Occupational Asbestos Exposure and Kidney Cancer: Systematic Review and Meta-analysis of Cohort Studies

Abstract

Objectives An estimated 125 million workers are exposed to asbestos worldwide. Asbestos is classified by the International Agency for Research on Cancer as a Group 1 carcinogen. The association between occupational asbestos exposure and kidney cancer is not well established however. This study aimed to determine the mortality and incidence of kidney cancer in workers who have been exposed to asbestos. We performed a systematic review and meta-analysis to evaluate the association between occupational asbestos exposure and kidney cancer. Methods Medline, EMBASE, and Web of Science were searched according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines for articles on occupational asbestos exposure and kidney cancer. The studies reported the standardized mortality ratio (SMR) or standardized incidence ratio (SIR) of kidney cancer in workers exposed to asbestos. SMRs or SIRs with its 95% confidence interval (CI) were pooled using a fixed-effect model. Results Forty-nine cohort studies involving 335 492 workers were selected for analysis. These studies included 468 kidney cancer deaths and 160 incident cases. The overall pooled-SMR of kidney cancer was 0.95 (95% CI: 0.86–1.05), with no significant heterogeneity (PQ = 0.09, I2 = 24.87%). The overall pooled-SIR of kidney cancer was 0.95 (95% CI: 0.79–1.11), with no significant heterogeneity (PQ = 0.68, I2 = 0.00%). Subgroup analysis did not find any increased association with occupational asbestos exposure. There was no evidence of publication bias with Egger’s test P values of 0.08 for mortality studies and 0.99 for incidence studies. Conclusions This systematic review and meta-analysis did not show evidence of association between occupational asbestos exposure and kidney cancer mortality or incidence.

Cancro Renal associado ao Trabalho

“…-Asbestos A IARC (International Agency for Research on Cancer) considera que os asbestos estão inseridos no grupo 1 (ou seja, comprovadamente cancerígenos), mas para o CR em específico, afirma que não há evidência clara (2). A associação entre CR e os asbestos surgiu na década de 70; contudo, como a incidência é baixa, os estudos ficam dificultados (6).…”

“…Ainda assim, alguns investigadores publicaram que estes estão associados ao CR, devido à depuração urinária existente (2), sobretudo em concentrações elevadas (6); aliás chegam a mencionar que a incidência deste cancro poderia ser superior se, por exemplo, a taxa de mortalidade de outras condições existentes e associadas aos asbestos tivessem menor mortalidade (ou menos precoce), como é o caso do cancro do pulmão. Para além disso, como o diagnóstico pode surgir mais de três décadas depois, alguns estudos não fazem acompanhamento tão longos (2). O maior estudo de relação entre os asbestos e o CR decorreu na década de noventa, com cerca de 1700 casos e este concluiu que o risco aumenta cerca de 40%.…”

Oxidative Stress and DNA Damages Induced by Occupational Exposure to Asbestos: A Systematic Review

“…According to WHO, approximately 125 million people worldwide are exposed to asbestos in the workplace. Asbestos exposure at work is responsible for approximately 233 000 deaths each year ( 8 ). Between 1970 and 2005, most Western countries prohibited the use of asbestos, except the United States, where it is only partially prohibited, and Canada, where the asbestos ban went into effect in 2018 ( 9 , 10 ).…”