Occupational exposure to methylene chloride and risk of cancer: a meta-analysis

Novel ultrasound assisted extraction and d-SPE clean-up for the analysis of multiple legacy and emerging organic contaminants in edible fish

Polychlorinated biphenyls (PCBs), polybrominated diphenyl ethers (PBDEs), novel brominated flame retardants (NBFRs), phthalate esters (PAEs) are pervasive environmental pollutants, posing threats to both ecosystems and human health. Although several analytical methods were developed for these compounds, they are not performed simultaneously. This study addresses the need for a sustainable, novel, analytical approach capable of simultaneously determining these diverse chemical classes in edible fish muscles. Employing ultrasound extraction coupled with dispersive solid-phase extraction (d-SPE) as a cleanup procedure, the method was compared to conventional techniques, revealing significant improvements. Analytical parameters were thoroughly assessed, and the innovative method demonstrated notable advantages, reducing extraction and purification times by approximately 74-80 % and solvent consumption by around 94-97 %. Applied to Mediterranean Sea fish samples, the results underscore the method's potential as a viable, sustainable alternative to traditional approaches, promising enhanced efficiency and reduced environmental impact.

Therapeutic effect of Corbrin (Bailing) capsule on patients with renal insufficiency: A meta-analysis

Objective

At present, there remains controversy regarding the clinical efficacy of Corbrin (Bailing) capsules in the treatment of renal insufficiency (RI). A meta-analytic approach was adopted in this study to assess the clinical efficacy of Corbrin capsules for treating RI, aiming to provide a certain level of clinical evidence to guide the selection of RI therapeutic interventions.

Methods

The meta-analysis was conducted on databases containing PubMed, CNKI, Weipu Database, Cochrane Library and Wanfang until January 2023. The search for relevant studies was conducted without language restrictions. The study encompassed a randomized controlled trial that examined the efficacy of Corbrin capsules in treating RI. Blood urea nitrogen (BUN), serum creatinine (Scr), 24-h urine protein quantity (24 h UPQ), and estimated creatinine clearance (ECC) were amalgamated using standardized mean difference (SMD) and its corresponding 95 % confidence interval (CI). Meanwhile, the treatment effect (TE) outcome was aggregated using odds ratio (OR) and its corresponding 95 % CI. To evaluate heterogeneity, the Q test and I2 statistics were employed within a random-effects model framework.

Results

A total of 11 eligible articles were included, involving 1100 patients (594 in the Corbrin capsule group and 516 in the control group). Compared with control subjects, the SMD was-1.3532 for Ser (95 % CI: 2.0617 to -0.6448), -1.7868 for UPQ (95 % CI: 2.8901 to -0.6836), -1.3302 for BUN (95 % CI: 2.2428 to -0.4176), and 1.7842 for ECC (95 % CI: 0.6774-2.8910). TE had an OR of 1.9786 (95 % CI: 0.7153-5.4734), and publications were not found to be biased (t = 0.5627, P = 0.6738).

Conclusion

In RI patients, Corbrin capsule has a relatively good therapeutic effect.

Unlocking the secrets: Volatile Organic Compounds (VOCs) and their devastating effects on lung cancer

Lung cancer (LCs) is still a serious health problem globally, with many incidences attributed to environmental triggers such as Volatile Organic Compounds (VOCs). VOCs are a broad class of compounds that can be released via various sources, including industrial operations, automobile emissions, and indoor air pollution. VOC exposure has been linked to an elevated risk of lung cancer via multiple routes. These chemicals can be chemically converted into hazardous intermediate molecules, resulting in DNA damage and genetic alterations. VOCs can also cause oxidative stress, inflammation, and a breakdown in the cellular protective antioxidant framework, all of which contribute to the growth of lung cancer. Moreover, VOCs have been reported to alter critical biological reactions such as cell growth, apoptosis, and angiogenesis, leading to tumor development and metastasis. Epidemiological investigations have found a link between certain VOCs and a higher probability of LCs. Benzene, formaldehyde, and polycyclic aromatic hydrocarbons (PAHs) are some of the most well-researched VOCs, with comprehensive data confirming their cancer-causing potential. Nevertheless, the possible health concerns linked with many more VOCs and their combined use remain unknown, necessitating further research. Identifying the toxicological consequences of VOCs in LCs is critical for establishing focused preventative tactics and therapeutic strategies. Better legislation and monitoring mechanisms can limit VOC contamination in occupational and environmental contexts, possibly reducing the prevalence of LCs. Developing VOC exposure indicators and analyzing their associations with genetic susceptibility characteristics may also aid in early identification and targeted therapies.

Development and validation of a modified QuEChERS method for extracting polychlorinated biphenyls and organochlorine pesticides from marine mammal blubber

The monitoring of legacy persistent organic pollutants (POPs) in blubber of key sentinel marine mammal species has been conducted using established techniques for decades. Although these methods for polychlorinated biphenyl (PCB) and organochlorine (OC) pesticide determination provide accurate and reproducible results, they possess some drawbacks in terms of cost, time, and a need for large volumes of toxic solvents. QuEChERS (quick, easy, cheap, effective, rugged, and safe) extractions may help address these issues, but have not been applied to marine mammal blubber/adipose. As such, our aim was to develop, validate, and apply a QuEChERS method for the extraction of PCB and OC contaminants in marine mammal blubber. First, we tested multiple solid-phase extraction and clean-up steps to find the approach that provided the cleanest extracts along with consistent and acceptable analyte recovery, accuracy, and precision. QuEChERS extractions followed by two enhanced matrix removal-lipid (EMR-lipid), one primary-secondary amine (PSA), and one silica gel clean-up showed the highest matrix removal and acceptable recoveries of spiked internal (62-97%) and external standards (61-94%). Solvent usage was reduced by ∼393% and extraction time was reduced by ∼25% (from 16 to 12 h). Next, the method was validated using standard reference material (SRM) NIST 1945. Recovery experiments on SRM (n = 5) showed acceptable recovery for 76% and 77% of PCBs and OC pesticides, respectively, and high precision for 73% and 69% of PCBs and OCs, respectively. Finally, the method was used on a set of southeast Greenland killer whales (n = 13), with previously published PCB and OC data. Bland-Altman plots indicated good agreement between QuEChERS and current-use methods for ΣPCBs and some OCs with no significant constant or proportional bias. These results demonstrate that this QuEChERS extraction method represents an effective, lower cost alternative to current-use extractions for PCBs and OCs in blubber, and likely other high-lipid samples.

Exposição ocupacional e câncer: uma revisão guarda-chuva

Resumo Objetivo: fornecer uma visão geral das associações entre exposição ocupacional e risco da ocorrência ou morte por câncer. Métodos: esta revisão guarda-chuva da literatura utilizou as bases Medline e Web of Science. A partir de protocolo de busca, foram incluídas metanálises para diversas circunstâncias ocupacionais e cânceres selecionados que possuíssem algum nível de evidência para associação com ocupação. Resultados: foram incluídas 37 metanálises, abrangendo 18 localizações de câncer. Considerando a avaliação da heterogeneidade dos estudos, da qualidade da evidência e da força de associação, obteve-se evidências altamente sugestivas de associações entre exposição a solvente e mieloma múltiplo; amianto e câncer de pulmão; hidrocarbonetos e câncer de trato aerodigestivo superior; e estresse ocupacional e câncer colorretal. Conclusão: há evidências robustas para associar exposições ocupacionais e tipos de câncer não previstos, inicialmente, nas orientações de vigilância do câncer relacionado ao trabalho no Brasil. Permanecem lacunas sobre exposições de grande relevância, que carecem de metanálises mais consistentes, por exemplo, exposição a poeiras inorgânicas e câncer de pulmão e mesotelioma; exposição a solventes e tumores hematológicos. Evidências de câncer em outras regiões anatômicas foram menos robustas, apresentando indícios de incerteza ou viés.

Occupational exposure and cancer: an umbrella review

Abstract Objective: to provide an overview of the associations between occupational exposure and risk of occurrence or death from cancer. Methods: this umbrella review used the Medline and Web of Science databases. Based on the search protocol, meta-analysis was included for several occupational circumstances and selected cancers that had some level of evidence associated with the occupation. Results: 37 meta-analysis were included, covering 18 cancer locations. By assessing the heterogeneity of studies, quality of evidence, and strength of association, results highly indicated associations between solvent exposure and multiple myeloma, asbestos and lung cancer, hydrocarbons and upper aerodigestive tract cancer, occupational stress and colorectal cancer. Conclusion: robust evidence shows an association between occupational exposures and types of cancer not initially foreseen in the guidelines for work-related cancer surveillance in Brazil. Gaps in relevant exposures require further research and more consistent meta-analysis, including: exposure to inorganic dust and lung cancer and mesothelioma; solvents and hematological tumors. Evidence of cancer in other anatomical regions was less robust, showing signs of uncertainty or bias.

Occupational Exposure and Multiple Myeloma Risk: An Updated Review of Meta-Analyses

The precise etiology of multiple myeloma remains elusive, but both genetic and environmental factors have been suggested to contribute to disease risk. Several occupational categories and toxic agents have been implicated as potentially causative, yet findings from the literature are inconsistent. The aim of this review was to summarize and critically comment on the accumulated epidemiological evidence, across published meta-analyses, about the association between occupational exposure and risk of multiple myeloma. Overall, results from eleven meta-epidemiological studies underscore a significantly increased risk for firefighters, hairdressers, and employees exposed to engine exhaust, whereas farming and methylene chloride exposure have been non-significantly correlated with the disease. Further epidemiological studies are of utmost importance whilst emphasis should be placed on occupational hazard surveillance, as such studies will obtain a more accurate picture of disease occurrence in working populations, and will enable both the implementation of preventive actions and the evaluation of their effectiveness.

Polymorphisms in CRYAA Promoter with Susceptibility to Cataract: A Meta-Analysis

AIM

Polymorphisms in alpha A crystallin (CRYAA) gene have been implicated in susceptibility to cataracts, but some published studies have reported inconclusive results. Our study aimed to conduct a meta-analysis investigating the association between polymorphisms in CRYAA and susceptibility to cataracts.

METHODS

The PubMed, Excerpta Medica Database, Cochrane Library and China National Knowledge Infrastructure were searched for all articles published up to 20 March 2019 that reported cataracts and three polymorphisms (rs3761381, rs13053109, and rs7278468) of CRYAA. Afterwards, statistical analysis was performed for available articles.

RESULTS

Four articles published between 2014 and 2017 were included, involving 869 cases and 1,950 controls. There was no statistical evidence of an association between cataract risk and CRYAA gene polymorphisms rs13053109 (p > .05) and rs3761382 (p > .05). Significant decreased cataract risks were observed for different gene models of rs7278468 polymorphism: for G vs T, OR = 0.6640; 95% CI, 0.5361-0.7736, p < .001; for GG vs TT, OR = 0.3864; 95% CI, 0.2379-0.6278, p < .001; for GG vs TT+GT, OR = 0.4492; 95% CI, 0.2829-0.7134, p = .001; for GG+GT vs TT, OR = 0.6645; 95% CI, 0.5058-0.8729, p = .003; for GT vs TT, OR = 0.7508; 95% CI, 0.5639-0.9996, p = .050.

CONCLUSION

Our meta-analysis indicated that rs3761382 and rs13053109 polymorphisms of CRYAA may not be associated with susceptibility to cataracts. Individuals carrying mutant genotype of rs7278468 polymorphism are associated with a significantly decreased cataract risk.

ABBREVIATIONS

CC: Congenital cataract; ARC: Age-related cataract; SNPs: single nucleotide polymorphisms; NOS: Newcastle-Ottawa Scale; HWE: Hardy-Weinberg equilibrium; OR: odds ratio; CI: confidence interval; qPCR: quantitative polymerase chain reaction; NO: nuclear opalescence; NC: nuclear color.

Development of a Questionnaire for the Search for Occupational Causes in Patients with Non-Hodgkin Lymphoma: The RHELYPRO Study

Non-Hodgkin lymphoma (NHL), multiple myeloma and chronic lymphocytic leukemia are possibly related to environmental and/or occupational exposure. The primary objective of this study was to develop a questionnaire for screening patients with these blood disorders who might benefit from a specialized consultation for possible recognition of the disease as an occupational disease. The study included 205 subjects (male gender, 67.3%; mean age, 60 years; NHL, 78.5%). The questionnaire performed very satisfactorily in identifying the exposures most frequently retained by experts for their potential involvement in the occurrence of NHL. Its sensitivity and specificity in relation to the final expertise were 96% and 96% for trichloroethylene, 85% and 82% for benzene, 78% and 87% for solvents other than trichloroethylene and dichloromethane, 87% and 95% for pesticides, respectively. Overall, 15% of the subjects were invited to ask National Social Insurance for compensation as occupational disease. These declarations concerned exposure to pesticides (64%), solvents (trichloroethylene: 29%; benzene: 18%; other than chlorinated solvents: 18%) and sometimes multiple exposures. In conclusion, this questionnaire appears as a useful tool to identify NHL patients for a specialized consultation, in order to ask for compensation for occupational disease.

Genetic polymorphisms in serine protease inhibitor Kazal-type 5 and risk of atopic dermatitis: A meta-analysis

BACKGROUND

This study aimed to investigate the role of serine protease inhibitor Kazal-type 5 (SPINK5) polymorphisms (Asn368Ser, Asp386Asn and Glu420Lys) and the risk of atopic dermatitis (AD).

METHODS

Studies associated with SPINK5 mutations and AD risk were searched from three databases, including PubMed, Embase, and Cochrane library, with a retrieval deadline of April 22, 2019. An odds ratio (OR) with a 95% confidence interval (95% CI) was chosen as the effect size. Egger's linear regression test was enrolled to assess the level of publication bias.

RESULTS

Overall, 6 studies met the inclusion criteria for meta-analysis. Significantly statistical differences were calculated between patients with AD and healthy individuals on Asn368Ser polymorphism in the allele model (G vs A: OR = 1.2643, 95% CI = 1.0666-1.4987, P = .0069), co-dominant model (GG vs AA: OR = 1.6609, 95% CI = 1.1736-2.3505, P = .0042; GA vs AA: OR = 1.5448, 95% CI = 1.1263-2.1189, P = .0070), and dominant model (GG+GA vs AA: OR = 1.5700, 95% CI = 1.1656-2.1146, P = .0030). However, no statistically significant difference was found in the recessive model for Asn368Ser and other genetic models for Asp386Asn and Glu420Lys (all P > .05). No significant publication bias was found.

CONCLUSION

The SPINK5 Asn368Ser polymorphism may be a risk factor for AD.

Association between tumor necrosis factor alpha gene polymorphisms and multiple myeloma risk: an updated meta-analysis

OBJECTIVE

This study aimed to investigate the relationship between tumor necrosis factor alpha (TNFα) polymorphisms and multiple myeloma (MM) risk.

METHODS

Eligible studies were retrieved from PubMed, the Cochrane Library, Embase, CNKI and the Wanfang database. Polymorphisms of TNFα-308 G/A, TNFα-857 C/T, and TNFα-238 G/A were analyzed based on the allele, recessive, dominant, and additive-dominant models. The meta-analysis was conducted using R 3.12 software. Odds ratio (OR) and 95% confidence intervals (CI) were used as evaluation indicators. Heterogeneity among studies was detected. Publication bias was evaluated. Sensitivity and power analyses were also conducted.

RESULTS

Significant associations existed between 'TT vs. CC' (OR = 2.3752, 95% CI = 1.1342-4.9740) and 'TT vs. CC + TC' (OR = 2.0802, 95% CI = 1.0250-4.2218) models of the TNFα-857 C/T gene and MM risk. There were no significant differences in other genetic models of TNFα-857 C/T or any genetic models of TNFα-308 G/A and TNFα-238 G/A. No significant publication bias existed among the studies. In addition, sensitivity analyses showed that meta-analysis results of all genetic models of the TNFα-238 G/A gene did not change after omitting one of these studies, but most models of TNFα-857 C/T and TNFα-308 G/A exhibited significant changes.

CONCLUSION

Our findings indicate that the 'TT vs. CC' and 'TT vs. CC + TC' of TNFα-857 C/T are correlated with MM risk. TNFα-857 C/T may be a risk factor for MM development. There is no association between TNFα-238/-308 polymorphisms and MM risk.

UGT1A1*28 gene polymorphism was not associated with the risk of neonatal hyperbilirubinemia: a meta-analysis

Background: This study aimed to evaluate the relationship between UGT1A1*28 gene polymorphism and the risk of neonatal hyperbilirubinemia (NHBI).Methods: The studies meet certain selection condition which was obtained from databases such as PubMed, Embase, and Cochrane Library. Newcastle-Ottawa Scale (NOS) was used to evaluate the quality of included studies. Meta-analysis was performed according to criteria such as country. Hardy-Weinberg's equilibrium (HWE) tests were performed on the control group using chi-square test, while the evaluation index was represented by odds ratio (OR) and 95% confidence interval (CI). Egger's test and sensitivity analysis were used to evaluate the publication bias and reliability, repetitively.Results: Totally, four studies with high overall quality were enrolled in this study. No association was observed between UGT1A1*28 gene polymorphisms and NHBI in allele model (TA7 versus TA6, OR (95% CI) = 2.13 (0.81-5.62), p = .13), codominance models (TA7/6 versus TA6/6, OR (95% CI) = 2.94 (0.90-9.57), p = .07; TA7/7 versus TA6/6, OR (95% CI) = 2.08 (0.37-11.52), p = .40), recessive model (TA7/7 versus TA6/6 + TA7/6, OR (95% CI) = 1.44 (0.41-5.14), p = .57), and dominant model (TA7/7 + TA7/6 versus TA6/6, OR (95% CI) = 2.92 (0.84-10.12), p = .09). Furthermore, there was no publication bias found in current meta-analysis.Conclusions: Gene polymorphism of UGT1A1*28 might not be associated with the risk of NHBI.

Inhalation exposure to volatile organic compounds in the printing industry

This study reports on the occupational inhalation exposure to VOCs of workers in the Kuwaiti printing industry. Using the evacuated canister methodology, we targeted 72 VOCs in three printeries and compared the concentrations to previous reports and relevant occupational exposure levels (OELs). We found that recent efforts in the printing industry to reduce VOC usage had been successful, as concentrations of key hazardous VOCs were substantially lower than anticipated. On the other hand, nearly all target VOCs were found. Non-production areas were sampled along with the offset printing areas, another strength of this study, and revealed exposures to hazardous VOCs among administers and digital printer and CTP operators. Exposure to ototoxic VOCs amounted to 1-3% of the OEL, consisting mostly of ethylbenzene, which was likely in use in two of the study printeries. Exposure to carcinogenic or probably carcinogenic VOCs was 15-20% of the OEL at four locations across the three printeries, consisting mostly of vinyl chloride and benzyl chloride. Vinyl chloride VOC was partially sourced from outdoors, but was also likely used inside the study printeries. Interestingly, concentrations of vinyl chloride were similar in most sampling locations to that of CFC-114, a CFC banned by the Montreal Protocol and not commonly used as a refrigerant. This unexpected finding suggests further study is warranted to identify the use of these VOCs in printeries. Exposure to hazardous VOCs up to nearly 50% of the OEL, consisting largely of bromoform and vinyl chloride. Bromoform was found in all the study printeries, sourced partially from outdoor air. The higher concentrations found inside the study printeries likely resulted from the use of the desalinated water for washing. This finding raises of emissions from sources other than blanket washes, and inks, etc. adding to the total VOC load in printery indoor air. Implications: Results from this study indicate that efforts to reduce worker exposure to VOCs particularly dangerous to human health in recent years have been successful, but there is still much to be done to protect workers. Exposures to ototoxic and carcinogenic VOCs were identified, among both production and non-production workers. Unexpected findings included the apparent use in printing activities of the carcinogen vinyl chloride and CFC-114, banned under the Montreal Protocol. Observed lapses in safety procedures included failure to utilize ventilation systems and closing doors between work areas, indicating management and worker education should remain a priority.

Comparison of efficacy of robotic surgery, laparoscopy, and laparotomy in the treatment of ovarian cancer: a meta-analysis

BACKGROUND

We intended to compare the clinical effect of robotic surgery with laparoscopy and laparotomy in ovarian cancer treatment.

METHODS

The included studies were retrieved from PubMed, Embase, and the Cochrane Library databases. The Methodological Index for Nonrandomized Studies (MINORS) was used to evaluate the study quality. Effect measures were presented with weighted mean difference (WMD)/odds ratio (OR) and 95% confidence interval (CI), and heterogeneity test was assessed using Q test and I2 statistics to determine the use of the random effects model or fixed effects model. Egger's test was used to assess the publication bias.

RESULTS

A total of eight studies was included in this meta-analysis with a MINORS score of 16-18. In the random effects model, estimated blood loss (EBL) of robotic surgery was significantly less compared with laparotomy (WMD = - 521.7027, 95% CI - 809.7816; - 233.6238). In the fixed effects model, length of hospital stay (LHS) (WMD = - 5.2225, 95% CI - 6.1485; - 4.2965) and postoperative complication (PC) (OR = 0.4710, 95% CI 0.2537; 0.8747) of robotic surgery were significantly less, and overall survival (OS) rate (OR = 6.4355, 95% CI 1.6722; 24.7678, P = 0.0070) of robotic surgery was significantly higher compared with laparotomy. There was no difference in the effect size of all variables between robotic surgery and laparoscopy. Meanwhile, a publication bias (t = 6.8290, P = 0.002405) was only identified for PC in robotic surgery and laparotomy groups; no publication bias was identified for the other variables.

CONCLUSIONS

Despite the above results, it failed to show oncological safety and recurrence by pathological stages or histologic types in this meta-analysis, and those confounding factors might affect the clinical outcome. Future meta-analyses with a larger number of eligible randomized controlled trial studies were needed to determine the most suitable treatment method for patients with different stages and types of ovarian cancer.

Association Between IL-6 Polymorphisms and Diabetic Nephropathy Risk: A Meta-analysis

BACKGROUND

The objective of this work was to evaluate the relevance of frequent interleukin-6 (IL-6) polymorphisms and diabetic nephropathy (DN) susceptibility by a systematic meta-analysis.

MATERIALS AND METHODS

The included studies related to the relationship between IL-6 and DN risk were searched from Pubmed, Embase and the Cochrane Library, and the Newcastle-Ottawa Scale was used to evaluate the study quality. A heterogeneity test was performed to determine the appropriate effect models based on the Q test and I² statistic. Odds ratios with 95% confidence intervals were used to determine the strength of associations. Afterwards, subgroup analysis was conducted to assess the effect of specific factors on the corresponding results. Additionally, publication bias and sensitivity analysis were also undertaken.

RESULTS

In total, 11 eligible articles were obtained. The meta-analysis revealed that the "C"allele of IL-6 rs1800795 was related to the decreased risk of DN (C versus G: P = 0.0471). The "G"allele of IL-6 rs1800796 was predominately associated with higher DN risks (GG versus CC: P = 0.0194; GG versus CC + GC: P = 0.0196). The "C"allele of IL-6 rs1800797 was implicated with higher prevalence of DN (C versus G: P = 0.0001; CC versus GG: P = 0.0003; CC versus GG + CG: P = 0.0227; CC + CG versus GG: P = 0.0001) while IL-6 rs2069837 and rs2069840 were not correlated with the susceptibility to DN.

CONCLUSIONS

This meta-analysis indicated that IL-6 rs1800795, rs1800796 and rs1800797 played important roles in DN development while IL-6 rs2069837 and rs2069840 might not be related to DN.

Occupational Risk Factors for Prostate Cancer: A Meta-analysis

Prostate cancer is the second most common cancer in men worldwide. There are many occupational factors that have been suggested to cause prostate cancer. Our aim was to evaluate the evidence for causality by a literature review of occupational factors. We searched literature in Medline and SCOPUS from 1966 to June 30, 2015 to identify occupational risk factors for prostate cancer. The following risk factors were selected: farmers/agricultural workers, pesticides - whole group, and separately organophosphate and organochlorine pesticides, carbamates and triazines, cadmium, chromium, cutting fluids, acrylonitrile, rubber manufacturing, whole body vibration, shift work, flight personnel, ionizing radiation, and occupational physical activity. For each factor a literature search was performed and presented as meta-analysis of relative risk and heterogeneity (Q and I2 index). A total of 168 original studies met the inclusion criteria with 90,688 prostate cancer cases. Significantly increased risks were observed for the following occupational exposures: pesticides (metaRR = 1.15, 95% confidence interval [CI] = 1.01-1.32; I2 = 84%), and specifically group of organochlorine pesticides (meta relative risk [metaRR] = 1.08, 95% CI = 1.03-1.14; I2 = 0%), chromium (metaRR = 1.19, 95% CI = 1.07-1.34; I2 = 31%), shift work (metaRR = 1.25, 95% CI = 1.05-1.49; I2 = 78%) and pilots (metaRR = 1.41, 95% CI = 1.02-1.94; I2 = 63%) and occupational physical activity in cohort studies (metaRR = 0.87, 95% CI = 0.81-0.94; I2 = 0%). The literature review supports a causal association for a few of the previously suggested factors.

Association of LIPC -250G/A and -514C/T polymorphisms and hypertension: a systematic review and meta-analysis

Background

Hypertension is the most common chronic disease, and most important risk factor for cardiovascular disease. This meta-analysis aimed to explore the association between hepatic lipase gene (LIPC) gene -250G/A (rs2070895) and -514C/T (rs1800588) polymorphisms and the susceptibility to hypertension.

Methods

Published studies were searched using the PubMed, Embase and Cochrane Library databases. Newcastle-Ottawa Scale (NOS) was used to assess the quality of the included studies. Sensitivity analysis was performed using “leave one out” method. Egger’s test was used to evaluate the publication bias. The random effect model was used to calculate the pooled effect size if P < 0.05 or I² ≥ 50%; otherwise, the fixed effect model was selected.

Results

Four eligible studies, including 2599 participants, were enrolled in the included studies from 2007 to 2014. Quality evaluation revealed that each study had high NOS scores ranged from 5 to 7. The LIPC rs1800588 polymorphism was not found to be associated with the susceptibility to hypertension under all genetic models (T vs C, P = 0.38; CT vs CC, P = 0.46; TT vs CC, P = 0.38; TT vs CC + CT, P = 0.54; TT + CT vs CC, P = 0.34). Notably, the frequencies of the AA+GA genotypes of LIPC rs2070895 polymorphism were related to an increased risk of hypertension (AA+GA vs. GG, OR = 1.1954, 95% CI: 1.0001–1.4288, P = 0.05).

Conclusion

The LIPC rs2070895 polymorphism was found to be related to an increased risk of hypertension. However, LIPC rs1800588 polymorphism was not associated with the susceptibility to hypertension.

The relationship between apolipoprotein genes polymorphisms and susceptibility to osteonecrosis of the femoral head: a meta-analysis

Background

The objective of this study was to evaluate whether apolipoprotein gene polymorphisms confer susceptibility to osteonecrosis of the femoral head (ONFH).

Methods

The relevant literature was screened from databases of Pubmed, Embase, Wanfang, Weipu and China National Knowledge Internet (CNKI) until May, 2017. In addition, odds ratio (OR) and its corresponding 95% confidence interval (CI) were used as a measure of effect size for calculating effect size.

Results

Totally, six case-control studies were included in this meta-analysis. It revealed that ApoB-C7623T polymorphism frequency was increased in ONFH group than in control group under three genetic models, including allele model (T vs. C, OR = 4.5149, 95% CI: 1.6968–12.0134); additive model (TC vs. CC, OR = 6.2515, 95% CI: 2.0939–18.6640); and dominant model (TT + TC vs. CC, OR = 5.4998, 95% CI: 1.9246–15.7163). In addition, the increased risk of ONFH were related to ApoA1-rs1799837 polymorphism under additive model (AA vs. GG, OR = 1.4175, 95% CI: 1.0522–1.9096) and recessive model (AA vs. GG + AG, OR = 1.7727, 95% CI: 1.3399–2.3452). However, four ApoB rs1042031, rs693, 3’-VNTR and G12619A polymorphisms under the all genetic models were not associated with susceptibility to ONFH.

Conclusion

The T allele and TC genotype of ApoB-C7623T and AA genotype of ApoA1-rs1799837 may contribute to increase the risk of ONFH.

Case–control study to assess the association between colorectal cancer and selected occupational agents using INTEROCC job exposure matrix

Background

Colorectal cancer is the third most prevalent cancer in the world and is twice as common in developed countries when compared with low-income and middle-income countries. Few occupational risk factors for colorectal cancer have been identified. This case–control study aimed to assess the association between colorectal cancer and occupational exposure to selected solvents, combustion products, metals, dusts and other agents.

Methods

Cases (n=918) were enrolled from the Western Australian Cancer Registry from June 2005 to August 2007. Controls (n=1021) were randomly selected from the Western Australian electoral roll. We collected lifetime occupational history from cases and controls, in addition to their demographic and lifestyle characteristics. We applied the INTEROCC job exposure matrix to convert the occupational history to occupational exposure for 18 selected agents. Three exposure indices were developed: (1) exposed versus non-exposed; (2) lifetime cumulative exposure; and (3) total duration of exposure. The associations between colorectal cancer and the selected agents were estimated using logistic regression models adjusting for sex and age.

Results

None of the 18 selected agents showed an association with colorectal cancer. No dose–response relationships with lifetime cumulative exposure or duration of exposure were observed.

Conclusion

There was no evidence to suggest that occupational exposure to 18 selected agents increased the risk of colorectal cancer.

Smoking increases the risk of diabetic foot amputation: A meta-analysis

Accumulating evidence suggests that smoking is associated with diabetic foot amputation. However, the currently available results are inconsistent and controversial. Therefore, the present study performed a meta-analysis to systematically review the association between smoking and diabetic foot amputation and to investigate the risk factors of diabetic foot amputation. Public databases, including PubMed and Embase, were searched prior to 29th February 2016. The heterogeneity was assessed using the Cochran's Q statistic and the I² statistic, and odds ratio (OR) and 95% confidence interval (CI) were calculated and pooled appropriately. Sensitivity analysis was performed to evaluate the stability of the results. In addition, Egger's test was applied to assess any potential publication bias. Based on the research, a total of eight studies, including five cohort studies and three case control studies were included. The data indicated that smoking significantly increased the risk of diabetic foot amputation (OR=1.65; 95% CI, 1.09-2.50; P<0.0001) compared with non-smoking. Sensitivity analysis demonstrated that the pooled analysis did not vary substantially following the exclusion of any one study. Additionally, there was no evidence of publication bias (Egger's test, t=0.1378; P=0.8958). Furthermore, no significant difference was observed between the minor and major amputation groups in patients who smoked (OR=0.79; 95% CI, 0.24-2.58). The results of the present meta-analysis suggested that smoking is a notable risk factor for diabetic foot amputation. Smoking cessation appears to reduce the risk of diabetic foot amputation.

Association between ADAM metallopeptidase domain 33 gene polymorphism and risk of childhood asthma: a meta-analysis

This study aimed to investigate the association between ADAM metallopeptidase domain 33 (ADAM33) gene polymorphisms and the risk of childhood asthma. The relevant studies about the relationship between ADAM33 gene polymorphisms and childhood asthma were searched from electronic databases and the deadline of retrieval was May 2016. The single nucleotide polymorphisms (SNPs) of ADAM33 (rs511898, rs2280092, rs3918396, rs528557, rs2853209, rs44707, rs2280091 and rs2280089) were analyzed based on several models including the allele, codominant, recessive and dominant models. The results showed that the ADAM33 rs2280091 polymorphism in all four genetic models was associated with an increased risk of childhood asthma. Positive associations were also found between the polymorphisms rs2280090, rs2787094, rs44707 and rs528557 and childhood asthma in some genetic models. This meta-analysis suggested that ADAM33 polymorphisms rs2280091, rs2280090, rs2787094, rs44707 and rs528557 were significantly associated with a high risk of childhood asthma.

Occupational exposures and the risk of amyotrophic lateral sclerosis

OBJECTIVES

To examine the associations of specific occupations and occupational exposures with the risk of amyotrophic lateral sclerosis (ALS) in the Swedish population.

METHODS

A nested case-control study was conducted in Sweden. Patients with ALS diagnosed during 1991-2010 (n=5020) were identified from the National Patient Register and 5 controls per case (n=25 100) were randomly selected from the general Swedish population, individually matched to cases by birth year and sex. Occupational history was obtained from the Swedish censuses in 1970, 1980 and 1990. The Nordic Occupational Cancer Study Job Exposure Matrix was used to identify exposures related to individual occupations. Conditional logistic regression was used to estimate ORs and their 95% CIs.

RESULTS

Higher risk of ALS was associated with precision-tool manufacturing (OR 1.68, 95% CI 1.11 to 2.52) and glass, pottery and tile work (OR 1.76, 95% CI 1.03 to 3.00), whereas lower risk was associated with textile work (OR 0.44, 95% CI 0.21 to 0.91). None of the examined occupational exposures were associated with ALS risk overall. However, among individuals younger than 65 years of age, an association with a higher risk of ALS was found for formaldehyde (OR 1.29, 95% CI 1.00 to 1.65), and an association with a lower risk of ALS was found for methylene chloride (OR 0.49, 95% CI 0.26 to 0.93).

CONCLUSIONS

We identified several occupations and occupational exposures that may be associated with the risk of ALS in Sweden. Occupational history obtained from censuses every 10 years remains a limitation of the study.

Body concentrations of persistent organic pollutants and prostate cancer: a meta-analysis

There have been some concerns that persistent organic pollutants (POPs) may be associated with the risk of prostate cancer. Meta-analyses have not yet investigated the association between human-biomonitoring data for POPs and prostate cancer risk. The purpose of this study was to assess the association between body concentration of individual compounds or mixtures of POPs and prostate cancer risk in the general population by performing a meta-analysis. A literature search was performed using PubMed, EMBASE, and KoreaMed from the period 1950 through 2014. The odds ratio (OR) and its 95% confidence interval (CI) of prostate cancer associated with POPs were estimated using fixed-effects model or random-effects model where appropriate. Dose-response relationships were assessed by using the generalized least-squares method for trend estimation. A total of eight (six case-control, one cross-sectional, one nested case-control) studies including 1158 prostate cancer cases among 6932 subjects were selected for the meta-analysis. Total POPs of interest showed positive associations with statistical significance on prostate cancer (OR 1.31, 95% CI 1.13, 1.57). In dose-response meta-analysis, 1 μg/g lipid of PCBs was found to be associated with a 49% increased risk of prostate cancer (OR 1.49, 95% CI 1.07, 2.06). One nanogram per gram (1000 μg/g) lipid of trans-nonachlor was found to be associated with approximately 2% increased risk of prostate cancer (OR = 1.02/1 ng/g lipid of trans-nonachlor, 95% CI 1.00, 1.03). The available evidence suggests that body concentrations of POPs are positively associated with prostate cancer risk, which implies valuable evidence for prostate cancer prevention.

Risk Factors for Multiple Myeloma: A Systematic Review of Meta-Analyses

The epidemiology of multiple myeloma (MM) is an increasingly investigated field, with many controversies. This systematic review aims to synthesize meta-analyses examining risk factors for MM so as to provide a comprehensive, parsimonious summary of the current evidence. Eligible meta-analyses were sought in PubMed adopting a predefined algorithm, without any restriction of publication language; end-of-search date was October 10, 2014. The selection of eligible studies and data extraction were performed by working in pairs, independently and blindly to each other; in case of disagreement, consensus with the whole team was reached. Among the 22 ultimately included meta-analyses, 9 examined occupational factors, 4 assessed aspects of lifestyle (smoking, alcohol, body mass index), 5 evaluated the presence of other diseases, and 4 addressed genetic factors as potential risk factors of MM. A vast compendium of significant associations arose, including farming, occupation as a firefighter, occupation as a hairdresser, exposures to chemicals or pesticides, overweight and obesity, patterns of alcohol intake, pernicious anemia, ankylosing spondylitis, gene promoter methylation, and polymorphisms. In conclusion, MM is a multifactorial disease, encompassing a wide variety of risk factors that span numerous life aspects. Further accumulation of evidence through meta-analyses is anticipated in this rapidly growing field.

Risk factors for pancreatic cancer: a summary review of meta-analytical studies

BACKGROUND

The aetiology of pancreatic cancer (PC) has been extensively studied and is the subject of numerous meta-analyses and pooled analyses. We have summarized results from these pooled and meta-analytical studies to estimate the fraction of PCs attributable to each of the identified risk factors.

METHODS

Using a comprehensive strategy, we retrieved 117 meta-analytical or pooled reports dealing with the association between specific risk factors and PC risk. We combined estimates of relative risk and estimates of exposure to calculate the fraction of PCs caused or prevented by a particular exposure.

RESULTS

Tobacco smoking ('strong' evidence) and Helicobacter pylori infection ('moderate' evidence) are the major risk factors associated with PC, with respective estimated population attributable fractions of 11-32% and 4-25%. The major protective factors are history of allergy ('strong' evidence) and increasing fruit or folate intake ('moderate' evidence), with respective population preventable fractions of 3-7% and 0-12%.

CONCLUSIONS

We summarized results of 117 meta-analytical or pooled data reports dealing with 37 aetiological exposures, to obtain robust information about the suspected causes of PC. By combining these estimates with their prevalences in the population, we calculated population attributable or population preventable fractions. About two-thirds of the major risk factors associated with PC are potentially modifiable, affording a unique opportunity for preventing one of our deadliest cancers.