社区研究中的可吸入结晶二氧化硅与肺癌:工作-暴露矩阵规格对暴露-反应关系的影响。

IF 4.7 2区 医学 Q1 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Scandinavian journal of work, environment & health Pub Date : 2024-04-01 Epub Date: 2024-01-24 DOI:10.5271/sjweh.4140
Johan Ohlander, Hans Kromhout, Roel Vermeulen, Lützen Portengen, Benjamin Kendzia, Barbara Savary, Domenico Cavallo, Andrea Cattaneo, Enrica Migliori, Lorenzo Richiardi, Nils Plato, Heinz-Erich Wichmann, Stefan Karrasch, Dario Consonni, Maria Teresa Landi, Neil E Caporaso, Jack Siemiatycki, Per Gustavsson, Karl-Heinz Jöckel, Wolfgang Ahrens, Hermann Pohlabeln, Guillermo Fernández-Tardón, David Zaridze, Jolanta Lissowska Jolanta Lissowska, Beata Swiatkowska Beata Swiatkowska, John K Field John K Field, John R McLaughlin, Paul A Demers, Tamas Pandics, Francesco Forastiere, Eleonora Fabianova, Miriam Schejbalova, Lenka Foretova, Vladimir Janout, Dana Mates, Christine Barul, Thomas Brüning, Thomas Behrens, Kurt Straif, Joachim Schüz, Ann Olsson, Susan Peters
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引用次数: 0

摘要

目的:定量工作暴露矩阵 SYN-JEM 由多个维度组成:特定工作估计值、特定地区估计值以及半定量 DOM-JEM 对工作的预先专家评级。我们分析了不同 JEM 维度对职业二氧化硅暴露与肺癌风险之间的暴露-反应关系的影响,以研究这些变化如何影响定量 JEM 的暴露估计值和相关健康终点:使用 SYN-JEM,以及包含不同维度的替代 SYN-JEM 规范,对从 14 项国际社区病例对照研究中汇集的 16 901 例肺癌病例和 20 965 例对照病例进行了累积二氧化硅暴露估算。使用回归分析(按四分位数和对数转换的连续二氧化硅暴露量)和广义加和模型(GAM)分析了基于 SYN-JEM 和替代 SYN-JEM 规范的暴露-反应关系,并对年龄、性别、研究、吸烟包年、戒烟时间和曾经从事的肺癌风险职业进行了调整:SYN-JEM和替代规格产生了总体升高和相似的肺癌几率比,从1.13(第一四分位数)到1.50(第四四分位数)不等。在分类和对数线性分析中,包含所有维度的 SYN-JEM 模型拟合度最高,而排除 SYN-JEM 中特定工作的估计值后,模型拟合度最差。此外,在排除特定工作估计值的情况下,GAM 的模型拟合效果最差:结论:职业性二氧化硅暴露与肺癌之间已确立的暴露-反应关系受 SYN-JEM 不同维度的影响很小。当纳入所有相关维度(即先前评级、工作、时间和地区)时,暴露-反应关系的模型将得到优化。针对特定工作的定量估计似乎是这一普通人群 JEM 最突出的维度。
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Respirable crystalline silica and lung cancer in community-based studies: impact of job-exposure matrix specifications on exposure-response relationships.

Objectives: The quantitative job-exposure matrix SYN-JEM consists of various dimensions: job-specific estimates, region-specific estimates, and prior expert ratings of jobs by the semi-quantitative DOM-JEM. We analyzed the effect of different JEM dimensions on the exposure-response relationships between occupational silica exposure and lung cancer risk to investigate how these variations influence estimates of exposure by a quantitative JEM and associated health endpoints.

Methods: Using SYN-JEM, and alternative SYN-JEM specifications with varying dimensions included, cumulative silica exposure estimates were assigned to 16 901 lung cancer cases and 20 965 controls pooled from 14 international community-based case-control studies. Exposure-response relationships based on SYN-JEM and alternative SYN-JEM specifications were analyzed using regression analyses (by quartiles and log-transformed continuous silica exposure) and generalized additive models (GAM), adjusted for age, sex, study, cigarette pack-years, time since quitting smoking, and ever employment in occupations with established lung cancer risk.

Results: SYN-JEM and alternative specifications generated overall elevated and similar lung cancer odds ratios ranging from 1.13 (1st quartile) to 1.50 (4th quartile). In the categorical and log-linear analyses SYN-JEM with all dimensions included yielded the best model fit, and exclusion of job-specific estimates from SYN-JEM yielded the poorest model fit. Additionally, GAM showed the poorest model fit when excluding job-specific estimates.

Conclusion: The established exposure-response relationship between occupational silica exposure and lung cancer was marginally influenced by varying the dimensions of SYN-JEM. Optimized modelling of exposure-response relationships will be obtained when incorporating all relevant dimensions, namely prior rating, job, time, and region. Quantitative job-specific estimates appeared to be the most prominent dimension for this general population JEM.

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来源期刊
Scandinavian journal of work, environment & health
Scandinavian journal of work, environment & health 医学-公共卫生、环境卫生与职业卫生
CiteScore
8.20
自引率
9.50%
发文量
65
审稿时长
>12 weeks
期刊介绍: The aim of the Journal is to promote research in the fields of occupational and environmental health and safety and to increase knowledge through the publication of original research articles, systematic reviews, and other information of high interest. Areas of interest include occupational and environmental epidemiology, occupational and environmental medicine, psychosocial factors at work, physical work load, physical activity work-related mental and musculoskeletal problems, aging, work ability and return to work, working hours and health, occupational hygiene and toxicology, work safety and injury epidemiology as well as occupational health services. In addition to observational studies, quasi-experimental and intervention studies are welcome as well as methodological papers, occupational cohort profiles, and studies associated with economic evaluation. The Journal also publishes short communications, case reports, commentaries, discussion papers, clinical questions, consensus reports, meeting reports, other reports, book reviews, news, and announcements (jobs, courses, events etc).
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