Occupational trichloroethylene exposure and kidney cancer risk: a meta-analysis

Karami, S; Lan, Q; Rothman, N; Stewart, PA; Lee, KMu; Vermeulen, R; Moore, L

HERO ID

2128070

Reference Type

Journal Article

Year

2012

Language

English

PMID

23000822

HERO ID 2128070
In Press No
Year 2012
Title Occupational trichloroethylene exposure and kidney cancer risk: a meta-analysis
Authors Karami, S; Lan, Q; Rothman, N; Stewart, PA; Lee, KMu; Vermeulen, R; Moore, L
Journal Occupational and Environmental Medicine
Volume 69
Issue 12
Page Numbers 858-867
Abstract Inconsistent epidemiological findings, debate over interpretation, and extrapolation of findings from animal studies to humans have produced uncertainty surrounding the carcinogenicity of trichloroethylene (TCE) exposure in occupational settings. We updated meta-analyses of published case-control and cohort studies exploring occupational TCE exposure and kidney cancer risk, incorporating new analytical results from three recently published cohort studies and a case-control study. PubMed MEDLINE was searched for studies published from 1950 to 2011 assessing occupational exposure to chlorinated solvents, degreasers or TCE. All cohort (N=15) and case-control (N=13) studies included in analyses were stratified by assessment of occupational exposure to TCE specifically and to any chlorinated solvent. Significantly elevated summary estimates were observed for cohort studies (relative risk (RR) 1.26, 95% CI 1.02 to 1.56; p heterogeneity=0.65), case-control studies (OR 1.35, 95% CI 1.17 to 1.57; p heterogeneity=0.41), and cohort and case-control studies combined (RR 1.32, 95% CI 1.17 to 1.50, p heterogeneity=0.63) that specifically assessed TCE exposure after excluding outlier studies that contributed to heterogeneity. Non-significantly elevated summary estimates were generally observed for studies of workers exposed to chlorinated solvents but who were not assessed for TCE specifically. Regardless of study design, significant and stronger estimates were only observed in studies specifically assessing occupational exposure to TCE. Estimates were lower in studies assessing occupational exposure to chlorinated solvents. This updated meta-analysis supports an association between occupational TCE exposure and kidney cancer and provides evidence that exposure misclassification may weaken estimates assessing exposure to the broader class of chlorinated solvents.
Doi 10.1136/oemed-2012-100932
Pmid 23000822
Wosid WOS:000311106600002
Is Certified Translation No
Dupe Override No
Is Public Yes
Language Text English
Keyword Humans; Risk Factors; Index Medicus