한국환경보건학회지 (Journal of Environmental Health Sciences)

  • 제40권5호
  • /
  • Pages.385-396
  • /
  • 2014
  • /
  • 1738-4087(pISSN)
  • /
  • 2233-8616(eISSN)
한국환경보건학회 (Korean Society of Environmental Health)
권호 표지
DOI QR코드

DOI QR Code

건강근로자효과 보정 전후의 메타 분석 결과 비교 -직업적 트리클로로에틸렌 노출과 암의 연관성-

Comparison of Meta-analysis Results with and Without Adjustment for Healthy Worker Effect on the Association Between Occupational Exposure to Trichloroethylene and Cancer Risk

  • 박태원 (한국방송통신대학교 환경보건학과) ;
  • 황성호 (아주대학교 의과대학 직업환경의학교실) ;
  • 이경무 (한국방송통신대학교 환경보건학과)
  • Park, Tae Won (Department of Environmental Health, Korea National Open University) ;
  • Hwang, Sung Ho (Department of Occupational and Environmental Medicine, Ajou University School of Medicine) ;
  • Lee, Kyoung-Mu (Department of Environmental Health, Korea National Open University)
  • 투고 : 2014.10.15
  • 심사 : 2014.10.28
  • 발행 : 2014.10.31
PDF 다운로드
⟨ 이전 논문 다음 논문 ⟩

초록

Objectives: By conducting a meta-analysis of cohort studies reporting standardized mortality ratios (SMRs) for workers exposed to trichloroethylene, we attempted to adjust for healthy hired effect by applying the same methods as described in a recent report from the Agricultural Health Study. Methods: Among all cohort studies that evaluated the association between all cancer, non-Hodgkin's lymphoma (NHL), kidney cancer, liver cancer and occupational exposure to trichloroethylene, a total of 10 studies reporting SMR values were selected. A random-effects model was used to estimate the summary SMRs or rSMRs and 95% confidence intervals. Relative SMR ($rSMR=SMR_x/SMR_{not\;x}$) was calculated comparing observed and expected counts for all cancer, NHL, kidney cancer, and liver cancer with an independent referent set of values consisting of the observed and expected counts for other causes. Results: The SMR values for all causes ranged from 0.68 to 1.03, suggesting moderate to weak healthy worker effect for the selected studies. When the healthy worker hire effect was taken into account, the summarized risk became statistically significant; the summary SMR of all cancer was 0.95 (0.91-1.00) and the summary rSMR of all cancer was 1.10 (1.04-1.15). The summary SMR of NHL was 1.04 (0.93-1.14) and the summary rSMR of NHL was 1.23 (1.04-1.46). The summary SMR of kidney cancer was 1.08 (0.88-1.33) and the summary rSMR of kidney cancer was 1.23 (1.02-1.49). The summary SMR of liver cancer was 0.88 (0.78-0.99), and the summary rSMR of liver cancer was 0.95 (0.84-1.07). Conclusion: The rSMR method is useful to determine summary risk adjusted for healthy worker effect through meta-analysis.

키워드

참고문헌

  1. Lee KM, Chun JB, Park DU, Lee W. Methods to minimize or adjust for healthy worker effect in occupational epidemiology. J Environ Health Sci. 2011; 37(5): 342-391.
  2. Chun JB, Han S, Yoon H, Lee E, Lee KM. Occupational exposure to trichloroethylene and non-Hodgkin lymphoma risk. J Environ Health Sci. 2011; 37(5): 358-368. https://doi.org/10.5271/sjweh.3180
  3. Park JS, Jeon YW, Kim YI, Gil HW, Yang JO, Lee EY, et al. A Case of Acute respiratory failure after trichloroethylene inhalation. J. Korean Society of Clinical Toxicology 2011;9(1):30-33.
  4. Huff JE. New evidence on the old problems of trichloroethylene. Ind Med Surg. 1971; 40: 25-33.
  5. Nakayama T, Yamanoshita O, Kamijima M, Kish R, Ichihara G. Generalized skin reaction in relation to trichloroethylene exposure: A review from the view point of drug-metabolizing enzyme. J Occup Health. 2003; 45: 8-14. https://doi.org/10.1539/joh.45.8
  6. Anttila A, Pukkala E, Sallmen M, Hernberg S, Hemminki K. Cancer incidence among Finnish workers exposed to halogenated hydrocarbons. J Occup Environ Med. 1995; 37(7): 797-806. https://doi.org/10.1097/00043764-199507000-00008
  7. Spirtas R, Stewart PA, Lee JS, Marano DE, Forbes CD, Grauman DJ. Retrospective cohort mortality study of workers at an aircraft maintenance facility. I. Epidemiological results. Br J Ind Med 1991; 48(8): 515-530.
  8. Wartenberg D, Reyner D, Scott CS. Trichloroethylene and cancer: epidemiologic evidence. Environ Health Perspect. 2000; 108(Suppl 2): 161-176. https://doi.org/10.1289/ehp.00108s2161
  9. Kaneko T, Wang PY, and Sato A. Assessment of the health effects of trichloroethylene. Ind Health. 1997; 35(3): 301-324. https://doi.org/10.2486/indhealth.35.301
  10. Karami S, Bassiq B, Stewart PA, Lee KM, Rothman N, Moore LE, Lan Q. Occupational trichloroethylene exposure and risk of lymphatic and haematopoietic cancers: a meta-analysis. Occup Environ Med. 2013; 70(8): 591-599. https://doi.org/10.1136/oemed-2012-101212
  11. Karami S, Lan Q, Rothman N, Stewart PA, Lee KM, Vermeulen R, Lee EM. Occupational trichloroethylene exposure and kidney cancer risk: a metaanalysis. Occup Environ Med. 2012; 69: 858-867. https://doi.org/10.1136/oemed-2012-100932
  12. Alexander DD. Kelsh MA. Mink PJ. Mandel JH. Basu R. Weingart M. A meta-analysis of occupational trichloroethylene exposure and liver cancer. Int Arch Occup Environ Health. 2007; 81: 127-143. https://doi.org/10.1007/s00420-007-0201-4
  13. Waggoner JK, Kullman GJ, Henneberger PK, Umbach DM, Blair A, Alavanja MCR, et al. Mortality in the Agricultural Health Study, 1993-2007. Am J Epidemiol. 2011; 173: 71-83. https://doi.org/10.1093/aje/kwq323
  14. Garabrant DH, Held J, Langholz B, Bernstein L. Mortality of aircraft manufacturing workers in southern California. Am J Ind Med. 1988; 13(6): 683-693. https://doi.org/10.1002/ajim.4700130607
  15. Blair A, Haas T, Prosser R, Morrissette M, Blackman K, Grauman D, van Dusen P, et al. Mortality among United States Coast Guard marine inspectors. Arch. Environ Health 1989; 44(3): 150-156. https://doi.org/10.1080/00039896.1989.9935879
  16. Henschler D, Vamvakas S, Dekant W, Kraus B, Thomas B, Ulm K. Increased incidence of renal cell tumors in a cohort of cardboard workers exposed to trichloroethene. Arch Toxicol. 1995; 69: 291-299. https://doi.org/10.1007/s002040050173
  17. Blair A, Hartge P, Stewart PA, McAdams M, Lubin J. Mortality and cancer incidence of aircraft maintenance workers exposed to trichloroethylene and other organic solvents and chemicals: extended follow up. Occup Environ Med. 1998; 55(3): 161-171. https://doi.org/10.1136/oem.55.3.161
  18. Morgan RW, Kelsh MA, Zhao K, Heringer S. Mortality of aerospace workers exposed to trichloroethylene. Epidemiology. 1998; 9(4): 424-431. https://doi.org/10.1097/00001648-199807000-00013
  19. Ritz B. Cancer mortality among workers exposed to chemicals during uranium processing. J Occup Environ Med. 1999; 41(7): 556-566. https://doi.org/10.1097/00043764-199907000-00004
  20. Boice JD Jr, Marano DE, Cohen SS, Mumma MT, Blot WJ, Brill AB, Fryzek JP, et al. Mortality among Rocketdyne workers who tested rocket engines, 1948-1999. J Occup Environ Med. 2006; 48(10): 1070-1092. https://doi.org/10.1097/01.jom.0000240661.33413.b5
  21. McLean D, Pearce N, Langseth H, Jappinen P, Szadkowska-Stanczyk I, Persson B, Wild P, et al. Cancer mortality in workers exposed to organochlorine compounds in the pulp and paper industry: an international collaborative study. Environ Health Perspect. 2006; 114(7): 1007-1012. https://doi.org/10.1289/ehp.8588
  22. Lipworth L, Sonderman JS, Mumma MT, Tarone RE, Marano DE, John D. Boice JD, et al. Cancer Mortality Among Aircraft Manufacturing Workers: An Extended Follow-Up. JOEM. 2011; 53(9): 992-1007.
  23. Bahr DE, Timothy E. Aldrich TE, Seidu D, Brion GM, David J, et al. Occupational exposure to trichloroethylene and cancer risk for workers at the PADUCAH gaseous diffusion plant. Int J Occup Medi Environ Heal. 2011; 24(1): 67-77. https://doi.org/10.2478/s13382-011-0007-1
  24. Chun JB, Han S, Yoon H, Lee E, Lee KM. Occupational exposure to trichloethylene and non-Hodgkin lymphoma risk. J Environ Health Sci. 2011; 37(5): 358-368. https://doi.org/10.5271/sjweh.3180
  25. Lee J. Meta-analysis. Endocrinology and Metabolism. 2008; 23(6): 361-377.
  26. Wartenberg D, Reyer D, Scott CS. Trichloroethylene and cancer: epidemiologic evidence. Environ Health Perspect. 2000; 108(suppl 2): 161-176. https://doi.org/10.1289/ehp.00108s2161