中国石棉接触人员癌症死亡队列研究的Meta分析

目的以M eta分析探讨单纯接触温石棉人员癌症是否高发。方法凡满足明确是中国石棉接触人员且为癌症死亡率队列研究的资料均被纳入研究对象,以直接法与随机效应模型法计算主要部位癌症标准化死亡比(SMR)及其95%可信区间(CI),计算Q统计量与Z值检验研究结果异质性及其来源。结果共有13个队列符合入选标准,平均间皮瘤死亡百分比为0.62%,全死因、全癌亡、肺癌的M eta-SMR显著上升(分别为1.51、1.96、4.54),单纯接触温石棉人员肺癌的M eta-SMR也显著上升(4.39),消化系统、喉、乳腺和生殖泌尿系统等其他部位癌症的M eta-SMR未见显著上升。结论单纯温石棉暴露能使作业人员肺癌、间皮瘤显著高发,与其他部位癌症无病因联系。

Cohort studies on cancer mortality among workers exposed to asbestos in China: a Meta-analysis

Objective To analyse whether there was excessive risk of malignant tumors or not among workers exposed to chrysotile fiber alone with Meta-analysis technique.Methods All data which met the criteria of cohort studies on cancer mortality among workers exposed to asbestos in China would incorporate into the Meta-analysis.The pooled standardized mortality ratios(SMRs) and their corresponding 95% confidence intervals(CI) for main cancer sites were calculated using two approaches of unweighted ratio and random effect model.The heterogeneity and its sources of the results were examined with a Q-statistic and Z-score test.Results 13 asbestos-exposed cohorts were summarized.The percentage of all deaths due to mesothelioma was 0.62% on average.The significantly elevated Meta-SMRs for all deaths(1.51),all cancers(1.96),lung cancer(4.54) were observed.The significantly elevated Meta-SMRs for lung cancer(4.39) among workers exposed to chrysotile alone were also observed.Meta-SMRs for cancers at other sites were not significant.Conclusion There were excessive risks of lung cancer and mesothelioma among workers exposed to chrysotile fiber alone,and there were likely no convincing evidences of an etiological association between chrysotile exposure and cancers at other sites.