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Ethylene oxide and risk of lympho-hematopoietic cancer and breast cancer: a systematic literature review and meta-analysis.

Authors
  • Marsh, Gary M1
  • Keeton, Kara A2
  • Riordan, Alexander S3
  • Best, Elizabeth A4
  • Benson, Stacey M1
  • 1 Cardno ChemRisk, 20 Stanwix Street, Suite 505, Pittsburgh, PA, 15222, USA.
  • 2 Cardno ChemRisk, 30 N. LaSalle St., Suite 3910, Chicago, IL, 60602, USA. [email protected]
  • 3 Cardno ChemRisk, 30 N. LaSalle St., Suite 3910, Chicago, IL, 60602, USA.
  • 4 Cardno ChemRisk, 4940 Pearl East Circle, Suite 100, Boulder, CO, 80301, USA.
Type
Published Article
Journal
International Archives of Occupational and Environmental Health
Publisher
Springer-Verlag
Publication Date
Oct 01, 2019
Volume
92
Issue
7
Pages
919–939
Identifiers
DOI: 10.1007/s00420-019-01438-z
PMID: 31111206
Source
Medline
Keywords
Language
English
License
Unknown

Abstract

To conduct a systematic literature review and meta-analysis of studies of lympho-hematopoietic cancers (LHC) and breast cancer risk among persons occupationally exposed to ethylene oxide (EO). We performed a literature search for articles available in PubMed and Web of Science databases to identify literature and subsequently systematically searched the reference lists of identified studies, published review papers and meta-analyses, as well as relevant government or regulatory documents. We qualitatively reviewed 30 studies and conducted meta-analyses on 13 studies. Pooled risk estimates were calculated using random effects models, stratifying by occupational group, cancer type and decade of publication. The overall meta-relative risks (meta-RRs) for LHC and breast cancer, respectively, were 1.48 (95% CI 1.07-2.05) and 0.97 (95% CI 0.80-1.18). The meta-RR's for LHC among EO production and EO sterilization workers were 1.46 (95% CI 0.85-2.50) and 1.07 (95% CI 0.87-1.30), respectively. We observed higher risks of LHC in the earlier published studies, compared to the later studies, and the meta-RR's for the 1980s, 1990s, 2000s, and the 2010s, respectively, were 3.87 (95% CI 1.87-8.01), 1.38 (95% CI 0.85-2.25), 1.05 (95% CI 0.84-1.31), and 1.19 (95% CI 0.80-1.77). The most informative epidemiology studies, which were published in the 2000s and 2010s, do not support the conclusion that exposure to EO is associated with an increased risk of LHC or breast cancer.

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