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目的采用Meta-analysis方法,对游离二氧化硅暴露与肺癌之间的关系进行了系统综合评价,为制定防制措施提供科学依据,亦为今后开展“循证职业医学”提供借鉴。方法本研究对所收集游离二氧化硅暴露和肺癌关系研究方面的原始文献(已公开发表)按所制定的纳入标准进行分类整理,然后采用适用于职业流行病学调查资料分析的固定效应模型和随机效应模型,分析其间的关联强度。可概括为：(1)分别计算所收集资料的各自合并后的队列研究和病例对照研究SMR值及其相应95%可信区间；(2)分别按不同研究设计,进行分层,计算总SMR值及其95%可信限区间。并计算本研究的失效安全系数(Fail-safe Number)。结果分别合并所收集资料的所有队列研究和病例对照研究后,得出SMR值及其95%可信区间,分别为SMR_队=1．93,95%可信区间为0．55～6．92；SMR值= 1．73,95%可信区间为1．01～2．99；SMR_合=2．19,95%可信区间为1．45～3．31；均P＜0．05,游离二氧化硅暴露和肺癌之间的联系有统计学意义。结论游离二氧化硅暴露和肺癌之间属中等强度关联,与国内外大多数研究结论一致。
Objective To evaluate the relationship between free silica exposure and lung cancer using Meta-analysis method, provide a scientific basis for the development of prevention and control measures, and provide reference for future evidence-based occupational medicine. METHODS: The original literature (published) on the study of the association between free silica exposure and lung cancer was classified according to established inclusion criteria, and then the fixed effect model for occupational epidemiological survey data analysis and Random effects model to analyze the correlation between the intensity. Can be summarized as: (1) SMR values and their corresponding 95% confidence intervals for the combined data from the cohort and case-control studies, respectively, were calculated; (2) stratified by study design and stratified to calculate the total SMR Value and its 95% confidence limits. And calculate the fail-safe number in this study. Results All cohort and case-control studies that incorporated the collected data yielded SMR values with 95% confidence intervals of 1.93 and 95% confidence intervals of 0.55 to 6, respectively. 92; SMR = 1.73, 95% confidence interval was 1.01 ~ 2.99; SMR_combined = 2.19, 95% confidence interval was 1.45 ~ 3.31; 05, the correlation between free silica exposure and lung cancer was statistically significant. Conclusion There is a moderate correlation between free silica exposure and lung cancer, which is consistent with most of the studies at home and abroad.