BACKGROUND Benzene is classified as carcinogenic to humans based on evidence that benzene causes acute myeloid leukemia. However, there is limited evidence that benzene causes lung cancer. OBJECTIVES We performed a systematic review, quality assessment, and meta-analysis of published cohort and case-control studies on the association between occupational benzene exposure and lung cancer risk. METHODS We reviewed the relevant human epidemiological studies from PubMed and Embase databases to 19 August 2024. Data extraction included study characteristics, effect estimates, and exposure assessment details. Two investigators independently evaluated study quality using the Newcastle-Ottawa scale (NOS) framework and exposure assessment quality based on a priori criteria. Six risk of bias (ROB) domains were constructed from the NOS criteria to identify and quantify possible biases and their impacts on parameter estimates. Meta-analysis relative risk (pooled RR) and associated confidence intervals were calculated using random-effects models, and a flexible exposure-response meta-regression was fitted to assess the shape of the association. Subgroup analyses were conducted to explore the consistency of results. RESULTS Of 252 articles identified, 13 studies covering 366,975 participants (17,030 lung cancer cases) were included in our analysis. The meta-analysis of ever occupational benzene exposure showed an elevated risk of lung cancer (pooled RR=1.14; 95% CI: 1.03, 1.27; I²=72). Subgroup analyses revealed that larger pooled RRs in studies based on highly exposed groups had higher overall quality and better exposure assessments and included both males and females (as opposed to only males). A positive linear trend was observed in the exposure-response meta-analysis. DISCUSSION Our meta-analysis supports an association between occupational benzene exposure and an increased risk of lung cancer. https://doi.org/10.1289/EHP15086.

中文翻译：

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人类研究中的职业苯暴露和肺癌：系统评价和荟萃分析。


背景 根据苯导致急性髓性白血病的证据，苯被归类为对人类致癌物。然而，苯会导致肺癌的证据有限。目的 我们对已发表的关于职业苯暴露与肺癌风险之间关联的队列和病例对照研究进行了系统评价、质量评估和荟萃分析。方法 我们回顾了截至 2024 年 8 月 19 日来自 PubMed 和 Embase 数据库的相关人类流行病学研究。资料提取包括研究特征、效果估计和暴露评估细节。两名研究人员使用纽卡斯尔-渥太华量表 （NOS） 框架独立评估研究质量，并根据先验标准独立评估暴露评估质量。根据 NOS 标准构建了六个偏倚风险 （ROB） 域，以识别和量化可能的偏倚及其对参数估计的影响。使用随机效应模型计算 meta 分析相对风险 （合并 RR） 和相关置信区间，并采用灵活的暴露-反应 meta 回归来评估关联的形状。进行亚组分析以探讨结果的一致性。结果 在确定的 252 篇文章中，我们的分析纳入了 13 项研究，涵盖 366,975 名参与者 （17,030 例肺癌病例）。对曾经的职业苯暴露的荟萃分析显示肺癌风险升高（汇总 RR=1.14;95% CI：1.03,1.27;I²=72）。亚组分析显示，在基于高度暴露组的研究中，较大的合并 RRs 具有更高的整体质量和更好的暴露评估，并且包括男性和女性 （而不是仅包括男性）。在暴露-反应荟萃分析中观察到正线性趋势。 讨论 我们的荟萃分析支持职业苯暴露与肺癌风险增加之间的关联。https://doi.org/10.1289/EHP15086。