Inhalational exposures associated with risk of interstitial lung disease: a systematic review and meta-analysis.

Background

Identify inhalational exposures associated with ILD and estimate the effects of exposures on ILD risk.

识别与ILD相关的吸入暴露，并估计暴露对ILD风险的影响。

Methods

MEDLINE and EMBASE databases were searched from 1990 to 2022 to identify inhalational exposures associated with ILD diagnosis.

从1990年至2022年，检索MEDLINE和EMBASE数据库，以识别与间质性肺病（ILD）诊断相关的吸入暴露。

ILDs where causality is well-established (hypersensitivity pneumonitis, pneumoconiosis) and sarcoidosis were excluded.

排除了因果关系明确的间质性肺病（如过敏性肺炎、尘肺病）和结节病。

Two independent reviewers screened abstracts with full-text review and data extraction of eligible studies.

两位独立的评审员对摘要进行了筛选，并对符合条件的研究进行了全文审查和数据提取。

Where possible, data were pooled and multilevel meta-analysiswas specified using a random effects model.

在可能的情况下，数据被汇总，并使用随机效应模型指定了多层元分析。

Sources of heterogeneity and risk of bias were assessed.

评估了异质性的来源和偏倚风险。

main_results

96 studies were included in the systematic review, representing 40 819 116 subjects (295 167 had ILD, 40 523 949 controls).

系统综述纳入了96项研究，代表了40,819,116名受试者（其中295,167名患有间质性肺病，40,523,949名为对照）。

For the meta-analysis, 54 studies were included (40 490 793 subjects: 273 899 ILD, 40 216 894 controls).

在该荟萃分析中，共纳入了54项研究（40,490,793名受试者：273,899例间质性肺病（ILD），40,216,894例对照）。

Exposures associated with significantly increased ILD risk included smoking (OR 1.69, 95% CI 1.47 to 1.94), organic exposures (OR 1.56, 95% CI 1.12 to 2.16), metals (OR 1.52, 95% CI 1.07 to 2.16), dust (OR 1.45, 95% CI 1.20 to 1.76) and asbestos (OR 1.53, 95% CI 1.08 to 2.15).

与间质性肺病（ILD）风险显著增加相关的暴露因素包括吸烟（OR 1.69，95% 置信区间 1.47 至 1.94）、有机物暴露（OR 1.56，95% 置信区间 1.12 至 2.16）、金属（OR 1.52，95% 置信区间 1.07 至 2.16）、粉尘（OR 1.45，95% 置信区间 1.20 至 1.76）和石棉（OR 1.53，95% 置信区间 1.08 至 2.15）。

Silica and fumes had positive associations with ILD that trended towards significance.

二氧化硅和烟雾与间质性肺病（ILD）有正相关性，这种相关性趋向于显著性。

Conclusions

This systematic reviewand multilevel meta-analysisis the first to comprehensively assess the effect of inhalational exposures on overall risk of ILD, with multiple putative exposures identified.

这项系统综述和多层次荟萃分析是首次全面评估吸入暴露对间质性肺病（ILD）总风险的影响，识别了多种潜在的暴露因素。

Future work should investigate novel occupational exposures associated with ILD, characterise the gene-environment interaction and develop preventative strategies.

未来的工作应研究与间质性肺病（ILD）相关的新型职业暴露，表征基因-环境相互作用，并制定预防策略。

prospero_registration_number

CRD42022292908.

CRD42022292908。