Участие авторов

zurniimtpe

Медицина труда и промышленная экология

Russian Journal of Occupational Health and Industrial Ecology

1026-94282618-8945

FSBSI “Izmerov Research Institute of Occupational Health”

10.31089/1026-9428-2023-63-5-315-326

tqfqtq

zurniimtpe-3180

Research Article

ОБЗОР ЛИТЕРАТУРЫ

LITERATURE REVIEW

Смертность профессиональных водителей 9 стран: систематический обзор и мета-анализ

Professional driver mortality in 9 countries: a systematic review and meta-analysis

https://orcid.org/0000-0001-8700-7624

Котеров

Алексей Николаевич

Koterov

Aleksei N.

Зав. лаб., ФГБУ ГНЦ ФМБЦ им. А.И. Бурназяна, д-р биол. наук.

e-mail: govorilga@inbox.ru

Chief of laboratory, A.I. Burnazyan Federal Medical Biophysical Center, Moscow, Russia, D.Sc. (Biology).

e-mail: govorilga@inbox.ru

govorilga@inbox.ru

https://orcid.org/0000-0001-8486-8007

Ушенкова

Лилия Н.

Ushenkova

Liliya N.

noemail@neicon.ru

ФГБУ «Государственный научный цент Российской Федерации — Федеральный медицинский биофизический центр им. А.И. Бурназяна ФМБА России»РоссияA.I. Burnazyan Federal Medical Biophysical CenterRussian Federation

2023

05052023

635315326

2023

Котеров А.Н., Ушенкова Л.Н.

Koterov A.N., Ushenkova L.N.

Данная работа распространяется под лицензией Creative Commons Attribution 4.0.

This work is licensed under a Creative Commons Attribution 4.0 License.

https://www.journal-irioh.ru/jour/article/view/3180

Выполнен систематический обзор, объединяющий анализ (по средним значениям для выборок после удаления выпадающих вариант) и мета-анализ для показателей Standardized mortality ratio (SMR) сравнительно с генеральной популяцией по общей смертности и смертности от всех злокачественных новообразований для профессиональных водителей (только мужчины) различных стран (когорты Великобритании, Дании, Исландии, Италии, Канады, России, Сингапура, Швейцарии и Швеции (1988–2002 гг.); данные для США (1978) были недоступны; всего 13 работ). Критериями поиска и отбора источников (PubMed, Google, Cochrane Systematic Reviews и списки литературы публикаций) являлись: а) когорта только водителей, без добавления иных работников автопредприятий; б) наличие в исследовании показателей общей смертности ('all causes') и/или смертности от всех злокачественных новообразований ('all cancer', 'all malignant neoplasms'); в) выражение показателей смертности только в индексе SMR.

По результатам объединяющего анализа и мета-анализа для общей группы водителей (дальнобойщики, шофёры нефтяного производства, грузовиков, такси, автобусов и троллейбусов; 14 когорт) по показателю общей смертности продемонстрирован слабый «эффект здорового работника» (HWE; мета-анализ: SMR=0,92; 95% доверительные интервалы (CI): 0,85; 0,99; о наличии HWE судили по величине верхнего CI<1,0). Выявлены также тенденции к HWE по общей смертности для водителей такси и грузовиков (SMR=0,9–0,93), но для выводов выборки слишком малы. Для остальных групп водителей HWE не обнаружен.

В обоих типах синтетических исследований не наблюдалось HWE по показателю SMR для смертности от всех злокачественных новообразований ни для общей группы водителей (8 стран; 16 когорт), ни для отдельных профессиональных групп. Имелись слабые повышения SMR (на 3–10%), величина которых по эпидемиологическим канонам труднодоказуема, а по шкале рисков R.R. Monson соответствует отсутствию эффекта.

Отсутствие значимых рисков как по интегральному показателю благополучия (продолжительности жизни, обратно пропорциональна SMR), так и по смертности от всех типов злокачественных новообразований для профессиональных водителей, делает маловероятным ожидание повышенной смертности населения России из-за всё увеличивающейся массовой автомобилизации.

Участие авторов

Участие авторов:Котеров А.Н. — концепция и дизайн исследования, сбор и обработка данных, написание текста, редактирование;Ушенкова Л.Н. — сбор и обработка данных, редактирование.

Финансирование

Финансирование. В рамках более широкой бюджетной темы ФМБА России; без иных источников финансирования и спонсорской поддержки.

Конфликт интересов

Конфликт интересов. Авторы заявляют об отсутствии конфликта интересов.

Дата поступления

Дата поступления: 17.01.2023 / Дата принятия к печати: 24.01.2023 / Дата публикации: 05.05.2023

A systematic review, combining analysis (on means after deleting outliers from samples) and meta-analysis for Standardized mortality ratio (SMR) versus the general population for total and all-cancer mortality for professional drivers (men only) of various countries (cohorts of Great Britain, Denmark, Iceland, Italy, Canada, Russia, Singapore, Switzerland and Sweden (1988–2002); data for the USA (1978) were not available; 13 papers in total) were conducted. The criteria for the search and selection of sources (PubMed, Google, Cochrane Systematic Reviews and reference lists of publications) were: a) a cohort of drivers only, without adding other employees of auto enterprises; b) the presence in the study of index of total mortality (‘all causes’) and/or mortality from all malignant neoplasms (‘all cancer’); c) the expression of mortality rates only in the SMR index.

A combined analysis and meta-analysis showed a weak healthy worker effect (HWE; meta-analysis: SMR=0.92, 95% confidence intervals (CI): 0.85, 0.99, the presence of HWE was judged by the value of the upper CI<1.0). There are also trends towards HWE for overall mortality for taxi and truck drivers (SMR=0.9–0.93), but the samples are too small to draw conclusions. For other groups of drivers HWE was not found.

In both types of synthetic studies, no SMR for HWE was observed for mortality from all malignancies, either for the general group of drivers (8 countries; 16 cohorts) or for individual occupational groups. There were slight increases in SMR (by 3–10%), the magnitude of which, according to epidemiological canons, is difficult to prove, and according to the risk scale by R.R. Monson corresponds to no effect.

The absence of significant risks both in terms of the integral indicator of well-being (life expectancy, inversely proportional to SMR), and in terms of mortality from all types of malignant neoplasms for professional drivers makes it unlikely that the population of Russia will experience increased mortality due to ever-increasing mass motorization.

Contribution

Contribution:Koterov A.N. — the concept and design of the study, data collection and processing, writing the text, editing;Ushenkova L.N. — data collection and processing, editing.

Funding

Funding. As part of the broader budget theme of the FMBA of Russia; without other sources of funding and sponsorship.

Conflict of interests

Conflict of interests. The authors declare no conflict of interests.

Received

Received: 17.01.2023 / Accepted: 24.01.2023 / Published: 05.05.2023

профессиональные водителиобщая смертностьсмертность от злокачественных новообразованийстандартизованное отношение смертностиэффект здорового работника

professional driversoverall mortalitymortality from malignant neoplasmsstandardized mortality ratiohealthy worker effect

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The authors declare that there are no conflicts of interest present.