■我们决定用荟萃分析进行第一次系统评价,以提供有关多发性硬化症职业危险因素的最高水平的最新证据。
■系统,在四个电子学术数据库中进行了全面的文献检索。我们纳入了任何招募工作年龄受试者的病例对照研究,并比较了MS病例与未暴露于职业危险因素的对照组的比例。主要结果是MS的发生。质量评估是用病例对照研究的关键评估清单进行的,开发,由乔安娜·布里格斯研究所验证。所有选择过程也由两名独立且先前受过训练的研究人员进行。
■总的来说,总样本包括19,004名MS患者和4,164,162名对照。农业工人(OR=1.44,95%CI1.13-1.83),离岸工人(OR=3.56,95%CI2.74-4.61),和美发师(OR=8.25,95%CI1.02-66.52)与更高的被诊断为MS的可能性相关。并行,暴露于油井有毒烟雾的工人(OR=16.80,95%CI8.33-33.90),低频磁场(OR=1.71,95%CI1.03-2.72),农药(OR=3.17,95%CI=2.53-3.99)也增加了患MS的可能性。
■我们的研究有可能影响更自信的公共政策。然而,我们强烈建议未来研究职业环境如何影响MS的发病率.
■该方案已在国际前瞻性系统评价登记册(PROSPERO-CRD42023443257)中注册。
We decided to conduct the first systematic review with meta-analysis to provide the highest level of up-to-date evidence on the occupational risk factors for Multiple Sclerosis.
A systematic, comprehensive literature search was performed in four electronic academic databases. We included any case-control study that enrolled working-age subjects and compared the proportion of MS cases with controls who were not exposed to an occupational risk factor. The primary outcome was the occurrence of MS. The quality assessment was performed with the Critical Appraisal Checklist for Case Control Studies, developed, and validated by the Joanna Briggs Institute. All the selection process was also carried out by two independent and previously trained researchers.
Overall, the total sample included 19,004 people with MS and 4,164,162 controls. Agricultural workers (OR = 1.44, 95% CI 1.13-1.83), offshore workers (OR = 3.56, 95% CI 2.74-4.61), and hairdressers (OR = 8.25, 95% CI 1.02-66.52) were associated with a higher probability of being diagnosed with MS. In parallel, workers exposed to toxic fumes from oil wells (OR = 16.80, 95% CI 8.33-33.90), low-frequency magnetic fields (OR = 1.71, 95% CI 1.03-2.72), and pesticides (OR = 3.17, 95% CI = 2.53-3.99) also had an increased likelihood of having MS.
Our study has the potential to influence more assertive public policies. Nevertheless, future studies on how the occupational setting may contribute to the incidence of MS are highly recommended.
The protocol was registered in the international prospective register of systematic reviews (PROSPERO- CRD42023443257).