-
1.
Occupational exposure to silica and risk of heart disease: a systematic review with meta-analysis.
Liu, K, Mu, M, Fang, K, Qian, Y, Xue, S, Hu, W, Ye, M
BMJ open. 2020;(1):e029653
Abstract
OBJECTIVE To search for evidence of the relationship between occupational silica exposure and heart disease. DESIGN A systematic review and meta-analysis. BACKGROUND Growing evidence suggests a relationship between occupational silica exposure and heart disease; however, the link between them is less clear. DATA SOURCES PubMed, ScienceDirect, Springer and EMBASE were searched for articles published between 1 January 1995 and 20 June 2019. Articles that investigated the effects of occupational silica exposure on the risk of heart disease were considered. STUDY SELECTION We included cohort studies, including prospective, retrospective and retroprospective studies. DATA EXTRACTION AND SYNTHESIS We extracted data using a piloted data collection form and conducted random-effects meta-analysis and exposure-response analysis. The meta-relative risk (meta-RR), a measure of the average ratio of heart disease rates in those with and without silica exposure, was used as an inverse variance-weighted average of relative risks from the individual studies. The Newcastle-Ottawa Quality Assessment Scale for cohort studies was used for study quality assessment. OUTCOME MEASURE We calculated the risk of heart diseases such as pulmonary heart disease, ischaemic heart disease and others. RESULTS Twenty cohort studies were included. The results suggest a significant increase in the risk of overall heart disease (meta-RR=1.08, 95% CI 1.03 to 1.13). Stronger evidence of association with pulmonary heart disease was found in the risk estimate of both categories of heart disease (meta-RR=1.24, 95% CI 1.08 to 1.43) and in the exposure-response analysis (meta-RR=1.39, 95% CI 1.19 to 1.62). Our subgroup analyses also revealed that the statistical heterogeneity among studies could be attributed mainly to the diversity in reference group, occupation and study quality score. CONCLUSIONS Silica-exposed workers are at an increased risk for overall heart disease, especially pulmonary heart disease. Further research is needed to better clarify the relationship between occupational silica exposure and ischaemic heart disease. PROSPERO REGISTRATION NUMBER CRD42019124673.
-
2.
Low-dose computed tomography screening for lung cancer in people with workplace exposure to asbestos.
Maisonneuve, P, Rampinelli, C, Bertolotti, R, Misotti, A, Lococo, F, Casiraghi, M, Spaggiari, L, Bellomi, M, Novellis, P, Solinas, M, et al
Lung cancer (Amsterdam, Netherlands). 2019;:23-30
Abstract
OBJECTIVES Smoking is the main risk factor for lung cancer, but environmental and occupational exposure to carcinogens also increase lung cancer risk. We assessed whether extending low-dose computed tomography (LDCT) screening to persons with occupational exposure to asbestos may be an effective way reducing lung cancer mortality. MATERIALS AND METHODS We conducted a nested case-control study within the COSMOS screening program, assessing past asbestos exposure with a questionnaire. LDCT scans of asbestos-exposed participants were reviewed to assess the presence of pulmonary, interstitial and pleural alterations in comparison to matched unexposed controls. We also performed an exhaustive review, with meta-analysis, of the literature on LDCT screening in asbestos-exposed persons. RESULTS Exposure to asbestos, initially self-reported by 9.8% of COSMOS participants, was confirmed in 216 of 544 assessable cases, corresponding to 2.6% of the screened population. LDCT of asbestos-exposed persons had significantly more pleural plaques, diaphragmatic pleural thickening and pleural calcifications, but similar frequency of parenchymal and interstitial alterations to unexposed persons. From 16 papers, including this study, overall lung cancer detection rates at baseline were 0.81% (95% CI 0.50-1.19) in asbestos-exposed persons, 0.94% (95% CI 0.47-1.53) in asbestos-exposed smokers (12 studies), and 0.11% (95% CI 0.00-0.43) in asbestos-exposed non-smokers (9 studies). CONCLUSION Persons occupationally exposed to asbestos should be monitored to gather more information about risks. Although LDCT screening is effective in the early detection lung cancer in asbestos-exposed smokers, our data suggest that screening of asbestos-exposed persons with no additional risk factors for cancer does is not viable due to the low detection rate.
-
3.
Effect of Occupational Exposure to Radar Radiation on Cancer Risk: A Systematic Review and Meta-Analysis.
Safari Variani, A, Saboori, S, Shahsavari, S, Yari, S, Zaroushani, V
Asian Pacific journal of cancer prevention : APJCP. 2019;(11):3211-3219
Abstract
OBJECTIVE Microwave radiation is one of the most growing environmental workplace factors that exposes too many workers in the various workplaces. Regard to concerns about cancer incidence in these workers and lack of systematic or meta-analytic studies about this object, so, we conducted a meta-analysis to acquire an understanding of the association between cancer risk and occupational exposure to radar radiation. METHODS A systematic search was carried out on case-control, cohort and clinical control trial studies that published in the Cochrane Library, PubMed, ISI Web of Science, Scopus and Google scholar databases that accomplished from March 2017 to March 2018 and updated on 30 September, 2018 in English and Persian articles without time limit in publication date. Keywords were selected based on PICO principle and collected from MeSH database. After removal of duplicated studied, taking into inclusion and exclusion criteria, the process of screening was carried out and data were extracted after preparation of the full text of included articles. Article collection was completed by manually searching for a reference list of eligible studies. For quality assessment of included studies, Newcastle-Ottawa scale was used. RESULTS a total of 533 studies was found in the first step of literature search, only 6 were included with 53,008 sample size according to inclusion and exclusion criteria. Estimated pooled random effects size analysis showed no significant increasing effect of occupational exposure to radar radiation on mortality rate (MR=0.81, 95%CI: 0.78, 0.83) and relative risk (RR=0.87, 95%CI: 0.75, 0.99, P <0.0001) of cancer with a significant heterogeneity between the selected studies. CONCLUSIONS In conclusion, the results of this meta-analysis study have shown no significant increase in overall mortality ratio and cancer risk ratio from occupational exposure to the radar frequency of workers. But, these results are not conclusive. As regards to some limitation such as fewer numbers of included studies, lack of data about exposure characterizations and demographic characterizations in this meta-analysis, this result is not certain and conclusive. It is recommended to conduct future studies.
-
4.
Risk of obstructive pulmonary diseases and occupational exposure to pesticides: a systematic review and meta-analysis.
Pourhassan, B, Meysamie, A, Alizadeh, S, Habibian, A, Beigzadeh, Z
Public health. 2019;:31-41
Abstract
OBJECTIVE This meta-analysis study was performed to examine the relationship between occupational exposure to pesticides and the risk of obstructive pulmonary diseases such as chronic obstructive pulmonary disease (COPD) and chronic bronchitis. STUDY DESIGN This is a systematic review and meta-analysis study. METHODS PubMed and Scopus databases were searched for English-language publications. Eight cohort studies and one case-control study were included in the pooled analysis. RESULTS These studies had a total of 101,353 participants from eleven different countries and were published between 2006 and 2018. The heterogeneity among the studies was high (P < 0.001, I2 = 68.7%). In a random-effects model meta-analysis, a pooled odds ratio (OR) analysis showed that there was a direct relationship between occupational exposure to the pesticides and obstructive pulmonary diseases (OR = 1.33, 95% confidence interval [CI]: 1.21-1.47). A positive significant relationship was also observed between exposure to the pesticides and risk of chronic bronchitis (OR = 1.27, 95% CI: 1.23-1.31). Also, there was a significant relationship between occupational exposure to the pesticides and an increased risk of COPD (OR = 1.44, 95% CI: 1.14-1.81). No evidence of publication bias was found among the studies according to the results of the Egger's test (P of bias = 0.157). CONCLUSIONS Findings of this study show that occupational exposure to pesticides can be associated with an increased risk of obstructive lung diseases including chronic bronchitis and COPD.
-
5.
The risk of hearing loss associated with occupational exposure to organic solvents mixture with and without concurrent noise exposure: A systematic review and meta-analysis.
Hormozi, M, Ansari-Moghaddam, A, Mirzaei, R, Dehghan Haghighi, J, Eftekharian, F
International journal of occupational medicine and environmental health. 2017;(4):521-535
Abstract
This study is a meta-analysis of the previous epidemiological studies which investigated the quantitative estimates of the association between independent or combined exposure to noise and mixed organic solvents and hearing loss until October 2014. Overall, 15 studies with information on 7530 individuals (6% female) were included. Having assessed - by puretone audiometry - the adjusted odds ratio estimates for the association between solvents mixture exposure and the risk of developing hearing loss stood at 2.05 (95% confidence interval (CI): 1.44-2.9). Similarly, for subjects who were concurrently exposed to noise and solvents mixture, an OR of 2.95 (95% CI: 2.1-4.17) was obtained. There was some evidence of heterogeneity within each of the 2 exposure groups (p heterogeneity < 0.001). This heterogeneity was not explained by differences in strength of effect between duration of exposure, the number of solvent and exposure index in subgroups of solvents mixture exposure. Based on the available data, our analysis has provided the evidence of increased risk of developing hearing loss for workers exposed to organic solvents even at quite low concentration. Moreover, if such exposure is accompanied by noise, it will exacerbate the extent of hearing loss. Int J Occup Med Environ Health 2017;30(4):521-535.
-
6.
Risk of Lung Cancer in Workers Exposed to Benzidine and/or Beta-Naphthylamine: A Systematic Review and Meta-Analysis.
Tomioka, K, Saeki, K, Obayashi, K, Kurumatani, N
Journal of epidemiology. 2016;(9):447-58
Abstract
Benzidine (BZ) and beta-naphthylamine (BNA) have been classified as definite human carcinogens for bladder cancer by the International Agency for Research on Cancer. However, the epidemiological evidence for an association between exposure to BZ and/or BNA and lung cancer has been inconclusive. We conducted a systematic review and meta-analysis to determine the risk for lung cancer among workers exposed to BZ/BNA. A systematic literature search was conducted to identify studies that had reported occupational BZ/BNA exposure and the outcome of interest (lung cancer death and/or incidence). Meta-analyses were performed using random effects models to combine standardized mortality ratios (SMRs) or standardized incidence ratios (SIRs). We identified 23 retrospective cohort studies including 1745 cases of lung cancer; only one study reported smoking-adjusted lung cancer risk. A significantly increased lung cancer risk (pooled SMR/SIR 1.28; 95% CI, 1.14-1.43) was observed by combining all studies, with significant heterogeneity among studies (I(2) = 64.1%, P < 0.001). Effect estimates were higher for studies with direct BZ/BNA exposure (ie, dyestuff and manufacturing industries) (pooled SMR/SIR 1.58; 95% CI, 1.31-1.89), and studies that identified BZ/BNA-associated bladder cancer with SMR/SIR ≥4.7 (pooled SMR/SIR 1.68; 95% CI, 1.35-2.09). Effect estimates were similar for studies with and without concomitant occupational exposure to chromium, asbestos, arsenic, or bis(chloromethyl) ether. The cumulative meta-analysis showed that the evidence of association between occupational BZ/BNA exposure and lung cancer has been stable since 1995. Although the results of this meta-analysis have the potential for confounding by smoking and heterogeneity, our findings suggest that a finding of lung cancer following occupational BZ/BNA exposure should be considered to be a potential occupational disease.
-
7.
Occupational exposure to polycyclic aromatic hydrocarbons and lymphatic and hematopoietic neoplasms: a systematic review and meta-analysis of cohort studies.
Alicandro, G, Rota, M, Boffetta, P, La Vecchia, C
Archives of toxicology. 2016;(11):2643-2656
Abstract
Data on the risk of lymphatic and hematopoietic neoplasms among workers whose jobs entail high exposure to polycyclic aromatic hydrocarbons (PAH) are sparse, and mainly based on small-size studies. We carried out a systematic review of occupational cohort studies that reported results on incidence or mortality from Hodgkin lymphoma (HL), non-Hodgkin lymphoma (NHL), leukemia or multiple myeloma (MM) among workers exposed to PAH. We computed meta-analytic estimates using a random effect model. Meta-relative risk (meta-RR) was computed separately by each type of neoplasm, job or industry. We identified 41 studies (12 in iron and steel foundries, 11 in aluminum plant, 6 in cokeries, 6 in carbon electrode manufacturing, 2 on asphalt workers, 2 on creosote-exposed workers, 1 on tar distillery workers and 1 evaluating both tar distillery workers and roofers). No significant excess risk of any lymphatic and hematopoietic neoplasms was found among workers employed in jobs or industries entailing high PAH exposure. Among 18 meta-analytic estimates by job or industry and type of neoplasm, 16 were close to unit, i.e., between 0.72 and 1.27, whereas the meta-RR was 1.38 [95 % confidence interval (CI) 0.95-2.01] for HL in foundry workers and 2.01 (95 % CI 0.96-4.22) for NHL in workers exposed to creosote. There was no association between occupation entailing high PAH exposure and risk of MM or leukemia.
-
8.
Prevalence of dry eye disease in visual display terminal workers: a systematic review and meta-analysis.
Courtin, R, Pereira, B, Naughton, G, Chamoux, A, Chiambaretta, F, Lanhers, C, Dutheil, F
BMJ open. 2016;(1):e009675
Abstract
OBJECTIVE To evaluate the prevalence and risk factors of dry eye disease (DED) in workers using visual display terminals (VDT). DESIGN Systematic review and meta-analysis. DATA SOURCES We searched PubMed, Cochrane Library, Embase and Science Direct databases for studies reporting DED prevalence in VDT workers. RESULTS 16 of the 9049 identified studies were included, with a total of 11,365 VDT workers. Despite a global DED prevalence of 49.5% (95% CI 47.5 to 50.6), ranging from 9.5% to 87.5%, important heterogeneity (I(2)=98.8%, p<0.0001) was observed. Variable diagnosis criteria used within studies were: questionnaires on symptoms, tear film anomalies and corneoconjunctival epithelial damage. Some studies combined criteria to define DED. Heterogeneous prevalence was associated with stratifications on symptoms (I(2)=98.7%, p<0.0001), tears (I(2)=98.5%, p<0.0001) and epithelial damage (I(2)=96.0%, p<0.0001). Stratification of studies with two criteria adjusted the prevalence to 54.0% (95% CI 52.1 to 55.9), whereas studies using three criteria resulted in a prevalence of 11.6% (95% CI 10.5 to 12.9). According to the literature, prevalence of DED was more frequent in females than in males and increased with age. CONCLUSIONS Owing to the disparity of the diagnosis criteria studied to define DED, the global prevalence of 49.5% lacked reliability because of the important heterogeneity. We highlight the necessity of implementing common DED diagnostic criteria to allow a more reliable estimation in order to develop the appropriate preventive occupational actions.
-
9.
Pesticide exposure and risk of Alzheimer's disease: a systematic review and meta-analysis.
Yan, D, Zhang, Y, Liu, L, Yan, H
Scientific reports. 2016;:32222
Abstract
Evidence suggests that lifelong cumulative exposure to pesticides may generate lasting toxic effects on the central nervous system and contribute to the development of Alzheimer's disease (AD). A number of reports indicate a potential association between long-term/low-dose pesticide exposure and AD, but the results are inconsistent. Therefore, we conducted a meta-analysis to clarify this association. Relevant studies were identified according to inclusion criteria. Summary odds ratios (ORs) were calculated using fixed-effects models. A total of seven studies were included in our meta-analysis. A positive association was observed between pesticide exposure and AD (OR = 1.34; 95% confidence interval [CI] = 1.08, 1.67; n = 7). The summary ORs with 95% CIs from the crude and adjusted effect size studies were 1.14 (95% CI = 0.94, 1.38; n = 7) and 1.37 (95% CI = 1.09, 1.71; n = 5), respectively. The sensitivity analyses of the present meta-analysis did not substantially modify the association between pesticide exposure and AD. Subgroup analyses revealed that high-quality studies tended to show significant relationships. The present meta-analysis suggested a positive association between pesticide exposure and AD, confirming the hypothesis that pesticide exposure is a risk factor for AD. Further high-quality cohort and case-control studies are required to validate a causal relationship.
-
10.
Occupation and cancer of the larynx: a systematic review and meta-analysis.
Bayer, O, Cámara, R, Zeissig, SR, Ressing, M, Dietz, A, Locati, LD, Ramroth, H, Singer, S
European archives of oto-rhino-laryngology : official journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : affiliated with the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery. 2016;(1):9-20
Abstract
The aim of the study was to explore the relationship between occupational exposure, defined by occupational categories and job title, and laryngeal cancer. A systematic review and meta-analysis of 21 tobacco and alcohol-adjusted case-control studies including data from 6,906 exposed cases and 10,816 exposed controls was performed to investigate the frequency of laryngeal cancer in different occupations. Job classifications were harmonized using the International Standard Classification of Occupations. Pooled odds ratios (OR [95 % confidence intervals (CI)]) were calculated for the different occupational groups. A significantly increased risk of laryngeal cancer was observed for the occupational category of 'production-related workers, transport equipment operators, and laborers' (OR=1.3 [1.2-1.4]); particularly at risk were occupations as: miners (OR=1.6 [1.2-2.1]), tailors (OR=1.7 [1.2-2.3]), blacksmith and toolmakers (OR=1.5 [1.2-1.7]), painters (OR=1.4 [1.1-1.9]), bricklayers and carpenters (OR=1.3 [1.2-1.5]), and transport equipment operators (OR=1.3 [1.2-1.5]). Individuals working as 'professional, technical, and related workers' (OR=0.7 [0.6- 0.8]), 'administrative and managerial workers' (OR=0.6 [0.4-0.7]), or 'clerical and related workers' (OR=0.8 [0.7-0.9]) had laryngeal cancer less frequently. Occupational exposure, defined by occupational categories and job title, is likely to be an independent risk factor for laryngeal cancer. Further research on specific occupations with increased risk of laryngeal cancer is warranted to explore the underlying mechanisms.