TY - JOUR
T1 - Endotoxin exposure and lung cancer risk
T2 - a systematic review and meta-analysis of the published literature on agriculture and cotton textile workers
AU - Lenters, Virissa
AU - Basinas, Ioannis
AU - Beane-Freeman, Laura
AU - Boffetta, Paolo
AU - Checkoway, Harvey
AU - Coggon, David
AU - Portengen, Lützen
AU - Sim, Malcolm
AU - Wouters, Inge M
AU - Heederik, Dick
AU - Vermeulen, Roel
PY - 2010/4
Y1 - 2010/4
N2 - OBJECTIVE: To examine the association between exposure to endotoxins and lung cancer risk by conducting a systematic review and meta-analysis of epidemiologic studies of workers in the cotton textile and agricultural industries; industries known for high exposure levels of endotoxins.METHODS: Risk estimates were extracted from studies published before 2009 that met predefined quality criteria, including 8 cohort, 1 case-cohort, and 2 case-control studies of cotton textile industry workers, and 15 cohort and 2 case-control studies of agricultural workers. Summary risk estimates were calculated using random effects meta-analyses. Potential sources of heterogeneity were explored through subgroup analyses.RESULTS: The summary risk of lung cancer was 0.72 (95% CI, 0.57-0.90) for textile workers and 0.62 (0.52-0.75) for agricultural workers. The relative risk of lung cancer was below 1.0 for most subgroups defined according to sex, study design, outcome, smoking adjustment, and geographic area. Two studies provided quantitative estimates of endotoxin exposure and both studies tended to support a dose-dependent protective effect of endotoxins on lung cancer risk.CONCLUSION: Despite several limitations, this meta-analysis based on high-quality studies adds weight to the hypothesis that occupational exposure to endotoxin in cotton textile production and agriculture is protective against lung cancer.
AB - OBJECTIVE: To examine the association between exposure to endotoxins and lung cancer risk by conducting a systematic review and meta-analysis of epidemiologic studies of workers in the cotton textile and agricultural industries; industries known for high exposure levels of endotoxins.METHODS: Risk estimates were extracted from studies published before 2009 that met predefined quality criteria, including 8 cohort, 1 case-cohort, and 2 case-control studies of cotton textile industry workers, and 15 cohort and 2 case-control studies of agricultural workers. Summary risk estimates were calculated using random effects meta-analyses. Potential sources of heterogeneity were explored through subgroup analyses.RESULTS: The summary risk of lung cancer was 0.72 (95% CI, 0.57-0.90) for textile workers and 0.62 (0.52-0.75) for agricultural workers. The relative risk of lung cancer was below 1.0 for most subgroups defined according to sex, study design, outcome, smoking adjustment, and geographic area. Two studies provided quantitative estimates of endotoxin exposure and both studies tended to support a dose-dependent protective effect of endotoxins on lung cancer risk.CONCLUSION: Despite several limitations, this meta-analysis based on high-quality studies adds weight to the hypothesis that occupational exposure to endotoxin in cotton textile production and agriculture is protective against lung cancer.
KW - Agricultural Workers' Diseases/etiology
KW - Cotton Fiber
KW - Endotoxins/poisoning
KW - Humans
KW - Lung Neoplasms/etiology
KW - Occupational Diseases/etiology
KW - Occupational Exposure/adverse effects
KW - Occupational Health
KW - Risk Assessment
KW - Risk Factors
KW - Textile Industry
KW - Textiles/adverse effects
U2 - 10.1007/s10552-009-9483-z
DO - 10.1007/s10552-009-9483-z
M3 - Review article
C2 - 20012774
SN - 0957-5243
VL - 21
SP - 523
EP - 555
JO - Cancer Causes & Control
JF - Cancer Causes & Control
IS - 4
ER -
