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023 UPDATED META-ANALYSIS OF FORMALDEHYDE EXPOSURE AND RESPIRATORY CANCER
In a previous meta-analysis of formaldehyde exposure and respiratory cancer, Collins et al (J Occup Environ Med 1997;39(7):639–51) concluded that the available studies do not support a causal relationship between formaldehyde exposure and cancers of the nasopharynx, nose and nasal cavities, or lung. In 2006 the International Agency for Research on Cancer (IARC) working group concluded that the evidence for carcinogenicity in humans is adequate for nasopharyngeal cancer, is limited for sinonasal cancer and does not support a causal role for formaldehyde for lung cancer. The aim of this study was to carry out an updated meta-analysis of occupational exposure to formaldehyde and cancers of the nasopharynx, nose and nasal cavities, and lung.
Relevant studies were identified using searches of electronic databases and from previous meta-analyses. Meta-analyses were carried out on the original scale for cohort studies (because of the problem of studies with zero exposed cases for nasopharyngeal cancer and sinonasal cancer) and were carried out on the log scale in the usual way for case-control and other studies.
The random effects meta-RR for nasopharyngeal cancer for cohort studies was 2.10 (95% CI 0.36 to 4.55) based on nine studies containing 14 cases. The equivalent result for case-control and other studies was 1.39 (1.10 to 1.76) (seven studies; 234 cases). For sinonasal cancer, the fixed effect meta-RR was 0.58 (0.19 to 1.39) for cohort studies (11 studies; five cases) and 1.37 (1.10 to 1.70) for case-control and other studies (six studies; 178 cases). The random effects meta-RR for lung cancer was 0.77 (0.62 to 0.92) for cohort studies (17 studies; 1990 cases) and was 0.99 (0.91 to 1.08) for case-control and other studies (five studies; 614 cases).
The results of the meta-analysis support IARC’s finding that there is an excess risk for nasopharyngeal cancer and that there …