Journal of Environmental Health Sciences (한국환경보건학회지)

Korean Society of Environmental Health (한국환경보건학회)
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Comparison of Meta-analysis Results with and Without Adjustment for Healthy Worker Effect on the Association Between Occupational Exposure to Trichloroethylene and Cancer Risk

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

  • 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)
  • 박태원 (한국방송통신대학교 환경보건학과) ;
  • 황성호 (아주대학교 의과대학 직업환경의학교실) ;
  • 이경무 (한국방송통신대학교 환경보건학과)
  • Received : 2014.10.15
  • Accepted : 2014.10.28
  • Published : 2014.10.31
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Abstract

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.

Keywords

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