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首页> 外文期刊>Toxicological reviews >Is there a causal relationship between exposure to diesel exhaust and multiple myeloma?
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Is there a causal relationship between exposure to diesel exhaust and multiple myeloma?

机译：柴油机废气暴露与多发性骨髓瘤之间是否存在因果关系？

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This article presents a comprehensive critical review of the epidemiology of multiple myeloma in relation to occupational diesel exhaust exposure. The review includes cohort and proportional mortality studies of workers exposed to diesel exhaust, and population-based case-control studies of multiple myeloma. None of the cohort or proportional mortality studies reported a significant increase of multiple myeloma in relation to diesel exhaust, with the exception of a study of Danish truck drivers. Several limitations in this Danish study (such as inadequate cohort identification, small number of multiple myeloma deaths and inappropriate analytical method) made the result unreliable. Furthermore, the data in this study of Danish truck drivers were part of and, hence, superseded by a large study in Denmark, which did not find any increased risk of multiple myeloma. Similarly, none of the case-control studies reported a significant increase of multiple myeloma in relation to diesel exhaust, with the exception of the smallest case-control study based on multiple myeloma patients in central and southeast Sweden. The result of this small Swedish study was not reliable because of incomplete case ascertainment, inappropriate controls and confounding. Furthermore, the data in this small Swedish study were part of and, hence, superseded by a large national study of workers exposed to diesel exhaust in Sweden, which did not find any increased risk of multiple myeloma. Other than the study of Danish truck drivers and the small case-control study of multiple myeloma patients in central and southeast Sweden, all other epidemiological investigations consistently reported no increase of multiple myeloma in relation to occupational diesel exhaust exposure. Furthermore, none of the studies reported a positive exposure-response relationship between diesel exhaust and multiple myeloma. Several studies that analysed data by jobs or occupations according to level of exposure and by duration of exposure did not find any upward trend. In addition to the review, a formal causation analysis based on an application of the Hill criteria confirms that there is no causal relationship between diesel exhaust and multiple myeloma.
机译：本文对与职业性柴油机废气暴露相关的多发性骨髓瘤的流行病学进行了全面的批判性综述。该评价包括对暴露于柴油机废气的工人进行的队列和比例死亡率研究，以及基于人群的多发性骨髓瘤病例对照研究。除丹麦卡车驾驶员的研究外，没有任何队列研究或比例死亡率研究报告与柴油机排气有关的多发性骨髓瘤显着增加。这项丹麦研究的一些局限性（例如队列识别不足，多发性骨髓瘤死亡人数少和分析方法不适当）使结果不可靠。此外，该丹麦卡车司机研究的数据是丹麦一项大型研究的一部分，因此被丹麦的一项大型研究所取代，该研究并未发现多发性骨髓瘤的风险增加。同样，除瑞典中部和东南部基于多发性骨髓瘤患者的最小病例对照研究外，没有任何病例对照研究报告与柴油机排气有关的多发性骨髓瘤显着增加。这项小型瑞典研究的结果不可靠，原因是案件确定不完整，控制不当和令人困惑。此外，这项小型瑞典研究中的数据是瑞典一项大型国家工人暴露于柴油机废气中的大规模研究的一部分，因此该研究没有被多发性骨髓瘤增加的风险所取代。除了丹麦卡车司机的研究和瑞典中部和东南部对多发性骨髓瘤患者的小型病例对照研究以外，所有其他流行病学调查均一致报告，与职业性柴油机废气暴露相关的多发性骨髓瘤没有增加。此外，没有一项研究报告柴油机排气与多发性骨髓瘤之间存在积极的暴露-反应关系。几项根据职业或职业根据接触水平和接触时间分析数据的研究没有发现任何上升趋势。除审查外，根据希尔标准的应用进行的正式因果分析还证实，柴油机排气与多发性骨髓瘤之间没有因果关系。

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