occupational carcinogens

职业性致癌物
  • 文章类型: Journal Article
    背景:肝胰胆管(HPB)癌包括肝脏恶性肿瘤,胰腺,胆囊,和胆管在非洲构成了巨大的健康负担。虽然癌症中某些职业致癌物的关联在全球范围内已经确立,它们在HPB癌症中的潜在作用仍未得到充分研究,尤其是在非洲的背景下。
    目的:本系统综述探讨了非洲职业性致癌物与HPB癌症之间的关系。它审查了非洲职业性致癌物和HPB癌症的研究现状,确定关键挑战和知识差距。
    方法:本系统综述审查了非洲职业性致癌物和HBP癌症的出版物(2012年1月1日至2023年5月31日出版)。搜索是在电子数据库上进行的,即PubMed,WebofScience,和非洲广泛的信息。
    结果:由于缺乏有关非洲职业性致癌物与HPB癌症之间关联的信息,由于缺乏发表的研究,本研究仅纳入4篇文章.肝细胞癌(HCC)是与职业性致癌物相关的主要癌症,黄曲霉毒素.农业工人,特别是那些参与玉米和花生生产和加工的人,似乎最容易接触黄曲霉毒素。
    结论:尽管由于缺乏关于非洲职业性致癌物和HPB癌症的研究,样本量有限,这项研究为后续的流行病学研究提供了一个合理的工具.有必要对非洲职业性致癌物和HPB癌症的关联进行更多的研究,特别是随着工业化的发展。
    BACKGROUND: Hepatopancreatobiliary (HPB) cancers encompassing malignancies of the liver, pancreas, gall bladder, and bile ducts pose a significant health burden in Africa. While the association of certain occupational carcinogens in cancer is well established globally, their potential role in HPB cancers remains understudied, especially in an African context.
    OBJECTIVE: This systematic review delves into the association between occupational carcinogens and HPB cancer in Africa. It examines the current state of research on occupational carcinogens and HPB cancers in Africa, identifying key challenges and knowledge gaps.
    METHODS: This systematic review examined publications (published between 01 January 2012 and 31 May 2023) that highlight occupational carcinogens and HBP cancers in Africa. The search was conducted on electronic databases namely PubMed, Web of Science, and Africa Wide Information.
    RESULTS: Due to the lack of information on the association between occupational carcinogens and HPB cancers in Africa, as a result of the paucity of published studies, only four articles were included in this study. Hepatocellular carcinoma (HCC) was the predominant cancer associated with the occupational carcinogen, aflatoxin. Agricultural workers, especially those involved in the production and processing of maize and peanuts, appear to be the most exposed to aflatoxin.
    CONCLUSIONS: Despite the sample size limitations due to the paucity of research studies on occupational carcinogens and HPB cancers in Africa, this study provides a reasonable tool for subsequent epidemiological studies. There is a need for more research on the association of occupational carcinogens and HPB cancers in Africa, especially with the growing industrialization.
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  • 文章类型: Meta-Analysis
    已广泛建议职业暴露于致癌物会增加癌症风险。需要对这些证据进行强有力的评估,以指导公共政策和医疗保健。我们旨在对13种职业性致癌物(OC)与癌症风险关联的证据强度进行分类。我们搜索了截至2022年11月的PubMed和WebofScience,以确定潜在的相关研究。我们把证据定格为有说服力,高度暗示性,暗示,弱,根据基于随机效应p值的标准化分类,或不显著,癌症病例数,最大研究的95%置信区间,研究之间的异质性,95%预测区间,小的研究效果,具有可信度上限的过度显著性偏差和敏感性分析。通过AMSTAR2评估荟萃分析的质量。48篇文章产生了79项荟萃分析,纳入了当前的综述。相关证据对石棉暴露和吸烟者肺癌风险增加具有说服力(I类)或高度暗示性(II类)(队列研究RR=8.79,95CI:5.81-13.25,病例对照研究OR=8.68,95CI:5.68-13.24),石棉暴露和间皮瘤风险增加(RR=4.61,95CI:2.57-8.26),甲醛暴露与鼻窦癌风险增加(RR=1.68,95CI:1.38-2.05)。15个协会得到了暗示性证据(III类)的支持。总之,目前的综述发现:石棉暴露与吸烟者肺癌风险增加;石棉暴露与间皮瘤风险增加;甲醛暴露与鼻窦癌风险增加之间存在密切关联.其他协会可能是真实的,但仍存在很大的不确定性。
    Occupational exposure to carcinogens of increasing cancer risk have been extensively suggested. A robust assessment of these evidence is needed to guide public policy and health care. We aimed to classify the strength of evidence for associations of 13 occupational carcinogens (OCs) and risk of cancers. We searched PubMed and Web of Science up to November 2022 to identify potentially relevant studies. We graded the evidence into convincing, highly suggestive, suggestive, weak, or not significant according to a standardized classification based on: random-effects p value, number of cancer cases, 95% confidence interval of largest study, heterogeneity between studies, 95% prediction interval, small study effect, excess significance bias and sensitivity analyses with credibility ceilings. The quality of meta-analysis was evaluated by AMSTAR 2. Forty-eight articles yielded 79 meta-analyses were included in current umbrella review. Evidence of associations were convincing (class I) or highly suggeastive (class II) for asbestos exposure and increasing risk of lung cancer among smokers (RR = 8.79, 95%CI: 5.81-13.25 for cohort studies and OR = 8.68, 95%CI: 5.68-13.24 for case-control studies), asbestos exposure and increasing risk of mesothelioma (RR = 4.61, 95%CI: 2.57-8.26), and formaldehyde exposure and increasing risk of sinonasal cancer (RR = 1.68, 95%CI: 1.38-2.05). Fifteen associations were supported by suggestive evidence (class III). In summary, the current umbrella review found strong associations between: asbestos exposure and increasing risk of lung cancer among smokers; asbestos exposure and increasing risk of mesothelioma; and formaldehyde exposure and higher risk of sinonasal cancer. Other associations might be genuine, but substantial uncertainty remains.
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  • 文章类型: Meta-Analysis
    背景:我们的目的是对暴露于焊接烟雾(WF)的工人的泌尿生殖系统(GU)癌症风险的队列研究进行荟萃分析。
    方法:我们对发表在Pubmed,Scopus和Embase遵循PRISMA标准。两名研究人员选择了关于WF暴露的队列研究。从2582篇文章中,纳入7项非重叠研究。根据CASP对研究质量进行评分。我们运行随机效应荟萃分析来计算GU癌症的相对风险(RR)和95%置信区间(CI)。整体和按癌症分层,国家,和质量得分。
    结果:我们纳入了7项报告GU癌症结果的研究,包括前列腺,膀胱癌和肾癌(PC,BC,和KC)。GU癌症的RR为1.19(95%CI=1.07-1.32,16个风险估计值);PC为1.13(95%CI=0.90-1.42,4个风险估计值);BC为1.26(95%CI=0.98-1.60,7个风险估计值),KC为1.28(95%CI=1.12-1.47,5个风险估计值)。所有meta分析均存在异质性(p<0.001)。北美的风险增加比欧洲的研究更明显(分别是,OR=1.35,95%CI=1.18-1.55;OR=1.13,95%CI=1.01-1.27p异质性=0.03)。根据质量评分,没有异质性(p=0.4)。数据不足以按行业或焊接类型调查协会。排除每种癌症的发表偏倚。
    结论:这项荟萃分析提示KC和BC的风险增加,但不是PC,在接触WF的工人中。不能排除其他职业和非职业危险因素的混淆。数据不足以解决特定暴露环境的风险。
    BACKGROUND: Our aimed to conduct a meta-analysis of cohort studies on risk of genitourinary (GU) cancers in workers exposed to welding fumes (WF).
    METHODS: We performed a systematic review of studies published on Pubmed, Scopus and Embase following PRISMA criteria. Two researchers selected cohort studies on WF exposure. From 2582 articles, 7 non-overlapping studies were included. Quality of studies was scored according to CASP. We run a random effects meta-analysis to calculate the relative risk (RR) and 95% confidence intervals (CI) of GU cancer, overall and stratified by cancer, country, and quality score.
    RESULTS: We included seven studies reporting results on GU cancers, including prostate, bladder and kidney cancer (PC, BC, and KC). The RR was 1.19 (95% CI = 1.07-1.32, 16 risk estimates) for GU cancer; 1.13 (95% CI = 0.90-1.42, 4 risk estimates) for PC; 1.26 (95% CI = 0.98-1.60, 7 risk estimates) for BC and 1.28 (95% CI = 1.12-1.47, 5 risk estimates) for KC. Heterogeneity was present in all meta-analyses (p < 0.001). The increased risk was more pronounced in North American than in European studies (respectively, OR = 1.35, 95% CI = 1.18-1.55; OR = 1.13, 95% CI = 1.01-1.27 p heterogeneity = 0.03). There was no heterogeneity according to quality score (p = 0.4). Data were insufficient to investigate associations by industry or welding type. Publication bias for each cancer was excluded.
    CONCLUSIONS: This meta-analysis suggests increased risk of KC and BC, but not of PC, in workers exposed to WF. Confounding by other occupational and non-occupational risk factors could not be excluded. Data were not adequate to address the risk of specific exposure circumstances.
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  • 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
    背景:暴露于职业性致癌物是癌症的重要且可避免的原因。我们旨在提供意大利职业相关癌症负担的循证估计。
    方法:归因分数(AF)是根据没有职业性接触致癌物的反事实情景计算的。我们纳入了分类为IARC第1组的暴露,并在意大利有可靠的暴露证据。选定癌症的相对风险估计和暴露的患病率来自大规模研究。除了间皮瘤,我们考虑了暴露与癌症之间的15-20年潜伏期.意大利2020年癌症发病率和2017年死亡率的数据来自意大利癌症登记协会。
    结果:最普遍的暴露是紫外线(5.8%),柴油机尾气(4.3%),木尘(2.3%)和硅尘(2.1%)。间皮瘤对职业致癌物的AF最大(86.6%),其次是鼻窦癌(11.8%)和肺癌(3.8%)。我们估计,在意大利,0.9%的癌症病例(N〜3500)和1.6%的癌症死亡(N〜2800)归因于职业性致癌物。其中,约60%可归因于石棉,17.5%的柴油废气,其次是铬和二氧化硅粉尘(7%和5%)。
    结论:我们的估计提供了对低,但坚持不懈,意大利职业性癌症的负担。
    BACKGROUND: Exposure to occupational carcinogens is an important and avoidable cause of cancer. We aimed to provide an evidence-based estimate of the burden of occupation-related cancers in Italy.
    METHODS: The attributable fraction (AF) was calculated based on the counterfactual scenario of no occupational exposure to carcinogens. We included exposures classified as IARC group 1 and with reliable evidence of exposure in Italy. Relative risk estimates for selected cancers and prevalences of exposure were derived from large-scale studies. Except for mesothelioma, a 15-20-year latency period between exposure and cancer was considered. The data on cancer incidence in 2020 and mortality in 2017 in Italy were obtained from the Italian Association of Cancer Registries.
    RESULTS: The most prevalent exposures were UV radiation (5.8%), diesel exhaust (4.3%), wood dust (2.3%) and silica dust (2.1%). Mesothelioma had the largest AF to occupational carcinogens (86.6%), followed by sinonasal cancer (11.8%) and lung cancer (3.8%). We estimated that 0.9% of cancer cases (N~3500) and 1.6% of cancer deaths (N~2800) were attributable to occupational carcinogens in Italy. Of these, about 60% were attributable to asbestos, 17.5% to diesel exhaust, followed by chromium and silica dust (7% and 5%).
    CONCLUSIONS: Our estimates provide up-to-date quantification of the low, but persistent, burden of occupational cancers in Italy.
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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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  • 文章类型: Journal Article
    背景:可以通过从工作场所去除危险化学品或限制职业暴露来避免职业性癌症。大约,10个主要危险因素占所有职业性癌症的85%。这项范围审查研究旨在确定与5种已知职业癌症相关的最重要的化学致癌物。方法:在这篇范围界定综述中,我们遵循了Arksey和O'Malley的5步框架。四个数据库(PubMed,WebofScience,谷歌学者,Scopus)在2000年1月至2021年9月期间对相关已发表论文进行了系统审查。研究包括在这次范围审查中,它检查了致癌(明确和可能的)化学暴露对5种已知的职业性癌症(肺癌,膀胱,喉,白血病,和肝脏)。我们报道了职业性致癌物的类型,研究的地理多样性,提取相对风险(RR),危险比(HR),或赔率比(OR),并确定了现有文献中的差距。结果:与肺癌(LC)相关的研究数量最多(n=26),膀胱癌(BC)(n=11),喉癌(LaC)(n=8),白血病(LeC)(n=3),和原发性肝癌(PLC)(n=2),分别。大多数研究在法国和加拿大进行(n=8),德国(n=4),芬兰(n=3),荷兰(n=2),芬兰(n=2),分别。此外,与5种已知职业癌症相关的最常见的职业化学致癌物是石棉,苯,结晶二氧化硅,多环芳烃(PAH),和柴油机排气(DME)。结论:尽管发展中国家职业性癌症的归因风险要高得多,一小部分研究是在这些国家进行的.
    Background: Occupational cancers can be avoided by removing dangerous chemicals from the workplace or limiting occupational exposure. Approximately, 10 major risk factors account for 85% of all occupational cancers. This scoping review study aimed to determine the most important chemical carcinogens related to 5 known occupational cancers. Methods: In this scoping review, we followed Arksey and O\'Malley\'s 5-step framework. Four databases (PubMed, Web of Science, Google Scholar, Scopus) were systematically reviewed for relevant published papers from January 2000 to September 2021. Studies were included in this scoping review, which examined the effect of carcinogenic (definite and probable) chemical exposures on 5 known occupational cancers (lung, bladder, laryngeal, leukemia, and liver). We reported the types of occupational carcinogens, the geographical diversity of studies, extraction of relative risks (RRs), hazard ratios (HRs), or odds ratios (ORs), and identified gaps in the existing literature. Results: The highest number of studies was related to lung cancer (LC) (n = 26), bladder cancer (BC) (n = 11), laryngeal cancer (LaC) (n = 8), leukemia (LeC) (n = 3), and primary liver cancer (PLC) (n = 2), respectively. Most studies were performed in France and Canada (n = 8), Germany (n = 4), Finland (n = 3), Netherlands (n = 2), and Finland (n = 2), respectively. Furthermore, the most common occupational chemical carcinogens associated with the 5 known occupational cancers were asbestos, benzene, crystalline silica, polycyclic aromatic hydrocarbons (PAH), and diesel motor exhausts (DME). Conclusion: Although the attributable risk of occupational cancers in developing countries is much higher, a small proportion of studies were performed in these countries.
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  • 文章类型: Journal Article
    职业性接触致癌物与气管有关,支气管,肺癌(TBL)。这项研究的目的是提供1990年至2019年间与职业性致癌物(OC)相关的TBL癌症负担的全球和地区估计。
    从《全球疾病负担2019》中提取了1990-2019年全球和区域水平与暴露于OC相关的TBL癌症的年龄标准化死亡率(ASMR)和年龄标准化残疾调整寿命年(DALYs)率(ASDR)。Joinpoint回归用于分析与OCs相关的TBL癌症负荷的ASMR和ASDR趋势,并记录年度百分比变化和平均年度百分比变化(AAPC)。
    与暴露于OCs相关的TBL癌症的死亡率在全球范围内增加。在1990年至2019年期间,男女和男性的ASMR和ASDR均下降。在1990年至2019年期间,男性ASMR和ASDR的AAPC下降,但女性增加。石棉死亡人数最高,铍死亡人数最低;柴油机尾气造成死亡人数变化百分比最大(145.3%),ASDR(14.9%),所有年龄段的DALY率(57.6%)。在高社会发展指数(SDI)国家中,石棉的死亡人数最多,而中低端SDI国家的百分比变化最大(321.4%)。石棉与高SDI国家的ASDR减少有关,与低SDI国家的ASDR增加有关,其他OCs也观察到类似的变化。
    在1990年至2019年期间,与OCs相关的TBL癌症负担的总死亡率和DALYs呈下降趋势,而死亡人数有所增加。石棉的死亡人数最高。与OCs相关的TBL癌症负担在不同程度上下降,低,中低端,和SDI中间国家,显示与暴露于OCs(石棉除外)相关的TBL癌症负担水平不同。
    Occupational exposure to carcinogens is associated with trachea, bronchus, and lung (TBL) cancer. The objective of this study was to provide global and regional estimates of the burden of TBL cancer associated with occupational carcinogens (OCs) between 1990 and 2019.
    Age-standardized mortality rates (ASMR) and age-standardized disability-adjusted life years (DALYs) rates (ASDR) of TBL cancer related to exposure to OCs at the global and regional levels were extracted for 1990-2019 from the Global Burden of Disease 2019. Joinpoint regression was used to analyze trends in the ASMR and ASDR of TBL cancer burden related to OCs, and the annual percent change and the average annual percent change (AAPC) were recorded.
    The mortality from TBL cancer related to exposure to OCs increased globally. The ASMR and ASDR decreased in both sexes and in men between 1990 and 2019. The AAPC of ASMR and ASDR decreased in men between 1990 and 2019, but increased in women. Asbestos accounted for the highest death number and beryllium accounted for the lowest; diesel engine exhaust caused the largest percentage change in death number (145.3%), in ASDR (14.9%), and in all ages DALY rates (57.6%). Asbestos accounted for the largest death number in high social development index (SDI) countries, whereas low-middle SDI countries had the largest percent change (321.4%). Asbestos was associated with decreased ASDR in high SDI countries and increased ASDR in low-middle SDI countries, and similar changes were observed for other OCs.
    The overall mortality and DALYs of TBL cancer burden related to OCs showed a decreasing trend between 1990 and 2019, whereas death number increased. Asbestos accounted for the highest death number. TBL cancer burden related to OCs decreased to different degrees in high, low, low-middle, and middle SDI countries, which showed variable levels of TBL cancer burden related to exposure to OCs (except asbestos).
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  • 文章类型: Journal Article
    OBJECTIVE: Analysis and comparison of clinical guidelines (CG) on malignant neoplasms of the respiratory system, placed in the CG rubricator of the Ministry of Health of Russia, for the information they contain on the role of factors and working conditions of the working environment in the etiology of respiratory diseases, including the upper respiratory tract, and comparison this information with published and regularly updated data from the International Agency for Research on Cancer (IARC).
    METHODS: Clinical recommendations from the heading of the Ministry of Health of Russia \"Cancer of the laryngopharynx\", \"Cancer of the nasopharynx\", \"Cancer of the oropharynx\", \"Cancer of the nasal cavity and paranasal sinuses\", \"Cancer of the larynx\", \"Cancer of the trachea\", \"Cancer of the lung\", and IARC data according to the List of Classifications by cancer sites with sufficient or limited evidence in humans dated 11/29/2019.
    RESULTS: The low level of registration of occupational cancer of the upper respiratory tract in Russia is due to an inadequate system of criteria for detecting this form of occupational pathology, a long latency period of diseases, and insufficient assessment of the history of information on the potential role of occupational carcinogens. The CGs developed to optimize the diagnosis and treatment of malignant neoplasms of the respiratory system do not contain up-to-date information on the role of professional potential carcinogens in the genesis of malignant neoplasms.
    CONCLUSIONS: Recognition of the professional nature of malignant neoplasms of the respiratory system implies, firstly, strengthening the role of otorhinolaryngologists in early diagnosis and rehabilitation of patients, and secondly, it has a pronounced preventive focus in the form of tasks facing the employer to reduce the carcinogenic load and develop preventive measures aimed to reduce and prevent the development of malignant tumors in workers, including the respiratory system.
    UNASSIGNED: Анализ клинических рекомендаций (КР) по злокачественным новообразованиям органов дыхания, размещенных в рубрикаторе КР Минздрава России, на предмет содержащихся в них сведений о роли факторов и условий труда рабочей среды в этиологии заболеваний органов дыхания, в том числе верхних дыхательных путей, и сопоставление этих сведений с публикуемыми и регулярно обновляемыми данными Международного агентства по изучению рака (МАИР).
    UNASSIGNED: Изучены клинические рекомендации из рубрикатора Минздрава России «Рак гортаноглотки» «Рак носоглотки», «Рак ротоглотки», «Рак полости носа и придаточных пазух», «Рак гортани» «Рак трахеи», «Рак легкого» и данные МАИР по List of Classifications by cancer sites with sufficient or limited evidence in humans от 29.11.19.
    UNASSIGNED: Низкий уровень регистрации профессионального рака верхних дыхательных путей в России обусловлен неадекватной системой критериев выявления данной формы профессиональной патологии, длительным латентным периодом заболеваний, недостаточной оценкой имеющейся в анамнезе информации о потенциальной роли производственных канцерогенов. Разрабатываемые с целью оптимизации диагностики и лечения злокачественных новообразований органов дыхания КР не содержат актуальных сведений о роли профессиональных потенциальных канцерогенов в генезе злокачественных новообразований.
    UNASSIGNED: Признание профессионального характера злокачественных новообразований органов респираторной системы подразумевает, во-первых, усиление роли специалистов оториноларингологов в вопросах ранней диагностики и реабилитации пациентов, во-вторых, носит выраженную профилактическую направленность в виде встающих перед работодателем задач по снижению канцерогенной нагрузки и разработке превентивных мер, направленных на снижение и профилактику развития у работников злокачественных опухолей, в том числе органов дыхания.
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