Alexander DD, Pastula ST, Riordan AS. 2021. Epidemiology of lung cancer among acrylonitrile-exposed study populations: A meta-analysis. Regul Toxicol Pharmacol 122:104896, doi: 10.1016/j.yrtph.2021.104896, PMID: 33617939.
To conduct a systematic review and meta-analysis of lung cancer among acrylonitrile-exposed workers.
A literature search through April 2020 was performed to identify relevant cohort and case-control studies. Data from these studies were meta-analyzed to generate summary relative risk estimates (SRREs). Heterogeneity was examined in sub-group and sensitivity analyses, and by meta-regression.
Twenty-two studies were reviewed systematically, and 10 cohort studies and one case-control study were meta-analyzed. Individual relative risk estimates reported across studies were heterogeneous, with most being relatively weak in statistical strength and non-statistically significant on both sides of the null value. Meta-analysis of these data resulted in an SRRE of 1.04 (95% CI: 0.89–1.21; overall model, largely consisting of all workers exposed to acrylonitrile). Sub-group analyses and meta-regression did not support patterns of positive dose-response relationships by duration of exposure/employment or cumulative exposure.
Although some positive associations have been reported in internal comparison analyses based on increasing exposure categories, few associations are statistically significant, there are no apparent or consistent patterns of dose-response, and the confounding influence of cigarette smoking was not adequately controlled. Thus, findings from this review and meta-analysis do not support an increased risk of lung cancer among acrylonitrile workers.