Occupational exposure to crystalline silica and gastric cancer: a systematic review and meta-analysis.
Crystalline silica is a widely used industrial material that is readily available worldwide, and is one of the most common types of particulate mineral pollutants. It has been classified as a group 1 human carcinogen of the respiratory system; however, whether it is linked to gastric cancer remains uncertain. We conducted a systemic review and meta-analyses to search for evidence of the relationship between gastric cancer and occupational exposure to crystalline silica. We searched for articles on occupations involving silica exposure and gastric cancer studies up to December 2014. Pooled-risk estimates of the association between occupational crystalline silica exposure and risk of gastric cancer were calculated by a random effects model. Metaregression analyses of industry type and histological confirmation status, study design and industrial subgroup analyses were performed. 29 articles, including 9 case-control and 20 cohort studies, were analysed. The overall summary effects size was 1.25 (95% CI 1.18 to 1.34) for the association of occupational silica exposure with gastric cancer. Both heterogeneity and publication bias were partially attenuated after subgroup analyses. Heterogeneity of studies was attenuated after metaregression by industry. Higher overall effects were observed in the mining and foundry industries. We found a significant relationship between occupational crystalline silica exposure and gastric cancer. Our results were strengthened by various subgroup analyses and, considering the biological plausibility of our premise, further studies are required to better understand this association.
The Institute for Occupational Health, Yonsei University College of Medicine, Seoul, Korea Graduate School of Public Health, Yonsei University College of Medicine, Seoul, Korea Incheon Worker's Health Center, Korea.
Wanhyung
W
Lee
Department of Occupational and Environmental Medicine, Dongguk University Ilsan Hospital, Goyang, Korea.
Yeon-Soon
YS
Ahn
The First Department of Internal Medicine, School of Medicine, University of Occupational and Environmental Health, Kitakyushu, Japan.
Seunghyun
S
Lee
Graduate School of Public Health, Yonsei University College of Medicine, Seoul, Korea Department of Preventive Medicine, Yonsei University College of Medicine, Seoul, Korea Cardiovascular and Metabolic Disease Etiology Research Center, Yonsei University College of Medicine, Seoul, Korea.
Bo Mi
BM
Song
Graduate School of Public Health, Yonsei University College of Medicine, Seoul, Korea Department of Preventive Medicine, Yonsei University College of Medicine, Seoul, Korea Institute for Health Promotion, Graduate School of Public Health, Yonsei University, Seoul, Korea.
Seri
S
Hong
The Institute for Occupational Health, Yonsei University College of Medicine, Seoul, Korea Graduate School of Public Health, Yonsei University College of Medicine, Seoul, Korea Incheon Worker's Health Center, Korea Department of Preventive Medicine, Yonsei University College of Medicine, Seoul, Korea.
Jin-Ha
JH
Yoon
D000395:Air Pollutants, Occupational / Q000009:adverse effects*; D000397:Air Pollution / Q000009:adverse effects*; D002273:Carcinogens; D006801:Humans; D007221:Industry; D008906:Mining; D009784:Occupational Diseases / Q000139:chemically induced* / Q000453:epidemiology; D016273:Occupational Exposure / Q000009:adverse effects*; D012044:Regression Analysis; D012307:Risk Factors; D012822:Silicon Dioxide / Q000009:adverse effects*; D013274:Stomach Neoplasms / Q000139:chemically induced* / Q000453:epidemiology
D000395:Air Pollutants, Occupational; D002273:Carcinogens; D012822:Silicon Dioxide
crystalline silica; gastric cancer