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Meta-Analysis
. 2024 Apr 24;115(2):e2024010.
doi: 10.23749/mdl.v115i2.15569.

Risk of Skin Cancer in Workers Exposed to Diesel Exhaust: A Systematic Review and Meta-Analysis of Cohort Studies

Marika D'Agostini  1 , Giulia Collatuzzo  1 , Federica Teglia  1 , Paolo Boffetta  2
Affiliations
Meta-Analysis

Risk of Skin Cancer in Workers Exposed to Diesel Exhaust: A Systematic Review and Meta-Analysis of Cohort Studies

Marika D'Agostini et al. Med Lav. .

Abstract

Background: Our objective was to study the association between occupational exposure to diesel exhaust (DE) and skin cancer.

Methods: A systematic review following STROBE guidelines and PECOS criteria was conducted to identify cohort studies describing the association between occupational DE exposure and the risk of skin cancer. We extracted 12 independent risk estimates for melanoma skin cancer (MSC), 8 for non-melanoma skin cancer (NMSC), and 3 for skin cancer not otherwise specified (SC-NOS). Random effects meta-analyses were performed, site-specific and stratified by geographic region and quality score. 95% confidence intervals (CI) were reported. Between-study heterogeneity and potential publication bias were investigated.

Results: There was no overall evidence of an increased risk of MSC [RR=0.90, 95% CI: 0.73-1.11; I2=92.86%, 95% CI: 82.83-97.03%], NMSC [RR=1.04, 95% CI: 0.88-1.23; I2=60.79%, 95% CI: 0-87.34%] or SC-NOS [RR=0.72, 95% CI: 0.54-0.97; I2=26.60%, 95% CI: 0-94.87%] in workers exposed to DE. No difference between low-quality and high-quality studies was found. A stratified analysis by geographical region did not reveal any significant differences. There was no evidence of publication bias.

Conclusions: No evidence of an association between skin cancer and occupational DE exposure was found. Residual confounding and other sources of bias cannot be ruled out.

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Conflict of interest statement

PB acted as expert witness in litigation concerning diesel exhaust exposure and gastrointestinal cancers, unrelated to the present work. No conflicts were reported by the other authors.

Figures

Figure S1.
Figure S1.
Forest plot of the leave-one-out meta-analysis of cohort studies on occupational diesel exhaust exposure and risk of melanoma skin cancer (MSC)
Figure S2.
Figure S2.
Funnel plot of the analysis on occupational diesel exhaust exposure and risk of melanoma skin cancer (MSC)
Figure S3.
Figure S3.
Galbraith plot of the analysis on occupational diesel exhaust exposure and risk of melanoma skin cancer (MSC)
Figure S4.
Figure S4.
Forest plot of the leave-one-out meta-analysis of cohort studies on occupational diesel exhaust exposure and risk of non-melanoma skin cancer (NMSC)
Figure S5.
Figure S5.
Funnel plot of the analysis on occupational diesel exhaust exposure and risk of non-melanoma skin cancer (NMSC)
Figure S6.
Figure S6.
Galbraith plot of the analysis on occupational diesel exhaust exposure and risk of non-melanoma skin cancer (NMSC)
Figure S7.
Figure S7.
Forest plot of the leave-one-out meta-analysis of cohort studies on occupational diesel exhaust exposure and risk of skin cancer not otherwise specified (SC-NOS)
Figure S8.
Figure S8.
Funnel plot of the analysis on occupational diesel exhaust exposure and risk of skin cancer not otherwise specified (SC-NOS)
Figure S9.
Figure S9.
Galbraith plot of the analysis on occupational diesel exhaust exposure and risk of skin cancer not otherwise specified (SC-NOS)
Figure 1.
Figure 1.
Flow diagram of the study selection process.
Figure 2.
Figure 2.
Forest plot of a meta-analysis of cohort studies on occupational exposure to diesel exhaust and skin cancer.
See this image and copyright information in PMC

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References

    1. Pronk A, Coble J, Stewart PA. Occupational exposure to diesel engine exhaust: a literature review. J Expo Sci Environ Epidemiol. 2009;19(5):443–457. Doi: 10.1038/jes.2009.21. - PMC - PubMed
    1. IARC: diesel engine exhaust carcinogenic. Cent Eur J Public Health. 2012;20(2):120–138. - PubMed
    1. Soll-Johanning H, Bach E, Olsen JH, Tüchsen F. Cancer incidence in urban bus drivers and tramway employees: a retrospective cohort study. Occup Environ Med. 1998;55(9):594–598. Doi: 10.1136/oem.55.9.594. - PMC - PubMed
    1. Vasama-Neuvonen K, Pukkala E, Paakkulainen H, et al. Ovarian cancer and occupational exposures in Finland. Am J Ind Med. 1999;36(1):83–9. Doi: 10.1002/(sici)1097-0274(199907)36:1<83::aid-ajim12>3.0.co;2-q. - PubMed
    1. Guo J, Kauppinen T, Kyyrönen P, et al. Risk of esophageal, ovarian, testicular, kidney and bladder cancers and leukemia among finnish workers exposed to diesel or gasoline engine exhaust. Int J Cancer. 2004;111(2):286–92. Doi: 10.1002/ijc.20263. - PubMed

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