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International Archives of Occupational and Environmental Health
Published in: International Archives of Occupational and Environmental Health 7/2019

01-10-2019 | Breast Cancer | Review

Ethylene oxide and risk of lympho-hematopoietic cancer and breast cancer: a systematic literature review and meta-analysis

Authors: Gary M. Marsh, Kara A. Keeton, Alexander S. Riordan, Elizabeth A. Best, Stacey M. Benson

Published in: International Archives of Occupational and Environmental Health | Issue 7/2019

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Abstract

Purpose

To conduct a systematic literature review and meta-analysis of studies of lympho-hematopoietic cancers (LHC) and breast cancer risk among persons occupationally exposed to ethylene oxide (EO).

Methods

We performed a literature search for articles available in PubMed and Web of Science databases to identify literature and subsequently systematically searched the reference lists of identified studies, published review papers and meta-analyses, as well as relevant government or regulatory documents. We qualitatively reviewed 30 studies and conducted meta-analyses on 13 studies. Pooled risk estimates were calculated using random effects models, stratifying by occupational group, cancer type and decade of publication.

Results

The overall meta-relative risks (meta-RRs) for LHC and breast cancer, respectively, were 1.48 (95% CI 1.07–2.05) and 0.97 (95% CI 0.80–1.18). The meta-RR’s for LHC among EO production and EO sterilization workers were 1.46 (95% CI 0.85–2.50) and 1.07 (95% CI 0.87–1.30), respectively. We observed higher risks of LHC in the earlier published studies, compared to the later studies, and the meta-RR’s for the 1980s, 1990s, 2000s, and the 2010s, respectively, were 3.87 (95% CI 1.87–8.01), 1.38 (95% CI 0.85–2.25), 1.05 (95% CI 0.84–1.31), and 1.19 (95% CI 0.80–1.77).

Conclusions

The most informative epidemiology studies, which were published in the 2000s and 2010s, do not support the conclusion that exposure to EO is associated with an increased risk of LHC or breast cancer.
Appendix
Available only for authorised users
Footnotes
1
For the purposes of consistency, values that were reported in mg/m3 were converted to ppm, assuming that 1 ppm = 1.8 mg/m3.
 
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Metadata
Title
Ethylene oxide and risk of lympho-hematopoietic cancer and breast cancer: a systematic literature review and meta-analysis
Authors
Gary M. Marsh
Kara A. Keeton
Alexander S. Riordan
Elizabeth A. Best
Stacey M. Benson
Publication date
01-10-2019
Publisher
Springer Berlin Heidelberg
Published in
International Archives of Occupational and Environmental Health / Issue 7/2019
Print ISSN: 0340-0131
Electronic ISSN: 1432-1246
DOI
https://doi.org/10.1007/s00420-019-01438-z

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