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Assessing Cumulative Musculoskeletal Strain in Automotive Mechanics: Insights from Real-World Occupational Analysis. 评估累积肌肉骨骼应变在汽车力学:从现实世界的职业分析的见解。
IF 2 4区 医学 Q2 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2025-12-16 DOI: 10.23749/mdl.v116i6.16988
Hadi Daneshmandi, Reyhane Sadeghian, Niloofar Rahgoshay, Nahideh Sartavi, Fardin Negahdari, Laleh Golkari

Background: This cross-sectional study aims to assess cumulative loads affecting the lower back, shoulders, and distal upper extremities among automotive mechanics.

Methods: The survey was conducted in automotive repair workshops in Shiraz, involving 157 independent mechanics selected through convenience sampling. Data were collected using a multiple-questionnaire including the Persian Cornell Musculoskeletal Discomfort Questionnaire (P-CMDQ), the Lifting Fatigue Failure Tool (LiFFT), the Shoulder Work Assessment Tool (SWAT), and the Distal Upper Extremity Tool (DUET). Descriptive statistics were used to assess musculoskeletal discomfort, and Partial correlation analyses, adjusted for age and Body Mass Index (BMI), examined the relationships between risk levels from LiFFT, SWAT, and DUET and discomfort reported in the P-CMDQ.

Results: The results showed a high level of musculoskeletal discomfort, especially in the lower back, shoulders, and hands. Risk assessments indicated that the cumulative loads are in the high range for the lower back in 42.7% of cases, the shoulders in 40.8%, and the distal upper extremities in 36.3%. A strong correlation was observed between cumulative load on the lower back and perceived discomfort in this region (r = 0.730), whereas the correlations for the shoulders (r = 0.611) and distal upper extremities (r = 0.537) were moderate.

Conclusions: The findings highlight the significant influence of workplace factors on the musculoskeletal health of automotive mechanics, emphasizing the importance of preventive measures and ergonomic solutions to enhance their health and productivity.

背景:本横断面研究旨在评估汽车机械师中影响下背部、肩部和远端上肢的累积载荷。方法:在设拉子地区的汽车修理厂进行调查,采用方便抽样的方法抽取157名独立修理工。数据通过多重问卷收集,包括波斯-康奈尔肌肉骨骼不适问卷(P-CMDQ)、举重疲劳失效工具(lift)、肩部工作评估工具(SWAT)和远端上肢工具(DUET)。描述性统计用于评估肌肉骨骼不适,部分相关分析,调整年龄和体重指数(BMI),检查LiFFT, SWAT和DUET的风险水平与P-CMDQ中报告的不适之间的关系。结果:结果显示了高度的肌肉骨骼不适,特别是在下背部,肩部和手部。风险评估表明,42.7%的病例中,下背部的累积负荷处于高负荷范围,40.8%的病例中肩部处于高负荷范围,36.3%的病例中上肢远端处于高负荷范围。下背部的累积负荷与该区域的感知不适感之间存在很强的相关性(r = 0.730),而肩部(r = 0.611)和上肢远端(r = 0.537)的相关性为中等。结论:工作场所因素对汽车修理工的肌肉骨骼健康有显著影响,强调预防措施和符合人体工程学的解决方案对提高他们的健康和生产力的重要性。
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引用次数: 0
Where Are We Going by Applying AI Tools? Are We Going to Lose Our Jobs? 应用人工智能工具我们将走向何方?我们会失业吗?
IF 2 4区 医学 Q2 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2025-12-16 DOI: 10.23749/mdl.v116i6.18255
Antonio Mutti
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引用次数: 0
Human Biomonitoring of Butylated Hydroxytoluene (BHT) in Germany: Methods, Exposure Levels, and Health-Based Interpretation. 德国丁基羟基甲苯(BHT)的人体生物监测:方法、暴露水平和基于健康的解释。
IF 2 4区 医学 Q2 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2025-12-16 DOI: 10.23749/mdl.v116i6.18008
Christoph Schmidtkunz, Isabell Schönrath, Aline Murawski, Katja Küpper, Nora Lemke, Till Weber, Gabriele Leng, Marike Kolossa-Gehring

Butylated hydroxytoluene (BHT) is an antioxidant which is used in a vast array of consumer products. The most sensitive toxicological endpoints of BHT are hepatic enzyme induction and reproductive effects. Because of its wide dispersive use and its potential relevance for human health, BHT was included in the human biomonitoring (HBM) cooperation between the German Federal Ministry for the Environment and the German Chemical Industry Association. An analytical method for the sensitive determination of 3,5‑di‑tert‑butyl‑4‑hydroxybenzoic acid (BHT acid)-an oxidized metabolite of BHT which is excreted in urine-was developed. This method was then applied in several environmental and occupational HBM surveys, and BHT acid was detected in the vast majority of samples. Health-based guidance values as well as reference values for the interpretation of HBM results were derived for BHT acid. Thus, a fine-grained picture of the current state of BHT exposure in different populations in Germany is now available. Uncertainties arise from large variability in the fraction of dose excreted as BHT acid and incomplete understanding of human metabolism, which limits reverse dosimetry and risk assessment, particularly for children.

丁基羟基甲苯(BHT)是一种抗氧化剂,广泛应用于各种消费品中。BHT最敏感的毒理学终点是肝酶诱导和生殖效应。由于BHT的广泛使用及其对人类健康的潜在相关性,它被纳入德国联邦环境部与德国化学工业协会之间的人体生物监测合作。建立了一种灵敏测定从尿中排泄的BHT氧化代谢物3,5 -二叔丁基- 4 -羟基苯甲酸(BHT酸)的分析方法。该方法随后被应用于几项环境和职业HBM调查中,绝大多数样本中检测到BHT酸。对BHT酸导出了基于健康的指导值以及解释HBM结果的参考值。因此,现在可以获得德国不同人群中BHT暴露现状的详细情况。不确定性来自于作为BHT酸排出的剂量比例的巨大变化,以及对人体代谢的不完全了解,这限制了反向剂量测定和风险评估,特别是对儿童。
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引用次数: 0
Evaluation of the Hearing Function in the Orchestra Professional Musicians of the Teatro alla Scala in Milan. 米兰斯卡拉大剧院管弦乐团专业音乐家听力功能评价。
IF 2 4区 医学 Q2 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2025-12-16 DOI: 10.23749/mdl.v116i6.17437
Terenzio Cassina, Alessia Tomasin, Orietta Calcinoni, Umberto Ambrosetti, Eliana Filipponi, Valeria Castelli, Riccardo Bianchin, Valentina Teodorani, Laura Magnoni, Leonardo Braga, Linda Parati, Federica Di Berardino

Background: This study was conducted to determine whether occupational exposure to high sound levels, typical of an opera orchestra, can cause hearing loss.

Methods: The orchestra professors at Teatro alla Scala in Milan underwent ear examinations, pure-tone audiometry, and other audiological tests. The hearing thresholds of these musicians were compared with those of populations not exposed to occupational noise and with populations exposed to industrial noise. Noise exposure levels were estimated through a phonometric survey conducted at our theater in 2011, which largely confirmed the exposure levels outlined in European guidelines.

Results: The average audiometric thresholds of the orchestra musicians were slightly worse than the median thresholds of a healthy, non-noise-exposed population. In three subjects (2.8%), bilateral hearing impairment (PTA 0.5, 1, 2, 3, 4 kHz > 25 dB HL) was observed; in four violinists (3.7%) left unilateral hearing impairment was found. This rate is lower than the expected risk from similar industrial noise exposures. Comparing these audiometries with those from about ten years earlier shows that the hearing threshold decline in the study group is comparable to that caused by presbycusis.

Conclusions: The risk of noise-induced hearing loss among professional orchestra musicians appears lower than predicted by the UNI ISO 1999:2015 standard. A few cases of hearing loss due to chronic acoustic trauma were noted, particularly among violinists who demonstrated a higher incidence of left unilateral hearing loss. The high levels of sound exposure and the presence of some hearing loss cases highlight the need for targeted preventative measures in this work activity.

背景:本研究旨在确定职业性暴露于高音量环境(典型的歌剧乐团)是否会导致听力损失。方法:对米兰斯卡拉歌剧院的乐团教授进行了耳部检查、纯音测听和其他听力学检查。将这些音乐家的听力阈值与未暴露于职业噪声和暴露于工业噪声的人群的听力阈值进行比较。噪音暴露水平是通过2011年在我们剧院进行的声频调查估计的,这在很大程度上证实了欧洲指导方针中概述的暴露水平。结果:管弦乐队音乐家的平均听力阈值略低于健康、非噪声暴露人群的中位数阈值。3例(2.8%)双侧听力障碍(PTA 0.5、1、2、3、4 kHz bb0 25 dB HL);4名小提琴手(3.7%)存在左单侧听力障碍。这一比率低于暴露在类似工业噪音中的预期风险。将这些听力测量结果与大约十年前的听力测量结果进行比较,发现研究组的听力阈值下降与老年性耳聋引起的听力阈值下降相当。结论:专业乐团音乐家噪声性听力损失的风险低于UNI ISO 1999:2015标准的预测。少数听力损失的情况下,由于慢性听觉创伤被注意到,特别是在小提琴家表现出较高的发生率左单侧听力损失。高水平的声音接触和一些听力损失病例的存在突出表明,需要在这项工作活动中采取有针对性的预防措施。
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引用次数: 0
Workplace Violence and Patient Management Time in the Emergency Department: An Observational Study. 急诊科工作场所暴力与病人管理时间:一项观察性研究
IF 2 4区 医学 Q2 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2025-10-24 DOI: 10.23749/mdl.v116i5.17113
Chiara Di Giorgio, Isabella Cucchi, Marco Mendola, Maria Cristina Costa, Fabio Tonelli, Elisa Turchet, Matteo Marrazzo, Paolo Carrer

Background: Workplace violence is steadily rising, and the healthcare sector is one of the most impacted areas. Several studies have shown that patients' long management times are a key factor in workplace violence in this setting.

Objective: This study aims to analyze the prevalence and characteristics of aggressions against healthcare workers (HCWs) that occurred in 2023 in the Emergency Rooms (ER) of a large university hospital and to evaluate the potential relationship between the management time of a patient in the ER and the risk of violence incidents.

Methods: To evaluate the prevalence and characteristics of aggressive events against HCWs that occurred in 2023, data from the "incident reporting" form were analyzed. Then, using the 2023 report on daily ER accesses, the management time of a patient at the ER was calculated. Finally, the average management times of patients on days when there were no aggressions were compared with those on days when there was one or more assaults against HCWs to evaluate the potential relationship between the average length of stay of a patient at the ER and the risk of aggression.

Results: In 2023, 271 violent incidents were reported. Verbal aggressiveness was the most common (82.7%), and working the night shift was riskier (42.8%). In 36.2% of cases, patient management time was identified as a potential predictor of aggression. Other identified potential predictors included the patient and/or caregiver relationship with HCW (30.6%), the refusal to accept diagnostic-therapeutic protocols (27.3%), and the cultural background and temperamental traits of the patient or caregiver (18.8% and 11.8%, respectively). According to the logistic regression analysis, the likelihood of a violent incident during a 150-minute stay was less than 10%; it increased to 53% after 650 minutes.

Conclusion: Workplace violence in healthcare settings results from a complex interaction of internal and external factors. Understanding how these elements interact and contribute to the development of incidents is essential for identifying key actions to reduce and mitigate violence.

背景:工作场所暴力正在稳步上升,医疗保健部门是受影响最严重的领域之一。几项研究表明,在这种情况下,病人的长时间管理是工作场所暴力的一个关键因素。目的:本研究旨在分析某大型大学医院急诊室(ER)在2023年发生的针对医护人员(HCWs)的攻击行为的发生率和特征,并评估患者在急诊室的管理时间与暴力事件风险之间的潜在关系。方法:分析“事件报告表”数据,评估2023年发生的针对医护人员的攻击事件的发生率和特征。然后,使用2023年的每日急诊室访问报告,计算患者在急诊室的管理时间。最后,将无攻击事件发生的天数与有一次或多次攻击事件发生的天数进行比较,以评估患者在急诊室的平均住院时间与攻击风险之间的潜在关系。结果:2023年共报告271起暴力事件。言语攻击是最常见的(82.7%),上夜班风险更大(42.8%)。在36.2%的病例中,患者管理时间被确定为攻击的潜在预测因子。其他确定的潜在预测因素包括患者和/或护理者与HCW的关系(30.6%),拒绝接受诊断-治疗方案(27.3%),以及患者或护理者的文化背景和气质特征(分别为18.8%和11.8%)。根据logistic回归分析,在150分钟的停留期间发生暴力事件的可能性小于10%;650分钟后增加到53%。结论:医疗机构中的工作场所暴力是内部和外部因素复杂相互作用的结果。了解这些因素如何相互作用并促进事件的发展,对于确定减少和减轻暴力的关键行动至关重要。
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引用次数: 0
Evaluation of the Workplace Accident Severity in an Underground Coal Mine By Logistic Regression Analysis. 用Logistic回归分析评价煤矿井下生产事故严重程度。
IF 2 4区 医学 Q2 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2025-10-24 DOI: 10.23749/mdl.v116i5.16841
Ilknur Erol

Background: Accidents in underground coal mining can cause deaths, serious injuries, and material losses.

Methods: This study examined 10,334 work accidents that occurred between 2011 and 2021, resulting in injuries, and evaluated the causes, severity, and types of injuries. The accidents were investigated under the following subheadings: location of accidents, causes of accidents, work shifts when the accidents occurred, accident time, accident days, distribution of accidents by months and years, age of workers, occupational groups, educational status of workers, working day losses, and body parts that were injured. The severity of accidents was categorized into three levels: mild, moderate, and severe, based on the workday losses incurred by the workers after the accident. The severity of accidents and factors affecting their severity were analyzed using multinomial logistic regression.

Results: There is a significant statistical relationship between the severity of accidents and factors such as experience, workplace, accident cause, age, education status, occupational category, and the affected body part, work shift, according to the analysis. The findings indicate that accident severity is influenced not only by the immediate circumstances of the incident but also by broader individual and occupational factors, such as the employee's level of experience, the work environment, the occupational group, and the specific body part affected. The analysis revealed that the occupational group variable had statistically significant interaction effects with multiple other variables.

Conclusions: The study presents all aspects of the hazards faced by the workers and suggests measures to reduce the number and severity of accidents that occur in underground coal mining.

背景:煤矿井下开采事故可造成死亡、重伤和物质损失。方法:本研究调查了2011年至2021年间发生的10334起工伤事故,并评估了工伤的原因、严重程度和类型。事故调查按以下小标题进行:事故地点、事故原因、事故发生时的轮班、事故时间、事故天数、按月份和年份划分的事故分布、工人年龄、职业类别、工人的教育程度、工作日损失和受伤的身体部位。根据事故发生后工人的工作日损失,将事故的严重程度分为轻度、中度、严重3个等级。采用多项logistic回归分析事故严重程度及其影响因素。结果:根据分析,事故严重程度与经历、工作场所、事故原因、年龄、文化程度、职业类别、受影响身体部位、工作班次等因素存在显著的统计关系。研究结果表明,事故严重程度不仅受到事故发生的直接环境的影响,还受到更广泛的个人和职业因素的影响,如员工的经验水平、工作环境、职业群体和受影响的特定身体部位。分析显示,职业组别变量与其他多个变量有显著的交互作用。结论:研究揭示了煤矿井下作业人员所面临的危害,并提出了减少煤矿井下事故数量和严重程度的措施。
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引用次数: 0
From Subjects to Partners: Rethinking Research Methodologies through Citizen Science. 从研究对象到合作伙伴:通过公民科学重新思考研究方法。
IF 2 4区 医学 Q2 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2025-10-24 DOI: 10.23749/mdl.v116i5.18007
Bruna De Marchi

The article will first introduce a general definition of Citizen Science (section 1), followed by an excursion of its foundations and of the different understandings and ways of applying it, with examples drawn from diverse research and policy areas (section 2). It will then focus more closely on the field of health and the environment (section 3), including occupational medicine (subsection 3.1), community response to environmental risks (section 3.2), biomonitoring (sub-section 3.3), and human biomonitoring (subsection 3.4). Section 4 will address some of the advantages (section 4.1) and challenges (section 4.2) of adopting CS in research and policy. Finally, section 5 will trace the legislative and normative background of participatory approaches and points to the challenges ahead.

本文将首先介绍公民科学的一般定义(第1节),然后介绍其基础和不同的理解和应用它的方法,并从不同的研究和政策领域中抽取例子(第2节)。然后,它将更密切地关注健康和环境领域(第3节),包括职业医学(第3.1节)、社区对环境风险的反应(第3.2节)、生物监测(第3.3分节)和人体生物监测(第3.4节)。第4节将讨论在研究和政策中采用CS的一些优势(第4.1节)和挑战(第4.2节)。最后,第5节将追溯参与性方法的立法和规范背景,并指出未来的挑战。
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引用次数: 0
Occupational Asthma Due to Subtilisin: The Power of Specific Inhalation Challenge. 枯草杆菌素引起的职业性哮喘:特定吸入挑战的力量。
IF 2 4区 医学 Q2 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2025-10-24 DOI: 10.23749/mdl.v116i5.17219
Filippo Liviero, Laura Fabris, Marco Biasioli, Francesco Favretto, Paola Mason

We report the first confirmed case in Italy of occupational asthma caused by subtilisin in a healthcare worker involved in cleaning surgical instruments. The diagnosis was confirmed through a specific inhalation challenge (SIC) performed one year after the last exposure and after stopping inhaled corticosteroid therapy. An immediate reaction was observed after three minutes of exposure to diluted Neogiozym ™, with a 30% decrease in FEV1. This case highlights the diagnostic importance of SIC even for high-molecular-weight (HMW) agents and emphasizes the need to reconsider occupational asthma as a complex, evolving disease influenced by both host and environmental factors. The patient exhibited a Type-2-high phenotype despite negative skin prick tests and normal IgE levels, reinforcing the value of dynamic, multi-marker assessment in occupational endotyping. This case supports the broader use of SIC in occupational settings where allergen-specific IgE testing is limited.

我们报告的第一个确诊病例在意大利职业性哮喘引起的枯草菌素在卫生保健工作者参与清洁手术器械。在最后一次暴露一年后并停止吸入皮质类固醇治疗后,通过特异性吸入刺激(SIC)确诊。暴露于稀释的Neogiozym™三分钟后观察到立即反应,FEV1下降30%。本病例强调了SIC对高分子量(HMW)药物的诊断重要性,并强调需要重新考虑职业性哮喘作为一种受宿主和环境因素影响的复杂、不断发展的疾病。尽管皮肤点刺试验呈阴性,IgE水平正常,但患者表现出2型高表型,这加强了动态、多标志物评估在职业内分型中的价值。本病例支持在过敏原特异性IgE检测有限的职业环境中更广泛地使用SIC。
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引用次数: 0
Girls and Women in Mines: an Invisible Path of Forced Labour in Italy. 矿山中的女孩和妇女:意大利一条看不见的强迫劳动之路。
IF 2 4区 医学 Q2 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2025-10-24 DOI: 10.23749/mdl.v116i5.17012
Silvana Salerno

This study aims to shed light on the largely understudied history of girls and women working in Italian mines during the 19th and 20th centuries. Giovanni Loriga authored an outstanding paper on Pneumoconiosis in 1930 at the Johannesburg Conference. By examining his sources from earlier surveys, travel records, and congressional proceedings, the research uncovers data on women and girls in slate (Liguria), asbestos (Piedmont), zinc-lead (Sardinia and Lombardy), and sulfur mines (Sicily), along with their working conditions. The research findings reveal that girls and women were integral to the mining industry throughout Italy, despite being underrepresented and relegated to specific tasks. Ultimately, the paper explores the development of protective Italian legislation, its inadequate enforcement, and suspension during World War I. The paper concludes by highlighting the ongoing global issue of girls' labour in mines, drawing a parallel between the historical situation in Italy and the contemporary reality denounced by organizations like the ILO and UNICEF.

这项研究旨在揭示19世纪和20世纪在意大利矿山工作的女孩和妇女的大部分未被充分研究的历史。1930年,乔瓦尼·洛里加在约翰内斯堡会议上发表了一篇关于尘肺病的杰出论文。通过检查他从早期调查、旅行记录和国会会议记录中获得的资料,这项研究揭示了石板(利古里亚)、石棉(皮埃蒙特)、锌铅(撒丁岛和伦巴第)和硫磺矿(西西里岛)中妇女和女孩的数据,以及她们的工作条件。研究结果表明,女孩和妇女是意大利采矿业不可或缺的组成部分,尽管她们的代表人数不足,而且只能从事特定的工作。最后,本文探讨了意大利保护性立法的发展,其执行不力,以及第一次世界大战期间的暂停。论文最后强调了正在进行的全球矿山女童劳动问题,并将意大利的历史情况与国际劳工组织和联合国儿童基金会等组织谴责的当代现实进行了比较。
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引用次数: 0
Occupational-Related Exposure to Diesel Exhaust and Kidney Cancer: Systematic Review and Meta-Analysis of Cohort Studies. 职业性接触柴油机废气与肾癌:队列研究的系统回顾与荟萃分析。
IF 2 4区 医学 Q2 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2025-10-24 DOI: 10.23749/mdl.v116i5.17014
Giulia Collatuzzo, Federica Teglia, Paolo Boffetta

Background: The association between diesel exhaust and cancer other than the lung is not well established. We aimed to conduct a systematic review and meta-analysis on the association between diesel and kidney cancer in workers.

Methods: Two trained researchers conducted a systematic review to identify cohort studies examining the relationship between occupational exposure to diesel exhaust and the risk of cancer other than lung cancer. Of the 43 retained studies, 15 reported information on kidney cancer. We performed random-effects meta-analyses for ever-exposure to diesel exhaust. Summary relative risks (RR) and 95% confidence intervals (CI) were calculated for the association between diesel exhaust exposure and kidney cancer.

Results: Overall, the RR of kidney cancer was 1.08 (95% CI=1.01-1.15, heterogeneity p=0.1, I2=28.6%). The summary RR was 1.08 for incidence (95% CI=1.01-1.16; I2=36.7%) and 1.09 for mortality (95% CI=0.92-1.30, I2=14.5%), p of heterogeneity=0.914. The summary RR of European studies was 1.08 (95% CI=1.00-1.16, I2=37.8 %), that of USA/Canada studies was 1.10 (95% CI=0.94-1.29, I2=8.5%), p of heterogeneity=0.837. Publication bias was not detected.

Conclusions: Workers exposed to diesel exhaust may experience an increased risk of developing kidney cancer, although the evidence is not entirely consistent, and residual confounding cannot be excluded.

背景:柴油废气与肺癌以外的癌症之间的关系尚未得到很好的确定。我们的目的是对柴油与工人肾癌之间的关系进行系统回顾和荟萃分析。方法:两名训练有素的研究人员进行了一项系统综述,以确定研究职业暴露于柴油废气与肺癌以外癌症风险之间关系的队列研究。在保留的43项研究中,有15项报告了肾癌的信息。我们对长期暴露于柴油废气的人群进行了随机效应荟萃分析。计算柴油机尾气暴露与肾癌之间的总相对危险度(RR)和95%可信区间(CI)。结果:总体而言,肾癌的RR为1.08 (95% CI=1.01-1.15,异质性p=0.1, I2=28.6%)。发病率的总RR为1.08 (95% CI=1.01-1.16, I2=36.7%),死亡率的总RR为1.09 (95% CI=0.92-1.30, I2=14.5%),异质性p =0.914。欧洲研究的总RR为1.08 (95% CI=1.00-1.16, I2= 37.8%),美国/加拿大研究的总RR为1.10 (95% CI=0.94-1.29, I2=8.5%),异质性p =0.837。未发现发表偏倚。结论:接触柴油废气的工人可能会增加患肾癌的风险,尽管证据并不完全一致,残留的混杂因素不能排除。
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引用次数: 0
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