI=1.09-1.54;P=0.004)的风险高于男性(RR=1.12;95%CI=0.95-1.33;P=0.173)。按位置,只有欧洲人群暴露于PIC后患肺癌的风险显著增加(95%CI=1.03-1.33;P=0.019),尽管其他地区的群体表现出类似的趋势。通过真诚的观察,对居民进行至少7年的观察可以提供足够的潜伏期来估计风险(RR=1.25;95%CI=1.17-1.34;P<0.001).关于22个欧盟国家的肺癌负担,每年有494名男性和478名女性居住在PIC附近。
生活在PICs附近的个体肺癌发病率明显较高。此结果为进一步制定政策以规范PIC附近的潜在污染物提供了强有力的流行病学证据。
居住在石化工业综合体附近的居民患肺癌的发生率更高。
Lung cancer is one of the most common cancers in the world. Higher incidence of lung cancer may be associated with residential proximity to a petrochemical industrial complex (PIC) due to exposure to various carcinogens, although results from previous epidemiologic studies remain inconclusive. Because disease burden due to residential inequality is a public health and societal concern, this study analyzed published data to estimate lung cancer incidence in association with residential proximity to PICs.
We performed a meta-analysis on selected epidemiologic studies that met the following criteria: lung cancer incidence was coded by the International Classification of Diseases; exposure groups were clearly defined as residents living near PICs; and confidence intervals were available or calculable from original articles. We further applied a population attributable factor (PAF) method to estimate disease burden attributable to living near PICs in 22 European Union (EU) countries.
Meta-analysis included six studies with a total of 466,066 residents living near PICs in six countries. Residents living near PICs had a 19% higher risk of lung cancer compared to those who lived farther away (95% CI = 1.06-1.32). By sex, risks were higher and more significant for females (RR = 1.29; 95% CI = 1.09-1.54; P = 0.004) than males (RR = 1.12; 95% CI = 0.95-1.33; P = 0.173). By location, only groups in Europe had a significantly greater risk of lung cancer with exposure to PICs (95% CI = 1.03-1.33; P = 0.019), although groups in other locations showed similar trends. By bona fide observation, observation of residents for at least seven years provided sufficient latency to estimate risk (RR = 1.25; 95% CI = 1.17-1.34; P < 0.001). Regarding burden of lung cancer in 22 EU countries, 494 males and 478 females were attributed to living in the vicinity of a PIC annually.
Lung cancer incidence is significantly higher in individuals living near PICs. This result provides strong epidemiologic evidence for further policy to regulate potential pollutants near PICs.
Higher incident rates of lung cancer for residents living close to petrochemical industry complex.