Flexible meta-regression to assess the shape of the benzene--leukemia exposure--response curve.
Background: Previous evaluations of the shape of the benzene-leukemia exposure-response curve (ERC) were based on a single set or on small sets of human occupational studies. Integrating evidence from all available studies that are of sufficient quality combined with flexible meta-regression models...
| Published in: | Environmental Health Perspectives Vol. 118; no. 4; pp. 526 - 533 |
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| Main Authors: | , , , , , |
| Format: | research systematic review tables/charts Journal Article |
| Published: |
National Institute of Environmental Health Sciences
Apr2010
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| Online Access: | View this record in EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=105169264&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 105169264 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 00916765 3B5 jtl: Environmental Health Perspectives issn: 00916765 maglogo: N pubinfo: dt: Apr2010 vid: 118 iid: 4 pid: 56539 pub: National Institute of Environmental Health Sciences place: Research Triangle Park, North Carolina artinfo: ui: 105169264 2010620798 10.1289/ehp.0901127 NLM20064779 PMC2854730 105169264 ppf: 526 ppct: 7 formats: fmt: @attributes: type: P tig: atl: Flexible meta-regression to assess the shape of the benzene--leukemia exposure--response curve. aug: au: Vlaanderen J Portengen L Rothman N Lan Q Kromhout H Vermeulen R affil: Institute for Risk Assessment Sciences, Utrecht University, Utrecht, The Netherlands sug: subj: Benzene Derivatives Adverse Effects Dose-Response Relationship Environmental Exposure Leukemia Risk Factors Confidence Intervals Data Analysis Software Human Meta Analysis Odds Ratio PubMed ab: Background: Previous evaluations of the shape of the benzene-leukemia exposure-response curve (ERC) were based on a single set or on small sets of human occupational studies. Integrating evidence from all available studies that are of sufficient quality combined with flexible meta-regression models is likely to provide better insight into the functional relation between benzene exposure and risk of leukemia. Objectives: We used natural splines in a flexible meta-regression method to assess the shape of the benzene-leukemia ERC. Methods: We fitted meta-regression models to 30 aggregated risk estimates extracted from nine human observational studies and performed sensitivity analyses to assess the impact of a priori assessed study characteristics on the predicted ERC. Results: The natural spline showed a supralinear shape at cumulative exposures less than 100 ppmyears, although this model fitted the data only marginally better than a linear model (p = 0.06). Stratification based on study design and jackknifing indicated that the cohort studies had a considerable impact on the shape of the ERC at high exposure levels (> 100 ppm-years) but that predicted risks for the low exposure range (< 50 ppm-years) were robust. Conclusions: Although limited by the small number of studies and the large heterogeneity between studies, the inclusion of all studies of sufficient quality combined with a flexible meta-regression method provides the most comprehensive evaluation of the benzene-leukemia ERC to date. The natural spline based on all data indicates a significantly increased risk of leukemia [relative risk (RR) = 1.14; 95% confidence interval (CI), 1.04-1.26] at an exposure level as low as 10 ppm-years. pubtype: Academic Journal doctype: meta analysis research systematic review tables/charts Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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