caa a22 4500 463193911 CHVBK 20180406164917.0 cr unu---uuuuu 170326e20071101xx s 000 0 eng 10.1007/s00420-007-0201-4 doi (NATIONALLICENCE)springer-10.1007/s00420-007-0201-4 A meta-analysis of occupational trichloroethylene exposure and liver cancer [Elektronische Daten] [Dominik Alexander, Michael Kelsh, Pamela Mink, Jeffrey Mandel, Rupa Basu, Michal Weingart] Objective: Findings from epidemiologic studies of trichloroethylene (TCE) exposure and liver cancer have been inconsistent. To quantitatively evaluate this association and to examine sources of heterogeneity, we conducted a meta-analysis of occupational studies of TCE exposure and liver/biliary tract cancer. Methods: We identified 14 occupational cohort studies of TCE exposed workers and one case-control study that met our inclusion criteria. Nine studies specifically identified TCE as a workplace exposure, and were classified as Group I cohort studies. Subcohorts of workers, identified within eight of these studies as more likely exposed to TCE than the total cohort, were analyzed separately. Results: The combined liver/biliary cancer summary relative risk estimate (SRRE) for all studies was 1.08 (95% CI 0.91-1.29; heterogeneity (H)-P-value=0.12). For the total study populations in the Group I cohorts, the SRRE was 1.14 (95% CI 0.93-1.39; H-P-value=0.05) and for the subcohorts, the SRRE was 1.30 (95% CI 1.09-1.55). Within this subcohort analysis, the association for the European studies of workers from various industries (SRRE=1.38; based on four studies) was higher than the association for the US studies of aerospace and aircraft workers (SRRE=0.97, based on four studies). Conclusion: Although positive associations were observed for some analyses, results were inconsistent across occupational groups (aerospace/aircraft vs. other industries combined), study location, and incidence versus mortality endpoints. In addition, exposure-response trends were not observed consistently across studies. Interpretation is also limited by the potential impact of uncontrolled confounding by other occupational or lifestyle exposures such as smoking or alcohol consumption. Given these limitations, the currently available epidemiologic data are not sufficient to support a causal relation between occupational TCE exposure and liver/biliary cancer. Springer-Verlag, 2007 Alexander Dominik Exponent Health Sciences, 185 Hansen Ct, Suite 100, 60191, Wood Dale, IL, USA aut Kelsh Michael Exponent Health Sciences, Menlo Park, CA, USA aut Mink Pamela Exponent Health Sciences, Washington DC, USA aut Mandel Jeffrey Exponent Health Sciences, 185 Hansen Ct, Suite 100, 60191, Wood Dale, IL, USA aut Basu Rupa Exponent Health Sciences, Menlo Park, CA, USA aut Weingart Michal Exponent Health Sciences, Oakland, CA, USA aut International Archives of Occupational and Environmental Health Springer-Verlag 81/2(2007-11-01), 127-143 0340-0131 81:2<127 2007 81 420 https://doi.org/10.1007/s00420-007-0201-4 text/html Onlinezugriff via DOI 1 review-article jats NATIONALLICENCE 856 40 https://doi.org/10.1007/s00420-007-0201-4 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Alexander Dominik Exponent Health Sciences, 185 Hansen Ct, Suite 100, 60191, Wood Dale, IL, USA aut NATIONALLICENCE 700 1- Kelsh Michael Exponent Health Sciences, Menlo Park, CA, USA aut NATIONALLICENCE 700 1- Mink Pamela Exponent Health Sciences, Washington DC, USA aut NATIONALLICENCE 700 1- Mandel Jeffrey Exponent Health Sciences, 185 Hansen Ct, Suite 100, 60191, Wood Dale, IL, USA aut NATIONALLICENCE 700 1- Basu Rupa Exponent Health Sciences, Menlo Park, CA, USA aut NATIONALLICENCE 700 1- Weingart Michal Exponent Health Sciences, Oakland, CA, USA aut NATIONALLICENCE 773 0- International Archives of Occupational and Environmental Health Springer-Verlag 81/2(2007-11-01), 127-143 0340-0131 81:2<127 2007 81 420 Metadata rights reserved Springer special CC-BY-NC licence nationallicence BK010053 XK010053 XK010000 NATIONALLICENCE NATIONALLICENCE NL-springer