Professional drivers and lung cancer: a systematic review and meta-analysis
- 5 July 2012
- journal article
- review article
- Published by BMJ in Occupational and Environmental Medicine
- Vol. 69 (11), 831-836
- https://doi.org/10.1136/oemed-2012-100666
Abstract
The objective of this study was to conduct a systematic review to provide summarised evidence on the association between professional drivers and lung cancer in the last decade after taking into consideration the potential confounding effect of cigarette smoking. We systematically searched all published cohort and case–control studies in English from Medline and Embase, from January 1996 to January 2011. We extracted the risk estimate (ie, RR, OR, and standardised mortality ratio) from each individual study, and meta-analysis was used to combine the RR of individual studies. The methodological quality of each study was assessed using a standard approach proposed by Downs and Black. Nineteen studies were included in the meta-analysis. A significantly increased risk of lung cancer (pooled smoking-adjusted RR 1.18, 95% CI 1.05 to 1.33) among professional drivers was observed after combining four cohort studies and nine case–control studies. A higher pooled RR was observed among smoking-adjusted studies reporting 10 years or more of employment (RR 1.19, 95% CI 1.06 to 1.34) as compared with the study having a shorter duration of employment (6 years) (RR 1.00, 95% CI 0.92 to 1.09). This systematic review revealed that a 18% excess risk of lung cancer was linked to professional drivers who are potentially exposed to diesel exhaust, after adjustment for the confounding effect of smoking. There is a tendency for a positive lung cancer gradient with increasing years of employment as a professional driver.Keywords
This publication has 9 references indexed in Scilit:
- Mortality Among Members of a Truck Driver Trade AssociationAAOHN Journal, 2010
- A historical mortality study among bus drivers and bus maintenance workers exposed to urban air pollutants in the city of Genoa, ItalyOccupational and Environmental Medicine, 2010
- Lung Cancer and Occupation in a Population-based Case-Control StudyAmerican Journal of Epidemiology, 2010
- Lung Cancer and Vehicle Exhaust in Trucking Industry WorkersEnvironmental Health Perspectives, 2008
- Cause-Specific Mortality in the Unionized U.S. Trucking IndustryEnvironmental Health Perspectives, 2007
- U.S. EPA Health Assessment for Diesel Engine Exhaust: A ReviewInhalation Toxicology, 2007
- Occupational exposure to diesel exhausts and risk for lung cancer in a population-based case–control study in ItalyAnnals of Oncology, 2006
- Lung and bladder cancer among Danish urban bus drivers and tramway employees: a nested case-control studyOccupational Medicine, 2003
- Quantifying heterogeneity in a meta-analysisStatistics in Medicine, 2002