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Onyije FM, Hosseini B, Togawa K, Schüz J, Olsson A. Cancer Incidence and Mortality among Petroleum Industry Workers and Residents Living in Oil Producing Communities: A Systematic Review and Meta-Analysis. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:4343. [PMID: 33923944 PMCID: PMC8073871 DOI: 10.3390/ijerph18084343] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/09/2021] [Revised: 04/14/2021] [Accepted: 04/16/2021] [Indexed: 12/28/2022]
Abstract
Petroleum extraction and refining are major sources of various occupational exposures and of air pollution and may therefore contribute to the global cancer burden. This systematic review and meta-analysis is aimed at evaluating the cancer risk in petroleum-exposed workers and in residents living near petroleum facilities. Relevant studies were identified and retrieved through PubMed and Web of Science databases. Summary effect size (ES) and 95% confidence intervals (CI) were analysed using random effect models, and heterogeneity across studies was assessed (I2). Overall, petroleum industry work was associated with an increased risk of mesothelioma (ES = 2.09, CI: 1.58-2.76), skin melanoma (ES = 1.34, CI: 1.06-1.70 multiple myeloma (ES =1.81, CI: 1.28-2.55), and cancers of the prostate (ES = 1.13, Cl: 1.05-1.22) and urinary bladder (ES = 1.25, CI: 1.09-1.43) and a decreased risk of cancers of the esophagus, stomach, colon, rectum, and pancreas. Offshore petroleum work was associated with an increased risk of lung cancer (ES = 1.20; 95% CI: 1.03-1.39) and leukemia (ES = 1.47; 95% CI: 1.12-1.92) in stratified analysis. Residential proximity to petroleum facilities was associated with childhood leukemia (ES = 1.90, CI: 1.34-2.70). Very few studies examined specific exposures among petroleum industry workers or residents living in oil producing communities. The present review warrants further studies on specific exposure levels and pathways among petroleum-exposed workers and residents living near petroleum facilities.
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Affiliation(s)
- Felix M. Onyije
- Environment and Lifestyle Epidemiology Branch, International Agency for Research on Cancer (IARC/WHO), 150 Cours Albert Thomas, CEDEX 08, 69372 Lyon, France; (B.H.); (K.T.); (J.S.); (A.O.)
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Mundt KA, Dell LD, Boffetta P, Beckett EM, Lynch HN, Desai VJ, Lin CK, Thompson WJ. The importance of evaluating specific myeloid malignancies in epidemiological studies of environmental carcinogens. BMC Cancer 2021; 21:227. [PMID: 33676443 PMCID: PMC7936449 DOI: 10.1186/s12885-021-07908-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2020] [Accepted: 02/12/2021] [Indexed: 11/10/2022] Open
Abstract
INTRODUCTION Although myelodysplastic syndrome (MDS), acute myeloid leukemia (AML), myeloproliferative neoplasms (MPN) - including chronic myeloid leukemia (CML) - and myelodysplastic/myeloproliferative neoplasms (MDS/MPN) are largely clinically distinct myeloid malignancies, epidemiological studies rarely examine them separately and often combine them with lymphoid malignancies, limiting possible etiological interpretations for specific myeloid malignancies. METHODS We systematically evaluated the epidemiological literature on the four chemical agents (1,3-butadiene, formaldehyde, benzene, and tobacco smoking, excluding pharmaceutical, microbial and radioactive agents, and pesticides) classified by the International Agency for Research on Cancer as having sufficient epidemiological evidence to conclude that each causes "myeloid malignancies." Literature searches of IARC Monographs and PubMed identified 85 studies that we critically assessed, and for appropriate subsets, summarized results using meta-analysis. RESULTS Only two epidemiological studies on 1,3-butadiene were identified, but reported findings were inadequate to evaluate specific myeloid malignancies. Studies on formaldehyde reported results for AML and CML - and not for MDS or MPN - but reported no increased risks. For benzene, several specific myeloid malignancies were evaluated, with consistent associations reported with AML and MDS and mixed results for CML. Studies of tobacco smoking examined all major myeloid malignancies, demonstrating consistent relationships with AML, MDS and MPN, but not with CML. CONCLUSIONS Surprisingly few epidemiological studies present results for specific myeloid malignancies, and those identified were inconsistent across studies of the same exposure, as well as across chemical agents. This exercise illustrates that even for agents classified as having sufficient evidence of causing "myeloid malignancies," the epidemiological evidence for specific myeloid malignancies is generally limited and inconsistent. Future epidemiological studies should report findings for the specific myeloid malignancies, as combining them post hoc - where appropriate - always remains possible, whereas disaggregation may not. Furthermore, combining results across possibly discrete diseases reduces the chances of identifying important malignancy-specific causal associations.
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Affiliation(s)
| | - L D Dell
- Ramboll US Consulting Inc., Amherst, MA, USA
| | - P Boffetta
- Stony Brook Cancer Center, Stony Brook, NY, USA
- Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy
| | | | | | - V J Desai
- Mount Sinai Hospital, New York, NY, USA
| | - C K Lin
- Cardno ChemRisk, Boston, MA, USA
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Vujic I, Gandini S, Stanganelli I, Fierro MT, Rappersberger K, Sibilia M, Tosti G, Ferrucci PF, Caini S, De Felici MB, Pagliarello C, Quaglino P, Sanlorenzo M. A meta-analysis of melanoma risk in industrial workers. Melanoma Res 2020; 30:286-296. [DOI: 10.1097/cmr.0000000000000531] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Systematic Review and Meta-Analysis of Selected Cancers in Petroleum Refinery Workers. J Occup Environ Med 2019; 60:e329-e342. [PMID: 29985303 DOI: 10.1097/jom.0000000000001336] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
Abstract
OBJECTIVE We studied the risk of 11 cancers of a priori interest in petroleum refinery workers. METHODS Iterative searches identified 36 studies for the 11 cancer sites. Statistical heterogeneity and publication bias were assessed to enhance interpretation of meta-relative risks. RESULTS Statistical heterogeneity was marked for mesothelioma, but was largely due to study quality. Higher quality studies showed a meta-relative risk (RR) of 3.22, (95% prediction interval 1.45 to 7.23). Melanoma (meta-RR = 1.23) and acute lymphoid leukemia (meta-RR = 1.51), showed results consistent with higher risk, but both were driven by one or two studies. Eight other cancer outcomes showed summary meta-RR's consistent with unity. CONCLUSIONS Most cancer outcomes are consistent with background risk in refinery workers. This work has clarified an excess mesothelioma risk, conditional on study quality stratification. Continued surveillance is warranted for melanoma and ALL.
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Shen R, Ye ZC, Gao J, Hou YP, Ye H. Climate change risk perception in global: Correlation with petroleum and liver disease: A meta-analysis. ECOTOXICOLOGY AND ENVIRONMENTAL SAFETY 2018; 166:453-461. [PMID: 30296610 DOI: 10.1016/j.ecoenv.2018.09.080] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/03/2018] [Revised: 09/15/2018] [Accepted: 09/18/2018] [Indexed: 06/08/2023]
Abstract
BACKGROUND Liver diseases have been bound to environmental factors, inclusive of air pollution. The exposure of workers to petrochemicals counts as a possible cause of Liver diseases, whereas results are inconsistent with the previous studies. In this study, a meta-analysis is conducted to assess the pooled risk. METHODS AND FINDING A systematic search was performed by related researchers. Correlations are analyzed among petroleum and liver cirrhosis mortality, fatty liver, alanine amino transferase (abbreviated as ALT), aspartate amino transferase (abbreviated as AST). Pooled risk ratios (RR) with 95% confidence interval (CI) and effect size(ES) with 95% confidence interval are calculated. Sensitivity analysis and publication bias are also tested. Data are analyzed from 5 studies involving 296 participants. Results are incorporated through adopting a random effects meta-analysis. Working in a petrochemical plant shall not increase the death risk posed by cirrhosis (RR = 0.44, 95% CI [0.36; 0.54]). Yet the incidence of fatty liver increases (RR = 1.22, 95% CI [1.21; 1.23]). Abnormal incidence of ALT and AST also increases. CONCLUSIONS Occupational exposure plays an important role in causing ALT abnormalities and fatty liver among oil workers, but not a risk factor of cirrhosis, AST abnormalities and liver cancer.
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Affiliation(s)
- Renze Shen
- Department of Stomatology, Zhongshan Hospital of Xiamen University, Medical College of Xiamen University, Xiamen University, Xiamen 361000, China
| | - Zhan Chao Ye
- Department of Stomatology, Zhongshan Hospital of Xiamen University, Medical College of Xiamen University, Xiamen University, Xiamen 361000, China
| | - Jie Gao
- Department of Endodontics, Guangzhou Medical University, 195 Dongfeng West Road, Guangzhou 510000, China
| | - Ye-Po Hou
- College of Stomatology, Southern Medical University, 1838 Guangzhou Avenue North, Guangzhou 510515, China
| | - Haicheng Ye
- Department of rehabilitation medicine, First Hospital Affiliated to Xiamen University, Xiamen, 361003 Fujian Province, China
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Leso V, Capitanelli I, Lops EA, Ricciardi W, Iavicoli I. Occupational chemical exposure and diabetes mellitus risk. Toxicol Ind Health 2016; 33:222-249. [DOI: 10.1177/0748233715624594] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
Diabetes mellitus (DM) is a group of metabolic diseases that may originate from an interaction between genetic and lifestyle risk factors. However, the possible role of occupational chemical exposures in the disease development and progression remains unclear. Therefore, this review aimed to provide a comprehensive evaluation of the relationship between occupational exposure to specific chemical substances or industrial activities and DM morbidity and mortality outcomes. Although some positive findings may support the diabetogenic role of certain pesticides and dioxins in different workplaces, the variable conditions of exposure, the lack of quantitative environmental or biological monitoring data and the different outcomes evaluated do not allow defining a specific exposure-disease causality. Therefore, further epidemiological studies will be necessary to adequately assess modes of action for different substances, dose–response relationships as well as individual susceptibility factors potentially affecting the exposure-disease continuum. Overall, this appears important to adequately assess, communicate and manage risks in occupational chemical exposure settings with the aim to protect workers and build healthier job conditions for diabetic employees.
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Affiliation(s)
- Veruscka Leso
- Institute of Public Health, Section of Occupational Medicine, Catholic University of the Sacred Heart, Rome, Italy
| | - Ilaria Capitanelli
- Institute of Public Health, Section of Occupational Medicine, Catholic University of the Sacred Heart, Rome, Italy
| | - Erika Alessandra Lops
- Institute of Public Health, Section of Occupational Medicine, Catholic University of the Sacred Heart, Rome, Italy
| | - Walter Ricciardi
- Institute of Public Health, Section of Hygiene, Catholic University of the Sacred Heart, Rome, Italy
| | - Ivo Iavicoli
- Department of Public Health, Section of Occupational Medicine, University of Naples Federico II, Naples, Italy
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Koh DH, Chung EK, Jang JK, Lee HE, Ryu HW, Yoo KM, Kim EA, Kim KS. Cancer incidence and mortality among temporary maintenance workers in a refinery/petrochemical complex in Korea. INTERNATIONAL JOURNAL OF OCCUPATIONAL AND ENVIRONMENTAL HEALTH 2014; 20:141-5. [PMID: 24999849 DOI: 10.1179/2049396714y.0000000059] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
Abstract
BACKGROUND Petrochemical plant maintenance workers are exposed to various carcinogens such as benzene and metal fumes. In Korea, maintenance operations in petrochemical plants are typically performed by temporary employees hired as contract workers. OBJECTIVES The purpose of this retrospective study was to evaluate cancer risk in temporary maintenance workers in a refinery/petrochemical complex in Korea. METHODS Subjects consisted of 14 698 male workers registered in a regional petrochemical plant maintenance workers union during 2002-2007. Cancer mortality and incidence were identified by linking with the nationwide death and cancer registries during 2002-2007 and 2002-2005, respectively. Standardized mortality ratios (SMRs) and standardized incidence ratios (SIRs) were calculated for each cancer. RESULTS Increased SMR 3·61 (six cases, 95% CI: 1·32-7·87) and SIR 3·18 (five cases, 95% CI: 1·03-7·42) were observed in oral and pharyngeal cancers. CONCLUSION Our findings may suggest a potential association between oral and pharyngeal cancers and temporary maintenance jobs in the petrochemical industry. Future studies should include a longer follow-up period and a quantitative exposure assessment.
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Keenan JJ, Gaffney S, Gross SA, Ronk CJ, Paustenbach DJ, Galbraith D, Kerger BD. An evidence-based analysis of epidemiologic associations between lymphatic and hematopoietic cancers and occupational exposure to gasoline. Hum Exp Toxicol 2013; 32:1007-27. [PMID: 23739846 DOI: 10.1177/0960327113476909] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
The presence of benzene in motor gasoline has been a health concern for potential increased risk of acute myelogenous leukemia and perhaps other lymphatic/hematopoietic cancers for approximately 40 years. Because of the widespread and increasing use of gasoline by consumers and the high exposure potential of occupational cohorts, a thorough understanding of this issue is important. The current study utilizes an evidence-based approach to examine whether or not the available epidemiologic studies demonstrate a strong and consistent association between occupational exposure to gasoline and lymphatic/hematopoietic cancers. Among 67 epidemiologic studies initially identified, 54 were ranked according to specific criteria relating to the relevance and robustness of each study for answering the research question. The 30 highest-ranked studies were sorted into three tiers of evidence and were analyzed for strength, specificity, consistency, temporality, dose-response trends and coherence. Meta statistics were also calculated for each general and specific lymphatic/hematopoietic cancer category with adequate data. The evidence-based analysis did not confirm any strong and consistent association between occupational exposure to gasoline and lymphatic/hematopoietic cancers based on the epidemiologic studies available to date. These epidemiologic findings, combined with the evidence showing relatively low occupational benzene vapor exposures associated with gasoline formulations during the last three decades, suggest that current motor gasoline formulations are not associated with increased lymphatic/hematopoietic cancer risks related to benzene.
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Cirera L, Cirarda F, Palència L, Estarlich M, Montes-Martínez A, Lorenzo P, Daponte-Codina A, López-Abente G. Mortality due to haematological cancer in cities close to petroleum refineries in Spain. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2013; 20:591-596. [PMID: 22996818 DOI: 10.1007/s11356-012-1152-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/14/2012] [Accepted: 08/27/2012] [Indexed: 06/01/2023]
Abstract
Controversy exists as to whether working or living in the vicinity of a petroleum refinery (RF) increases the risk of haematological cancer (HC). The European Pollutant Release and Transfer Register obliges petroleum refineries to notify their emissions of toxic substances which include carcinogenic substances. Our objective is to determine if living in the proximity of an RF is associated with a greater risk of mortality due to HC in the census tracts (CTs) of the Spanish cities of Bilbao, Cartagena, Castellón, La Coruña, Huelva, and Santa Cruz de Tenerife. This is an ecological study of mortality in the years 1996-2007 which includes 968 CTs with 1,263,371 inhabitants. Exposure has been measured as the distance from the centroid of each CT to the RF. The Besag-York-Mollié autoregressive spatial model has been fitted by R-INLA to estimate the relative risk (RR) and 95 % credible intervals (95 % CrI) for distance in quintiles. The most distant quintile has been taken as the reference. A total of 2,574 persons died of HC. The distances from the CTs to RFs ranged from 0.5 to 22.5 km (median = 7.6 km). All of the RRs for the quintiles of distances in Huelva were greater than 1. Statistically significant excess risk was shown in Cartagena in the nearest CT (1.8 to 6.8 km; RR = 1.43, 95 % CrI 1.02 to 2.02). Radial effects have not been detected between the CT of residence and the petroleum RF in mortality due to HC in any of the cities.
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Affiliation(s)
- Lluís Cirera
- Department of Epidemiology, Regional Health Council, Murcia, Spain.
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Vlaanderen J, Lan Q, Kromhout H, Rothman N, Vermeulen R. Occupational benzene exposure and the risk of chronic myeloid leukemia: a meta-analysis of cohort studies incorporating study quality dimensions. Am J Ind Med 2012; 55:779-85. [PMID: 22729623 DOI: 10.1002/ajim.22087] [Citation(s) in RCA: 40] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/31/2012] [Indexed: 02/04/2023]
Abstract
OBJECTIVE We documented previously that if study quality is accounted for, evidence from occupational cohort studies on benzene supports a possible association with some lymphoma subtypes, in particular multiple myeloma, and acute and chronic lymphocytic leukemia. Here, we extend these analyses to chronic myeloid leukemia (CML). METHODS Three strategies to assess study quality (stratification by the year-of-start of follow-up, stratification by the strength of the reported acute myeloid leukemia (AML) association, and stratification by the quality of benzene exposure assessment) were employed in a meta-analysis of occupational benzene exposure and CML. We hypothesized that stratification by these study quality dimensions would identify a subgroup of occupational cohort studies that is most informative for the evaluation of the possible association between benzene and CML. RESULTS The overall meta-relative risk (mRR) was non-significantly elevated (1.23; 95% confidence interval (CI): 0.93-1.63). The mRRs increased with increasing study quality for all dimensions with a significant elevation for studies with start of follow-up after 1970 (1.67; 95% CI: 1.02-2.74). The highest study quality stratum for AML significance and exposure quality showed an elevated but non-significant increased mRR (1.40; 95% CI: 0.86-2.27, and 1.68; 95% CI: 0.74-3.84, respectively). CONCLUSIONS Although limited by low statistical power, the current meta-analysis provides support for a possible association of occupational exposure to benzene and the risk of CML.
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Affiliation(s)
- Jelle Vlaanderen
- Division of Environmental Epidemiology, Institute for Risk Assessment Sciences, Utrecht University, Utrecht, The Netherlands
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Vlaanderen J, Lan Q, Kromhout H, Rothman N, Vermeulen R. Occupational benzene exposure and the risk of lymphoma subtypes: a meta-analysis of cohort studies incorporating three study quality dimensions. ENVIRONMENTAL HEALTH PERSPECTIVES 2011; 119:159-67. [PMID: 20880796 PMCID: PMC3040601 DOI: 10.1289/ehp.1002318] [Citation(s) in RCA: 79] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/20/2010] [Accepted: 09/29/2010] [Indexed: 05/22/2023]
Abstract
BACKGROUND The use of occupational cohort studies to assess the association of benzene and lymphoma is complicated by problems with exposure misclassification, outcome classification, and low statistical power. OBJECTIVE We performed meta-analyses of occupational cohort studies for five different lymphoma categories: Hodgkin lymphoma (HL), non-Hodgkin lymphoma (NHL), multiple myeloma (MM), acute lymphocytic leukemia (ALL), and chronic lymphocytic leukemia (CLL). DATA EXTRACTION We assessed three study quality dimensions to evaluate the impact of study quality variations on meta-relative risks (mRRs): stratification by the year of start of follow-up, stratification by the strength of the reported acute myelogenous leukemia association, and stratification by the quality of benzene exposure assessment. DATA SYNTHESIS mRRs for MM, ALL, and CLL increased with increasing study quality, regardless of the study quality dimension. mRRs for NHL also increased with increasing study quality, although this effect was less pronounced. We observed no association between occupational benzene exposure and HL. CONCLUSIONS Our meta-analysis provides support for an association between occupational benzene exposure and risk of MM, ALL, and CLL. The evidence for an association with NHL is less clear, but this is likely complicated by the etiologic heterogeneity of this group of diseases. Further consideration of the association between benzene and NHL will require delineation of risks by NHL subtype.
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Affiliation(s)
- Jelle Vlaanderen
- Institute for Risk Assessment Sciences, Utrecht University, Utrecht, the Netherlands
| | - Qing Lan
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Department of Health and Human Services, National Institutes of Health, Bethesda, Maryland, USA
| | - Hans Kromhout
- Institute for Risk Assessment Sciences, Utrecht University, Utrecht, the Netherlands
| | - Nathaniel Rothman
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Department of Health and Human Services, National Institutes of Health, Bethesda, Maryland, USA
| | - Roel Vermeulen
- Institute for Risk Assessment Sciences, Utrecht University, Utrecht, the Netherlands
- Address correspondence to R. Vermeulen, Institute for Risk Assessment Sciences, Division Environmental Epidemiology, Jenalaan 18d, 3584 CK, Utrecht, the Netherlands. Telephone: 31-30-2539448. Fax: 31-30-2539499. E-mail:
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Kane EV, Newton R. Occupational exposure to gasoline and the risk of non-Hodgkin lymphoma: a review and meta-analysis of the literature. Cancer Epidemiol 2010; 34:516-22. [PMID: 20561834 DOI: 10.1016/j.canep.2010.05.012] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2009] [Revised: 05/24/2010] [Accepted: 05/25/2010] [Indexed: 12/31/2022]
Abstract
AIMS Gasoline comprises over 500 chemicals, including the known or suspected carcinogens benzene, 1,3-butadiene, ethylbenzene and methyl tert-butyl ether (MTBE). To assess whether work in the production, distribution and use of gasoline is associated with non-Hodgkin lymphoma (NHL), we reviewed the published literature on this topic. METHOD English-language peer-reviewed articles were identified by keyword searches of bibliographic databases. Twenty-two cohorts and thirteen case-control studies examined the risk of NHL among persons employed in the downstream petroleum industry. RESULT No positive associations were found with the exception of one study. The pooled risk estimate from a random-effects meta-analysis was 1.02 (95% confidence interval (CI) 0.94-1.12). Although there were no estimates available, exposure is likely to have varied by occupation, location and time period; there was no evidence however that risk estimates varied by any of these factors. NHL is a heterogeneous disease, yet no data were reported for NHL subtypes. CONCLUSION In summary, there is no suggestion across an extensive literature that exposure to gasoline at the levels workers' experience in an occupational setting increases the risk of NHL.
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Affiliation(s)
- Eleanor V Kane
- Epidemiology and Genetics Unit, Department of Health Sciences, Seebohm Rowntree Building, University of York, Heslington, York YO10 5DD, UK.
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Mortality patterns and trends among 49,705 U.S.-based women in a petroleum company: update 1979-2000. J Occup Environ Med 2010; 52:99-108. [PMID: 20042877 DOI: 10.1097/jom.0b013e3181ca0db3] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVE To examine mortality patterns and trends in a cohort of women employed in U.S. operating segments of a petroleum company. METHODS Based on human resources databases, we defined a cohort of 49,705 U.S.-based women with at least one day of company employment during 1979 to 2000. These data sources provided demographic and most work history information. Standardized mortality ratios and 95% confidence intervals were calculated for 95 causes of death for the total cohort and with separate analyses by job type and operating segment when numbers allowed. RESULTS Cohort women have a 25% lower overall death rate than the general U.S. female population comparison. This lower rate is expected in light of the "healthy worker effect" that influences employee studies. Circulatory diseases have a deficit of 40%, and external causes of death and cancer have deficits of 13% and 9%, respectively. For analyses by job type, office/clerical workers have an elevation in ovarian cancer (standardized mortality ratio = 1.40, 95% confidence interval = 1.02 to 1.87), based on 46 deaths, with no work-related patterns. White-collar groups have generally large overall deficits for noncancer causes of death. In contrast, and based on smaller numbers, operators and laborers have elevations of motor vehicle accidents and other external causes of death, and laborers also have elevations of cerebrovascular disease and chronic obstructive pulmonary disease. These variations by job type are probably associated with differences in lifestyle factors. CONCLUSIONS This large mortality surveillance study of women in the petroleum industry provides an opportunity for meaningful analysis of many causes of death. The study found an overall favorable mortality profile and, for a small number of elevations, helped identify possible subgroups for health and safety prevention programs and interventions.
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Mortality Patterns and Trends Among 127,266 U.S.-Based Men in a Petroleum Company: Update 1979–2000. J Occup Environ Med 2009; 51:1333-48. [DOI: 10.1097/jom.0b013e3181be6c18] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Steinmaus C, Smith AH, Jones RM, Smith MT. Meta-analysis of benzene exposure and non-Hodgkin lymphoma: biases could mask an important association. Occup Environ Med 2008; 65:371-8. [PMID: 18417556 PMCID: PMC4353490 DOI: 10.1136/oem.2007.036913] [Citation(s) in RCA: 79] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
OBJECTIVES Benzene is a widely recognised cause of leukaemia but its association with non-Hodgkin's lymphoma (NHL) is less well established. The goal of this project is to review the current published literature on this association. METHODS We performed a meta-analysis of cohort and case-control studies of benzene exposure and NHL and a meta-analysis of NHL and refinery work, a potential source of benzene exposure. RESULTS In 22 studies of benzene exposure, the summary relative risk for NHL was 1.22 (95% CI 1.02 to 1.47; one-sided p value = 0.01). When studies that likely included unexposed subjects in the "exposed" group were excluded, the summary relative risk increased to 1.49 (95% CI 1.12 to 1.97, n = 13), and when studies based solely on self-reported work history were excluded, the relative risk rose to 2.12 (95% CI 1.11 to 4.02, n = 6). In refinery workers, the summary relative risk for NHL in all 21 studies was 1.21 (95% CI 1.00 to 1.46; p = 0.02). When adjusted for the healthy worker effect, this relative risk estimate increased to 1.42 (95% CI 1.19 to 1.69). CONCLUSIONS The finding of elevated relative risks in studies of both benzene exposure and refinery work provides further evidence that benzene exposure causes NHL. In addition, the finding of increased relative risks after removing studies that included unexposed or lesser exposed workers in "exposed" cohorts, and increased relative risk estimates after adjusting for the healthy worker effect, suggest that effects of benzene on NHL might be missed in occupational studies if these biases are not accounted for.
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Affiliation(s)
- C Steinmaus
- School of Public Health, University of California, Berkeley, California, USA.
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Abstract
Benzene-induced acute myeloid leukemia (AML) is considered a secondary form of AML, based both in theory and on limited cohort observations. Its latency, cytogenetic aberrations, and clinical features are thought similar to, or identical with, AML resulting from the use of modern day cytotoxic agents for chemotherapy and immunotherapy. Although distinction between secondary AML and the far more common de novo AML is difficult to establish with certainty in any given case, latency from toxic therapeutic and environmental exposure and certain clinical and pathological features generally separate these two entities. AML is the only human neoplasm proven to be potentially caused by benzene, which actually is an obsolete form of chemotherapy. Despite many years of environmental regulation, alleged toxic exposure to this ubiquitous chemical has become an expanding area of litigation. A review of benzene-induced AML suggests that, in developed countries, this entity should no longer merit serious consideration among workers in the modern petrochemical industry and related fields.
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MESH Headings
- Acute Disease
- Attitude of Health Personnel
- Benzene/adverse effects
- Benzene/therapeutic use
- Chromosome Aberrations/chemically induced
- Chromosome Inversion
- Chromosomes, Human, Pair 15
- Chromosomes, Human, Pair 16
- Chromosomes, Human, Pair 17
- Chromosomes, Human, Pair 21
- Chromosomes, Human, Pair 8
- Developed Countries
- Drug-Related Side Effects and Adverse Reactions
- Humans
- Leukemia, Myeloid/chemically induced
- Leukemia, Myeloid/diagnosis
- Leukemia, Myeloid/epidemiology
- Leukemia, Myeloid/etiology
- Leukemia, Myeloid/genetics
- Leukemia, Myeloid/pathology
- Occupational Diseases/chemically induced
- Occupational Diseases/epidemiology
- Occupational Exposure/adverse effects
- Occupational Exposure/analysis
- Petroleum/adverse effects
- Translocation, Genetic
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Affiliation(s)
- Ethan A Natelson
- Department of Medicine, Weill Medical College at the Methodist Hospital, Houston, Texas 77030, USA.
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17
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Alexander DD, Mink PJ, Adami HO, Chang ET, Cole P, Mandel JS, Trichopoulos D. The non-Hodgkin lymphomas: a review of the epidemiologic literature. Int J Cancer 2007; 120 Suppl 12:1-39. [PMID: 17405121 DOI: 10.1002/ijc.22719] [Citation(s) in RCA: 255] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
The non-Hodgkin lymphomas (NHL) are a heterogeneous group of B-cell and T-cell neoplasms that arise primarily in the lymph nodes. NHL incidence rates in the US doubled between about 1970 and 1990, and stabilized during the 1990s. NHL accounts for approximately 3.4% of cancer deaths in the US. Although some of the observed patterns in NHL have been related to HIV/AIDS, these conditions cannot fully explain the magnitude of the changes; neither do changes in classification systems nor improved diagnostic capabilities. Studies of occupational and environmental exposures (e.g., pesticides, solvents) have produced no consistent pattern of significant positive associations. Inverse associations with ultraviolet radiation exposure and alcohol and fish intake, and positive associations with meat and saturated fat intake have been reported in several studies; additional studies are needed to confirm or refute these associations. Family history of NHL or other hematolympho-proliferative cancers and personal history of several autoimmune disorders are associated with increased risk of NHL, but are not likely to account for a large proportion of cases. HIV and other infectious agents, such as human herpesvirus 8 and Epstein-Barr, appear to be associated with differing types of NHL, such as some B-cell lymphomas. Future epidemiologic studies should evaluate associations by NHL type, enhance exposure information collected, and elucidate factors that may identify susceptible (or resistant) subpopulations because of genetic, immunologic or other characteristics. The extent to which the etiology of NHL types may differ is important to resolve in ongoing and future studies.
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18
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Wong O. The interpretation of occupational epidemiologic data in regulation and litigation: Studies of auto mechanics and petroleum workers. Regul Toxicol Pharmacol 2006; 44:191-7. [PMID: 16464525 DOI: 10.1016/j.yrtph.2006.01.003] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2005] [Indexed: 11/25/2022]
Abstract
Epidemiologic data often serve as scientific basis for policies in regulation and opinions in litigation. The interpretation of epidemiologic data in both regulation and litigation is often challenged and debated. In this commentary, a wide range of issues concerning the interpretation of epidemiologic data in regulation and litigation are discussed. These issues include: case reports, study design, specificity of exposure, interview or recall bias, misclassification of occupation or exposure, confounding multiple exposures, confidence intervals and statistical power, selection of relevant studies, consistency of study results, study cohort definition, cohort membership misclassification, dilution effect, and subcohort or stratified analysis. Epidemiologic studies of auto mechanics and petroleum workers are used as examples to illustrate the importance of relying on sound epidemiologic principles in study interpretation. If these principles are not followed, the interpretation of epidemiologic studies will likely be erroneous and not useful to regulatory policy-makers or to those involved in litigation.
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Affiliation(s)
- Otto Wong
- Applied Health Sciences, Inc., P.O. Box 2078, San Mateo, CA 94010, USA.
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19
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Kang SH, Kim TY, Kim HY, Lee YK, Moon HW, Lee DS, Cho HI. Association of NQO1 Polymorphism with Multiple Myeloma Risk in Koreans. Ann Lab Med 2006; 26:71-6. [DOI: 10.3343/kjlm.2006.26.2.71] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Affiliation(s)
- Seong-Ho Kang
- Department of Laboratory Medicine, Seoul National University College of Medicine, Seoul, Korea
| | - Tae Young Kim
- Cancer Research Institue, Seoul National University College of Medicine, Seoul, Korea
| | - Ho Young Kim
- Cancer Research Institue, Seoul National University College of Medicine, Seoul, Korea
| | - Yun Kyung Lee
- Cancer Research Institue, Seoul National University College of Medicine, Seoul, Korea
| | - Hee Won Moon
- Department of Laboratory Medicine, Seoul National University College of Medicine, Seoul, Korea
| | - Dong Soon Lee
- Department of Laboratory Medicine, Seoul National University College of Medicine, Seoul, Korea
- Cancer Research Institue, Seoul National University College of Medicine, Seoul, Korea
| | - Han Ik Cho
- Department of Laboratory Medicine, Seoul National University College of Medicine, Seoul, Korea
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20
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Descatha A, Jenabian A, Conso F, Ameille J. Occupational exposures and haematological malignancies: overview on human recent data. Cancer Causes Control 2006; 16:939-53. [PMID: 16132803 DOI: 10.1007/s10552-005-2301-3] [Citation(s) in RCA: 64] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2004] [Accepted: 02/15/2005] [Indexed: 12/18/2022]
Abstract
OBJECTIVE Occupational causes of haematological malignancies are relatively uncommon, under-studied and under-identified. They are also often unrecognized by clinicians. This review summarizes the principal epidemiologic studies on this topic. METHODS We analyzed the recent relevant human data found in the Medline, the Pascal and the BDSP databases. RESULTS Benzene and ionizing radiation are the only agents conclusively demonstrated to be carcinogenic to the haematopoietic system. In particular, both exposures are strongly associated with acute myeloid leukaemia. Low doses of both may also be related to myeloid malignancies. Infectious agents and pesticides are also thought to induce lymphoproliferative cancers. Some studies show an association between haematological malignancies and low-frequency electromagnetic fields and organic solvents. All of these suspected occupational causes must be confirmed by further studies. CONCLUSIONS Better knowledge and understanding of occupational causes of haematological malignancies are necessary to improve their prevention and compensation.
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Affiliation(s)
- Alexis Descatha
- Unité de pathologie professionnelle et de santé au travail, Hôpital R. Poincaré, AP-HP 92380 Garches, France.
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21
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Saadat M, Ansari-Lari M. Alterations of liver function test indices of filling station workers with respect of genetic polymorphisms of GSTM1 and GSTT1. Cancer Lett 2005; 227:163-7. [PMID: 15894422 DOI: 10.1016/j.canlet.2005.03.044] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2005] [Revised: 03/29/2005] [Accepted: 03/30/2005] [Indexed: 11/24/2022]
Abstract
To determine the health effects of gasoline exposure on liver function test indices of filling station workers the present study was done. This case-control study was conducted in Shiraz on 56 male gasoline workers and 56 age- and sex-matched control subjects with no occupational exposure to gasoline. To elucidate the role of hepatic detoxifying enzymes, the genotypes of glutathione-S-transferases (GST) M1 and T1 were determined. Data analysis was done by multiple linear regression analysis and non-parametric Kruskal-Wallis test. The present study showed that all measurements were in normal range, although sub-clinical changes were detected in some indices. In liver function tests, exposure was associated with lower serum albumin (t=-3.88, P<0.001) and total proteins (t=-3.016, P=0.003) but higher alanine aminotransferase (t=2.856, P=0.005) and aspartate aminotransferase (t=2.11, P=0.038) levels in workers comparing to controls. Other investigators reported that GSTs involved in detoxification of several toxins including some of the compounds present in gasoline. Therefore, the possible influence of GSTT1 and GSTM1 genetic polymorphisms on alteration of liver function tests indices was investigated. The present findings showed that the genotype combinations of GSTM1 and GSTT1 did not alter the effects of exposure to gasoline in workers except for serum albumin. Serum albumin significantly decreased in workers with both active GST enzymes who had more than 5 years of employments (P=0.01). It is suggested that GSTM1 and GSTT1 are not involved in detoxification of toxicants present in gasoline which are hazardous to liver. Overall, due to detection of sub-clinical changes in hepatic test in gasoline station workers, exposure limitation and administrating safety device are recommended.
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