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href="//www.newsama.com/cdn-cgi/l/email-protection" aria-label="Mail Option"><span role="img" class="anticon"> <svg version="1.0" xmlns="http://www.w3.org/2000/svg" width="1em" height="1em" viewbox="0 0 1401 1101"> <path fill="#6ba439" d="M132.5 2.1C101.4 6 71.1 20.5 48.3 42.4c-22.7 21.7-37.5 48.3-44.6 80l-2.2 10.1v837l2.2 10.1c6.7 30 19.3 53.9 39.8 75.3 23.3 24.3 56.4 40.9 90 45 12.8 1.6 1122.2 1.6 1135 0 38.9-4.8 75.9-25.6 100-56.4 15-19.3 24.2-39 29.8-63.9l2.2-10.1v-837l-2.2-10.1c-7.1-31.8-21.9-58.3-44.6-80.1-20.2-19.2-43.9-31.7-73.6-38.5l-9.6-2.3L705 1.4c-321.9-.1-568.5.2-572.5.7zm1123.4 99.5c1.7.4 3.1 1 3.1 1.4 0 .5-125.6 87.7-279 194L700.9 490.2 422 297C268.5 190.7 143 103.4 143 103c0-.5 1-1.1 2.3-1.3 3.5-.7 1107.1-.8 1110.6-.1zM401 404c164.4 113.8 299.4 207 300 207 .6 0 135.6-93.2 300.1-207 164.5-113.9 299.3-207 299.5-207 .2 0 .4 170.9.4 379.7 0 417.9.5 386-6.1 398.3-6.2 11.6-19 21.4-31.9 24.4-5.8 1.4-67.4 1.6-562 1.6s-556.2-.2-562-1.6c-12.9-3-25.7-12.8-31.9-24.4-6.6-12.3-6.1 19.6-6.1-398.3 0-208.8.2-379.7.5-379.7S236.6 290.1 401 404z"></path> </svg></span></a><sup>1</年代up></span> <span class="articleHeader__authors_author">和<年代trong>肖恩·s·科尔</年代trong><a href="//www.newsama.com/cdn-cgi/l/email-protection" aria-label="Mail Option"><span role="img" class="anticon"> <svg version="1.0" xmlns="http://www.w3.org/2000/svg" width="1em" height="1em" viewbox="0 0 1401 1101"> <path fill="#6ba439" d="M132.5 2.1C101.4 6 71.1 20.5 48.3 42.4c-22.7 21.7-37.5 48.3-44.6 80l-2.2 10.1v837l2.2 10.1c6.7 30 19.3 53.9 39.8 75.3 23.3 24.3 56.4 40.9 90 45 12.8 1.6 1122.2 1.6 1135 0 38.9-4.8 75.9-25.6 100-56.4 15-19.3 24.2-39 29.8-63.9l2.2-10.1v-837l-2.2-10.1c-7.1-31.8-21.9-58.3-44.6-80.1-20.2-19.2-43.9-31.7-73.6-38.5l-9.6-2.3L705 1.4c-321.9-.1-568.5.2-572.5.7zm1123.4 99.5c1.7.4 3.1 1 3.1 1.4 0 .5-125.6 87.7-279 194L700.9 490.2 422 297C268.5 190.7 143 103.4 143 103c0-.5 1-1.1 2.3-1.3 3.5-.7 1107.1-.8 1110.6-.1zM401 404c164.4 113.8 299.4 207 300 207 .6 0 135.6-93.2 300.1-207 164.5-113.9 299.3-207 299.5-207 .2 0 .4 170.9.4 379.7 0 417.9.5 386-6.1 398.3-6.2 11.6-19 21.4-31.9 24.4-5.8 1.4-67.4 1.6-562 1.6s-556.2-.2-562-1.6c-12.9-3-25.7-12.8-31.9-24.4-6.6-12.3-6.1 19.6-6.1-398.3 0-208.8.2-379.7.5-379.7S236.6 290.1 401 404z"></path> </svg></span></a><sup>2</年代up></span> </div> <div class="simpleShowMore"> <button class="simpleShowMore__button">显示更多</button> </div> <div class="articleHeader__academicEditor"> <strong>学术编辑器:</年代trong> <span>大卫·o·卡彭特</年代pan> </div> <div class="articleHeader__timeline"> <div class="articleHeader__timeline_item "> <strong>收到了</年代trong> <span>2011年6月21日</年代pan> </div> <div class="articleHeader__timeline_item "> <strong>接受</年代trong> <span>2011年11月09</年代pan> </div> <div class="articleHeader__timeline_item articleHeader__timeline_item_sticky"> <strong>发表</年代trong> <span>03年4月2012年</年代pan> </div> </div> </div> <div class="articleBody"> <div class="xml-content"> <h4 class="header" id="abstract">文摘</h4> <p>多氯联苯(PCBs)是合成氯化碳氢化合物,广泛污染环境和生物蓄积在食物链中。多氯联苯一直被认为是可能的致癌物质由美国环境保护署和暴露于高水平的多氯联苯一直与非霍奇金淋巴瘤(NHL)的风险增加。在本文中,我们提出一个法医流行病学评价之间的因果关系。布拉德福德。希尔的NHL和PCB水平升高通过应用标准。包含在结果的评估是一个荟萃分析先前发表的病例对照研究,以评估之间的关联强度NHL和多氯联苯,导致浓度的比值比最低的百分比PCB(四分位数、五分位数或tertile)比较百分比浓度最高的学习小组。所有PCB同系物的体重调整一下给优势比为1.43,95%置信区间为1.31至1.55,表明NHL显著的因果联系。因为缺乏一个未曝光的对照组,小于2.0的理由使用因果贡献相对风险阈值,提出了包括生态分析NHL发病率和PCB积累(按销售额计算)。这里给出的总体结果显示强大的通用之间的因果联系NHL和PCB曝光。</p> <span class="end-abs"></span> <h4 id="introduction">1。介绍</h4> <p>多氯联苯是一种商业化生产有机氯称为氯化碳氢化合物(<一个href="#B1">1</一个>]。多氯联苯是不易燃烧的,良好的化学稳定性、高沸点,几乎不溶于水。此外,他们是抗氧化的影响,酸,基地,和其他化学物质<一个href="#B2">2</一个>,<一个href="#B3">3</一个>]。PCB分子由一对加入六碳环,附带氯(s)或增长”代替“在任何一个自由十的位置。有209个可能的氯安排,这是同族元素。氯原子的数目和他们在哪里决定同类的属性。同类的碳环可以扭曲,相对于对方,或者他们可以在同一个平面对齐(共面)。共面碳环对齐时氯(s)连接到最近的碳原子之间的联系两个环,称为邻位。共面同系物展览类二恶英的性质(<一个href="#B4">4</一个>,<一个href="#B5">5</一个>]。</p> <p>大约50年来(1929年开始),pcb制造在美国(美国)和被用于许多工业和商业应用程序以混合物的形式称为Aroclors [<一个href="#B6">6</一个>]。一个制造商(孟山都公司)产生了~ 99%的所有在美国使用的多氯联苯(<一个href="#B2">2</一个>]。在世界范围内,孟山都公司之间产生了39和48%的多氯联苯。广泛的工业使用的多氯联苯,加上不当处理实践,导致了多氯联苯的引入到环境中,这些化学物质被发现在所有环境媒体,包括空气、水、和土壤。基于越来越多的证据表明,环境中的多氯联苯是积累和坚持,这积累在人类和动物造成不良的健康影响,PCB生产在美国停止在1970年代末(<一个href="#B1">1</一个>]。</p> <p>多氯联苯是高度溶于脂质,因此,鱼类和其他动物被吸收,导致相当大的食物链的生物富集。多氯联苯通常是通过摄入人体吸收,吸入和/或皮肤接触(<一个href="#B1">1</一个>,<一个href="#B7">7</一个>- - - - - -<一个href="#B9">9</一个>]。在人类和动物发生在生物体内积累多氯联苯是身体吸收速率大于的速度从身体代谢和排泄。可检测水平的多氯联苯被发现在人类脂肪组织(脂肪),母乳,头发和血清脂质(<一个href="#B3">3</一个>,<一个href="#B10">10</一个>]。食用被污染的食物的主要来源为广大PCB接触美国人口增加,职业性暴露多氯联苯(<一个href="#B1">1</一个>,<一个href="#B2">2</一个>,<一个href="#B8">8</一个>,<一个href="#B10">10</一个>,<一个href="#B11">11</一个>]。不出所料,种群在特定风险高接触多氯联苯包括人消费sport-caught鱼类和其他污染食物,工人职业性暴露多氯联苯,个人居住附近的危险废物网站含有多氯联苯,和护理婴儿(<一个href="#B7">7</一个>,<一个href="#B8">8</一个>,<一个href="#B10">10</一个>,<一个href="#B12">12</一个>]。</p> <p>多氯联苯被认为是可能的致癌物质由环境保护署根据动物和人类研究的结果(<一个href="#B1">1</一个>]。一些动物研究已经证明直接剂量反应关系PCB水平和肝脏肿瘤发生[<一个href="#B13">13</一个>- - - - - -<一个href="#B16">16</一个>]。在人类中,也有很好的证据的增加癌症发病率之间的联系和多氯联苯。许多流行病学研究已经表明增加肝、胆道癌率(<一个href="#B17">17</一个>],乳腺癌[<一个href="#B18">18</一个>],皮肤癌[<一个href="#B19">19</一个>),而非霍奇金淋巴瘤(NHL),在其他癌症(<一个href="#B20">20.</一个>]。</p> <p>多氯联苯似乎有许多有毒的品质可能解释这些观察到的关联,包括一些副产品类二恶英的特性(118、156和169)<一个href="#B5">5</一个>),为别人模仿荷尔蒙的能力(<一个href="#B11">11</一个>],以及神经和免疫毒性[<一个href="#B21">21</一个>- - - - - -<一个href="#B23">23</一个>]。这最后的质量(免疫毒性)有助于解释某些同类浓度的观测高程之间的联系(118、138、153、170和180)和NHL的发病率的上升,免疫系统抑郁症被认为是最强的一个风险因素NHL (<一个href="#B24">24</一个>,<一个href="#B25">25</一个>]。免疫毒性是由其他有机氯共享的特点,包括杀虫剂和除草剂的二恶英和化学物质如六氯苯、七氯、氯丹和其他<一个href="#B26">26</一个>),也被发现与NHL(风险增加有关<一个href="#B27">27</一个>]。这是最有可能的免疫毒性质量链接多氯联苯和non-PCB有机氯NHL的发病率增加,当同时存在,每个独立有助于NHL的风险(<一个href="#B26">26</一个>]。</p> <p>NHL包括所有癌症的除了何杰金氏病、淋巴组织的恶性肿瘤淋巴结(<一个href="#B28">28</一个>]。NHL的发病率在世界的许多地方正在上升更快比几乎所有其他人类癌症的发病率<一个href="#B29">29日</一个>,<一个href="#B30">30.</一个>]。在美国,NHL的发病率以每年3.6%的平均增加1975 - 1991和1991 - 2005年期间持续上升,尽管以较慢的速度(~ 0.5%)<一个href="#B31">31日</一个>,<一个href="#B32">32</一个>]。人们普遍认为的变化诊断实践和已知的危险因素如年龄、免疫抑制感染的自身免疫性疾病发病率和患病率不足以解释NHL的新兴“流行”在世界上大多数[<一个href="#B33">33</一个>,<一个href="#B34">34</一个>]。此外,它是假设风险共享的世界各地的人口是最可能的解释的NHL发病率急剧增加(<一个href="#B31">31日</一个>,<一个href="#B33">33</一个>- - - - - -<一个href="#B35">35</一个>),这种接触有可能immunotoxic或免疫抑制<一个href="#B36">36</一个>]。因此,多氯联苯和其他持久性有机污染物提供了一个相当合理的解释,至少在某种程度上,NHL发病率的增加在20世纪下半叶。</p> <p>潜在的生理机制发展的NHL次要PCB暴露是不完全清楚。建立这类二恶英的副产品可以绑定并激活芳基碳氢化合物受体(AhR),一个通常不活跃转录因子(<一个href="#B37">37</一个>]。气道高反应性的overactivation可以诱导酶,产生细胞毒性代谢物或影响细胞代谢(<一个href="#B38">38</一个>]。特定共面类二恶英同类的程度可以作用于AhR是用有毒的等价物(可),比较与一组标准的剧毒类二恶英化合物2、3、7 8-Tetrachlorodibenzo<我>- p -</我>二恶英(TCDD) [<一个href="#B39">39</一个>]。还不知道这种noncoplanar nondioxin-like同系物,然而,他们似乎影响直接细胞免疫功能的影响,包括抑制白细胞的吞噬作用,其他操作(<一个href="#B22">22</一个>]。</p> <p>虽然有一些具体有效杂质测量的差异和变化NHL的PCB水平与风险增加相关,文献一般支持,通过病例对照和队列研究、概念与更高水平的人群暴露于特定PCB同类和具有较高的身体负担同样的副产品NHL的风险增加。多个代表出版物描述组先前发现的情况下从不同的注册中心和NHL临床调查和比较年龄和准确性控制,导致定量描述的相对百分比的影响组血浆PCB NHL风险通过条件逻辑回归(表<一个href="//www.newsama.com/journals/jeph/2012/258981/tab1/" target="_blank">1</一个>)(<一个href="#B26">26</一个>,<一个href="#B41">40</一个>- - - - - -<一个href="#B79">48</一个>]。一个额外的研究(<一个href="#B50">49</一个>),脂肪组织在后期评估分析。Rothman et al。<一个href="#B41">40</一个>),恩格尔et al。<一个href="#B42">41</一个>,<一个href="#B79">48</一个>),所有使用prediagnosis血液样本(不受减肥的偏见)。此外,三个具有里程碑意义的暴露研究调查之间的关系环境的各种Aroclor产品水平和死亡率从NHL(表<一个href="//www.newsama.com/journals/jeph/2012/258981/tab2/" target="_blank">2</一个>)(<一个href="#B51">50</一个>- - - - - -<一个href="#B53">52</一个>]。这些研究都提供了一个合理的基础结论之间存在因果关系高水平的多氯联苯,在环境和人体和NHL的风险增加。</p> <div class="floats-partial-section partial-other-wrapper" data-section="tab1"> <div class="floats-partial-footer"> <div class="floats-partial-caption"> <span class="caption-text">表1</年代pan> <a aria-label="View full page" class="caption-partial-url" href="//www.newsama.com/journals/jeph/2012/258981/tab1/" title="" target="_blank"></a> </div> <div class="floats-partial-caption-text"> 总结发表的病例对照研究人群检查血液NHL和PCB的风险内容包括meta-analyzed在目前的研究。总结或全部PCB指标所示。</div> <a class="table-thumb-overlay" href="//www.newsama.com/journals/jeph/2012/258981/tab1" target="_blank" aria-label="View full page"></a> </div> </div> <div class="floats-partial-section partial-other-wrapper" data-section="tab2"> <div class="floats-partial-footer"> <div class="floats-partial-caption"> <span class="caption-text">表2</年代pan> <a aria-label="View full page" class="caption-partial-url" href="//www.newsama.com/journals/jeph/2012/258981/tab2/" title="" target="_blank"></a> </div> <div class="floats-partial-caption-text"> 死亡率NHL的总结发表定群研究与电路板接触有关。注意描述的队列在王子et al ., (<一个href="#B51">50</一个>)包含在王子et al ., (<一个href="#B52">51</一个>)的研究。鼻中隔黏膜下切除术后,标准化死亡率()计算作为一个间接调整方法事件(死亡)的观察值在每个职业群体是相对于预期事件的数量(基于“标准”的速度)。</div> <a class="table-thumb-overlay" href="//www.newsama.com/journals/jeph/2012/258981/tab2" target="_blank" aria-label="View full page"></a> </div> </div> <p>几个作者报道子组与PCB的NHL曝光,包括弥漫性大细胞淋巴瘤与同类118和t细胞淋巴瘤和同类180 (<一个href="#B43">42</一个>]。哈报道最高观察协会在他们的群体之间提高PCB负担和低级的b细胞淋巴瘤,最普遍的一类NHL亚型(<一个href="#B46">43</一个>]。德鲁发现副产品180年和187年之间的关联和分散但不是卵泡NHL,而莫顿报告180年卵泡NHL和同类之间的联系,以及边缘区NHL亚型(<一个href="#B45">54</一个>]。</p> <p>给出一个合理的依据一般的结论(以人群为基础的)因果关系,如何确定的问题,在个别情况下NHL的血液和/或脂肪水平升高总或者个人PCB的副产品被观察到,如果两者之间的关系是因果关系。更被写在流行病学的评价一般(人口)比特定的因果关系(个人)因果关系。流行病学方法用于调查具体的因果关系在短期暴露/结果的情况下(即行动。,outbreak/injury investigation) and in settings in which disease onset is latent, sometimes for decades, following exposure, such as with exposure to environmental toxicological or radiological hazards. The discipline of forensic epidemiology is directed at addressing, often for presentation in legal settings, the specific causal correlation between a suspected hazard and a disease or injury outcome [<一个href="#B54">55</一个>- - - - - -<一个href="#B56">57</一个>]。调查的最终目的是回答“离婚”的问题,“<我>离婚的暴露风险,个人仍有疾病或伤害吗?</我>“(<一个href="#B57">58</一个>]。法医流行病学方法先回答这个问题是通过评估的合理性。布拉德福德。希尔的因果关系通过应用标准,然后估算由于风险百分比或因果关系(PC)的概率的概率量化,但是暴露,疾病或损伤的结果就不会发生(<一个href="#B58">59</一个>]。一般来说,如果电脑超过50%那么危险的接触被认为是最有可能有因果联系的疾病或损伤的结果(<一个href="#B59">60</一个>]。PC源于比较流行病学数据充分代表疾病或损伤的相对危险度(RR)之间<我>hazard-exposed</我>个人与人群最有意义相似<我>nonhazard-exposed</我>人口最类似于个人的意义。> 50%的PC相当于RR > 2.0,意味着疾病或损伤引起的个体随机选择暴露人口的利益往往的危害。这种方法相对简单的评估之间的因果关系,例如,吸烟和胰腺癌有明确和容易识别暴露(吸烟)和未曝光(不吸烟,不暴露于二手烟)的人口。</p> <p>PCB暴露评估和NHL,因果关系的问题更加复杂,因为无处不在的环境中多氯联苯的本质意味着没有真正未暴露的人群。结合多因子的可能病因NHL(病毒感染,免疫系统抑郁,自身免疫状况,和遗传异常都是扮演着一个角色),很容易得出结论,突出一个“可疑”的危险比如说升高血清水平的多氯联苯服务<我>贡献</我>个人的NHL的原因这样的假设完成减法风险可能会导致个人不发展疾病因素<我>必要的</我>发展的条件)。相反,NHL的发展最有可能需要大量的组件以及可疑的风险,任何数量的也可能是必要的为了让疾病清单。</p> <p>在目前的努力中,我们提出一个方法学框架具体的因果关系评估与电路板相关的NHL接触,考虑了普遍和持续的自然环境和多氯联苯的困难设置绝对阈值为特定的因果关系。完成这项任务,我们目前的荟萃分析此前发表的病例对照研究,检验NHL的风险相对于同类PCB效价。此外,我们讨论一个理由的使用调整后的相对风险或因果关系的概率阈值的结论有原因地分摊关系更可能出现在一个单独的NHL和PCB浓度升高。</p> <h4 id="methods">2。方法</h4> <h5 id="sec2.1">2.1。希尔因果评估标准的应用</h5> <p>本研究的目的,因果关系被定义为接触时发现担任前期发生的事件或条件是必要的一个特定的疾病或损伤目前它发生,鉴于其他条件是固定的(<一个href="#B60">61年</一个>]。也就是说,疾病或受伤的原因是一个事件或条件前的疾病或损伤<我>没有疾病或受伤就不会发生。</我>法医的应用流行病学解决因果关系的评价普遍遵循的标准设定的奥斯汀。布拉德福德。希尔爵士于1965年(<一个href="#B54">55</一个>,<一个href="#B55">56</一个>,<一个href="#B61">62年</一个>- - - - - -<一个href="#B65">66年</一个>]。希尔的九个标准,在他们的顺序在最初的出版物中,简要如下。<年代pan class="list"><span class="list-item"><span class="list-label">(1)</年代pan><span class="list-content"><i>协会的力量</我>:协会的力量是最重要的行列式的一般和具体的因果关系和量化RR,比值越大,入射条件的暴露组与未暴露的组的发病率,是因果关系的概率就越大。如前所述,RR > 2.0相当于电脑> 50%,这意味着它比不是说怀疑因果关系可能是真的。</年代pan></span><span class="list-item"><span class="list-label">(2)</年代pan><span class="list-content"><i>一致性</我>:重复观察的关系在不同的情况下加强因果推论。</年代pan></span><span class="list-item"><span class="list-label">(3)</年代pan><span class="list-content"><i>特异性</我>:怀疑因果因素的程度与一个特定的结果或人口。</年代pan></span><span class="list-item"><span class="list-label">(4)</年代pan><span class="list-content"><i>世事</我>:潜在的因素必须先于结果认为影响,和结果不能发生生理上可行之前或之后太大的潜伏期。暂时性的因素之一是必须出现在一般和特定的因果关系以得出结论,存在因果关系。</年代pan></span><span class="list-item"><span class="list-label">(5)</年代pan><span class="list-content"><i>生物梯度</我>:伤害结果增加比例随着剂量的接触(也称为剂量反应)。</年代pan></span><span class="list-item"><span class="list-label">(6)</年代pan><span class="list-content"><i>合理性</我>:观察协会的程度可以用已知的科学原理来解释。</年代pan></span><span class="list-item"><span class="list-label">(7)</年代pan><span class="list-content"><i>一致性</我>:因果结论不应该从根本上矛盾存在实质性的知识;鉴于目前的知识应该“有意义”。</年代pan></span><span class="list-item"><span class="list-label">(8)</年代pan><span class="list-content"><i>实验</我>:在某些情况下,可能会有来自随机实验动物或人类的证据。</年代pan></span><span class="list-item"><span class="list-label">(9)</年代pan><span class="list-content"><i>类比</我>:一个类似的暴露和结果可能是可翻译的情况下以前未知的因果调查。</年代pan></span></span></p> <p>在法医设置应用程序,这些标准包括有时修改<我>停止</我>(暴露)作为两次试验法的标准和考虑替代解释协会(如偏见和混淆),不经常用的<我>实验</我>标准(<一个href="#B59">60</一个>]。唯一的标准,是真正的因果联系是必不可少的<我>世事</我>,结果<我>必须</我>遵循及时曝光。事实上,没有一个标准(除<我>世事</我>)在所有情况下都适用<一个href="#B66">67年</一个>,<一个href="#B67">68年</一个>]。</p> <p>因果关系的标准可以集中到三个主要群体的效用:(1)用来评估是否有合理可信的结果和暴露之间的关系(<我>一致性、特异性生物梯度、合理性、一致性,实验中,</我>和<我>类比</我>和<我>停止</我>);(2)<我>世事</我>;(3)<我>协会的力量</我>(或因果关系的概率)。分析涉及的应用这些标准评价的合理性之间的因果关系NHL和PCB同类浓度升高,以及暂时性,提出在结果与讨论部分。协会的最终标准,强度是下面要讨论的。</p> <h5 id="sec2.2">2.2。荟萃分析的个体力量的副产品作为衡量协会(因果的贡献)</h5> <p>为了评估PCB同类水平的效用指数因果的贡献,有必要meta-analyze先前发表的病例对照研究数据的风险NHL与血清水平的个人有效杂质通过条件逻辑回归的应用。为了被包括在荟萃分析,研究需要有以下共同的特征:他们检查个人PCB同系物中确定等离子体从例NHL获得的样本(相对于群体的副产品),其中包括年龄和性别相匹配控制,他们排名结果同类的百分浓度(从低到高tertile,四分位数,或五分位数),他们量化结果的自然对数NHL的优势比作为衡量风险通过比较最小与最大百分比,和多个地层可用于任何包括同类。荟萃分析,固定效果Mantel-Haenszel (MH)调整后的优势比(或<年代ub>MH</年代ub>)是计算加权平均(<年代vg height="11.3375" id="M3" style="vertical-align:-3.2316pt;width:16.262501px;" version="1.1" viewbox="0 0 16.262501 11.3375" width="16.262501" xmlns="http://www.w3.org/2000/svg"> <g transform="matrix(1.25,0,0,-1.25,0,11.3375)"> <g transform="translate(72,-62.93)"> <text transform="matrix(1,0,0,-1,-71.95,66.2)"> <tspan style="font-size: 12.50px; " x="0" y="0"> </t年代pan> </text> <text transform="matrix(1,0,0,-1,-62.26,63.07)"> <tspan style="font-size: 8.75px; " x="0" y="0"> </t年代pan> </text> </g> </g> </svg>)的自然对数(ln)比值比(<年代vg height="14.7125" id="M4" style="vertical-align:-3.2316pt;width:25.862499px;" version="1.1" viewbox="0 0 25.862499 14.7125" width="25.862499" xmlns="http://www.w3.org/2000/svg"> <g transform="matrix(1.25,0,0,-1.25,0,14.7125)"> <g transform="translate(72,-60.23)"> <text transform="matrix(1,0,0,-1,-71.95,63.5)"> <tspan style="font-size: 12.50px; " x="0" y="0"> O</t年代pan> <tspan style="font-size: 12.50px; " x="9.0271664" y="0"> R</t年代pan> </text> <text transform="matrix(1,0,0,-1,-54.58,60.37)"> <tspan style="font-size: 8.75px; " x="0" y="0"> </t年代pan> </text> </g> </g> </svg>)为每一个研究的最小百分比与最高百分比浓度(表<一个href="//www.newsama.com/journals/jeph/2012/258981/tab3/" target="_blank">3</一个>)。这最小最大的比较选择的荟萃分析,以总结极值的比较。使用以下计算:<年代pan class="equation" id="EEq1"> <svg height="48" id="M5" preserveaspectratio="xMaxYMin" style="vertical-align:-0pt;width:700.9375px;" version="1.1" viewbox="0 0 700.9375 48" width="700.9375" xmlns="http://www.w3.org/2000/svg"> <g transform="matrix(1.25,0,0,-1.25,0,48)"> <g transform="translate(72,-33.6)"> <text transform="matrix(1,0,0,-1,66.11,49.29)"> <tspan style="font-size: 12.50px; " x="0" y="0"> O</t年代pan> <tspan style="font-size: 12.50px; " x="9.0271664" y="0"> R</t年代pan> </text> <text transform="matrix(1,0,0,-1,83.47,46.17)"> <tspan style="font-size: 8.75px; " x="0" y="0"> 米</t年代pan> <tspan style="font-size: 8.75px; " x="7.7805281" y="0"> H</t年代pan> </text> <text transform="matrix(1,0,0,-1,101.54,49.29)"> <tspan style="font-size: 12.50px; " x="0" y="0"> =</t年代pan> <tspan style="font-size: 12.50px; " x="13.24" y="-10.56"> ∑</t年代pan> </text> <text transform="matrix(1,0,0,-1,126.2,66.1)"> <tspan style="font-size: 8.75px; " x="0" y="0"> </t年代pan> <tspan style="font-size: 8.75px; " x="0" y="9.9300003"> </t年代pan> <tspan style="font-size: 8.75px; " x="2.7218721" y="9.9300003"> =</t年代pan> <tspan style="font-size: 8.75px; " x="8.7169924" y="9.9300003"> 1</t年代pan> </text> <text transform="matrix(1,0,0,-1,141.88,57.36)"> <tspan style="font-size: 12.50px; " x="11.7" y="-2.51"> </t年代pan> <tspan style="font-size: 12.50px; " x="0" y="0"> </t年代pan> <tspan style="font-size: 12.50px; " x="5.8514042" y="0"> </t年代pan> </text> <text transform="matrix(1,0,0,-1,159.46,56.75)"> <tspan style="font-size: 8.75px; " x="0" y="0"> </t年代pan> </text> <text transform="matrix(1,0,0,-1,162.68,59.87)"> <tspan style="font-size: 12.50px; " x="0" y="0"> </t年代pan> </text> <text transform="matrix(1,0,0,-1,167.87,56.75)"> <tspan style="font-size: 8.75px; " x="0" y="0"> </t年代pan> </text> <text transform="matrix(1,0,0,-1,171.09,59.87)"> <tspan style="font-size: 12.50px; " x="0" y="0"> /</t年代pan> <tspan style="font-size: 12.50px; " x="3.4758339" y="0"> </t年代pan> </text> <text transform="matrix(1,0,0,-1,185.2,56.75)"> <tspan style="font-size: 8.75px; " x="0" y="0"> </t年代pan> </text> <text transform="matrix(1,0,0,-1,188.42,57.36)"> <tspan style="font-size: 12.50px; " x="0" y="0"> </t年代pan> <tspan style="font-size: 12.50px; " x="8.6300001" y="-2.51"> ×</t年代pan> <tspan style="font-size: 12.50px; " x="21.5" y="0"> </t年代pan> <tspan style="font-size: 12.50px; " x="27.35" y="-2.51"> </t年代pan> </text> <text transform="matrix(1,0,0,-1,222.05,56.75)"> <tspan style="font-size: 8.75px; " x="0" y="0"> </t年代pan> </text> <text transform="matrix(1,0,0,-1,225.27,59.87)"> <tspan style="font-size: 12.50px; " x="0" y="0"> </t年代pan> </text> <text transform="matrix(1,0,0,-1,231.92,56.75)"> <tspan style="font-size: 8.75px; " x="0" y="0"> </t年代pan> </text> <text transform="matrix(1,0,0,-1,235.14,59.87)"> <tspan style="font-size: 12.50px; " x="0" y="0"> /</t年代pan> <tspan style="font-size: 12.50px; " x="3.4758339" y="0"> </t年代pan> </text> <text transform="matrix(1,0,0,-1,244.49,56.75)"> <tspan style="font-size: 8.75px; " x="0" y="0"> </t年代pan> </text> <text transform="matrix(1,0,0,-1,247.71,59.87)"> <tspan style="font-size: 12.50px; " x="0" y="0"> </t年代pan> </text> <text transform="matrix(1,0,0,-1,252.9,56.75)"> <tspan style="font-size: 8.75px; " x="0" y="0"> </t年代pan> </text> <text transform="matrix(1,0,0,-1,256.12,57.36)"> <tspan style="font-size: 12.50px; " x="0" y="0"> </t年代pan> <tspan style="font-size: 12.50px; " x="5.8514042" y="0"> </t年代pan> </text> <g> <path d="m 114.78,52.42 153.04,0" style="fill:none;stroke:#000000;stroke-width:0.82499999;stroke-linecap:butt;stroke-linejoin:miter;stroke-miterlimit:10;stroke-opacity:1;stroke-dasharray:none"></path> </g> <text transform="matrix(1,0,0,-1,160.33,37.43)"> <tspan style="font-size: 12.50px; " x="0" y="0"> ∑</t年代pan> </text> <text transform="matrix(1,0,0,-1,171.76,43.68)"> <tspan style="font-size: 8.75px; " x="0" y="0"> </t年代pan> <tspan style="font-size: 8.75px; " x="0" y="9.9300003"> </t年代pan> <tspan style="font-size: 8.75px; " x="2.7218721" y="9.9300003"> =</t年代pan> <tspan style="font-size: 8.75px; " x="8.7169924" y="9.9300003"> 1</t年代pan> </text> <text transform="matrix(1,0,0,-1,187.43,37.45)"> <tspan style="font-size: 12.50px; " x="0" y="0"> </t年代pan> </text> <text transform="matrix(1,0,0,-1,193.31,34.33)"> <tspan style="font-size: 8.75px; " x="0" y="0"> </t年代pan> </text> <text transform="matrix(1,0,0,-1,196.53,37.45)"> <tspan style="font-size: 12.50px; " x="0" y="0"> </t年代pan> </text> <text transform="matrix(1,0,0,-1,201.72,34.33)"> <tspan style="font-size: 8.75px; " x="0" y="0"> </t年代pan> </text> <text transform="matrix(1,0,0,-1,204.94,37.45)"> <tspan style="font-size: 12.50px; " x="0" y="0"> /</t年代pan> <tspan style="font-size: 12.50px; " x="3.4758339" y="0"> </t年代pan> </text> <text transform="matrix(1,0,0,-1,219.05,34.33)"> <tspan style="font-size: 8.75px; " x="0" y="0"> </t年代pan> </text> <text transform="matrix(1,0,0,-1,272.49,49.29)"> <tspan style="font-size: 12.50px; " x="0" y="0"> =</t年代pan> <tspan style="font-size: 12.50px; " x="13.23" y="-9.79"> ∑</t年代pan> </text> <text transform="matrix(1,0,0,-1,297.15,65.34)"> <tspan style="font-size: 8.75px; " x="0" y="0"> </t年代pan> <tspan style="font-size: 8.75px; " x="0" y="9.9399996"> </t年代pan> <tspan style="font-size: 8.75px; " x="2.7218721" y="9.9399996"> =</t年代pan> <tspan style="font-size: 8.75px; " x="8.7169924" y="9.9399996"> 1</t年代pan> </text> <text transform="matrix(1,0,0,-1,312.83,59.1)"> <tspan style="font-size: 12.50px; " x="0" y="0"> </t年代pan> </text> <text transform="matrix(1,0,0,-1,322.52,55.98)"> <tspan style="font-size: 8.75px; " x="0" y="0"> </t年代pan> </text> <text transform="matrix(1,0,0,-1,325.74,59.1)"> <tspan style="font-size: 12.50px; " x="0" y="0"> O</t年代pan> <tspan style="font-size: 12.50px; " x="9.0271664" y="0"> R</t年代pan> </text> <text transform="matrix(1,0,0,-1,343.1,55.98)"> <tspan style="font-size: 8.75px; " x="0" y="0"> </t年代pan> </text> <g> <path d="m 285.72,52.42 60.6,0" style="fill:none;stroke:#000000;stroke-width:0.82499999;stroke-linecap:butt;stroke-linejoin:miter;stroke-miterlimit:10;stroke-opacity:1;stroke-dasharray:none"></path> </g> <text transform="matrix(1,0,0,-1,296.02,37.43)"> <tspan style="font-size: 12.50px; " x="0" y="0"> ∑</t年代pan> </text> <text transform="matrix(1,0,0,-1,307.45,43.68)"> <tspan style="font-size: 8.75px; " x="0" y="0"> </t年代pan> <tspan style="font-size: 8.75px; " x="0" y="9.9300003"> </t年代pan> <tspan style="font-size: 8.75px; " x="2.7218721" y="9.9300003"> =</t年代pan> <tspan style="font-size: 8.75px; " x="8.7169924" y="9.9300003"> 1</t年代pan> </text> <text transform="matrix(1,0,0,-1,323.12,37.45)"> <tspan style="font-size: 12.50px; " x="0" y="0"> </t年代pan> </text> <text transform="matrix(1,0,0,-1,332.81,34.33)"> <tspan style="font-size: 8.75px; " x="0" y="0"> </t年代pan> </text> <text transform="matrix(1,0,0,-1,347.52,49.29)"> <tspan style="font-size: 12.50px; " x="0" y="0"> 。</t年代pan> <tspan style="font-size: 12.50px; " x="126.6" y="0"> (</t年代pan> <tspan style="font-size: 12.50px; " x="130.7635" y="0"> 1</t年代pan> <tspan style="font-size: 12.50px; " x="137.015" y="0"> )</t年代pan> </text> </g> </g> </svg></span>这种方法利用亚种群在每个研究(<年代vg height="11.05" id="M6" style="vertical-align:-3.2316pt;width:12px;" version="1.1" viewbox="0 0 12 11.05" width="12" xmlns="http://www.w3.org/2000/svg"> <g transform="matrix(1.25,0,0,-1.25,0,11.05)"> <g transform="translate(72,-63.16)"> <text transform="matrix(1,0,0,-1,-71.95,66.44)"> <tspan style="font-size: 12.50px; " x="0" y="0"> </t年代pan> </text> <text transform="matrix(1,0,0,-1,-65.67,63.31)"> <tspan style="font-size: 8.75px; " x="0" y="0"> </t年代pan> </text> </g> </g> </svg>,<年代vg height="14.5875" id="M7" style="vertical-align:-3.2316pt;width:11.5px;" version="1.1" viewbox="0 0 11.5 14.5875" width="11.5" xmlns="http://www.w3.org/2000/svg"> <g transform="matrix(1.25,0,0,-1.25,0,14.5875)"> <g transform="translate(72,-60.33)"> <text transform="matrix(1,0,0,-1,-71.95,63.6)"> <tspan style="font-size: 12.50px; " x="0" y="0"> </t年代pan> </text> <text transform="matrix(1,0,0,-1,-66.07,60.47)"> <tspan style="font-size: 8.75px; " x="0" y="0"> </t年代pan> </text> </g> </g> </svg>,<年代vg height="11.05" id="M8" style="vertical-align:-3.2316pt;width:10.6375px;" version="1.1" viewbox="0 0 10.6375 11.05" width="10.6375" xmlns="http://www.w3.org/2000/svg"> <g transform="matrix(1.25,0,0,-1.25,0,11.05)"> <g transform="translate(72,-63.16)"> <text transform="matrix(1,0,0,-1,-71.95,66.44)"> <tspan style="font-size: 12.50px; " x="0" y="0"> </t年代pan> </text> <text transform="matrix(1,0,0,-1,-66.76,63.31)"> <tspan style="font-size: 8.75px; " x="0" y="0"> </t年代pan> </text> </g> </g> </svg>,<年代vg height="14.5875" id="M9" style="vertical-align:-3.2316pt;width:12.4625px;" version="1.1" viewbox="0 0 12.4625 14.5875" width="12.4625" xmlns="http://www.w3.org/2000/svg"> <g transform="matrix(1.25,0,0,-1.25,0,14.5875)"> <g transform="translate(72,-60.33)"> <text transform="matrix(1,0,0,-1,-71.95,63.6)"> <tspan style="font-size: 12.50px; " x="0" y="0"> </t年代pan> </text> <text transform="matrix(1,0,0,-1,-65.3,60.47)"> <tspan style="font-size: 8.75px; " x="0" y="0"> </t年代pan> </text> </g> </g> </svg>2乘2应急表中标识)分层<年代vg height="10.7375" id="M10" style="vertical-align:-0.13794pt;width:8.6000004px;" version="1.1" viewbox="0 0 8.6000004 10.7375" width="8.6000004" xmlns="http://www.w3.org/2000/svg"> <g transform="matrix(1.25,0,0,-1.25,0,10.7375)"> <g transform="translate(72,-63.41)"> <text transform="matrix(1,0,0,-1,-71.95,63.6)"> <tspan style="font-size: 12.50px; " x="0" y="0"> </t年代pan> </text> </g> </g> </svg>研究。的置信区间<年代ub>MH</年代ub>是由第一次计算或估计的标准误差(SE) (<年代vg height="14.7125" id="M11" style="vertical-align:-3.2316pt;width:25.862499px;" version="1.1" viewbox="0 0 25.862499 14.7125" width="25.862499" xmlns="http://www.w3.org/2000/svg"> <g transform="matrix(1.25,0,0,-1.25,0,14.7125)"> <g transform="translate(72,-60.23)"> <text transform="matrix(1,0,0,-1,-71.95,63.5)"> <tspan style="font-size: 12.50px; " x="0" y="0"> O</t年代pan> <tspan style="font-size: 12.50px; " x="9.0271664" y="0"> R</t年代pan> </text> <text transform="matrix(1,0,0,-1,-54.58,60.37)"> <tspan style="font-size: 8.75px; " x="0" y="0"> </t年代pan> </text> </g> </g> </svg>),由以下方程[<一个href="#B68">69年</一个>]:<年代pan class="equation" id="EEq2"> <svg height="95.675003" id="M12" preserveaspectratio="xMaxYMin" style="vertical-align:-0pt;width:700.9375px;" version="1.1" viewbox="0 0 700.9375 95.675003" width="700.9375" xmlns="http://www.w3.org/2000/svg"> <g transform="matrix(1.25,0,0,-1.25,0,95.675)"> <g transform="translate(72,4.54)"> <text transform="matrix(1,0,0,-1,43.11,61.13)"> <tspan style="font-size: 12.50px; " x="16.67" y="2.51"> </t年代pan> <tspan style="font-size: 12.50px; " x="0" y="0"> 年代</t年代pan> <tspan style="font-size: 12.50px; " x="6.9516678" y="0"> E</t年代pan> <tspan style="font-size: 12.50px; " x="22.530001" y="0"> l</t年代pan> <tspan style="font-size: 12.50px; " x="26.005835" y="0"> n</t年代pan> <tspan style="font-size: 12.50px; " x="34.332832" y="0"> O</t年代pan> <tspan style="font-size: 12.50px; " x="43.359997" y="0"> R</t年代pan> </text> <text transform="matrix(1,0,0,-1,94.81,58.01)"> <tspan style="font-size: 8.75px; " x="0" y="0"> 米</t年代pan> <tspan style="font-size: 8.75px; " x="7.7805281" y="0"> H</t年代pan> </text> <text transform="matrix(1,0,0,-1,109.41,58.62)"> <tspan style="font-size: 12.50px; " x="0" y="0"> </t年代pan> <tspan style="font-size: 12.50px; " x="-52.860001" y="37.650002"> =</t年代pan> <tspan style="font-size: 12.50px; " x="-40.830002" y="19.67"> </t年代pan> <tspan style="font-size: 12.50px; " x="-40.830002" y="26.719999"> </t年代pan> <tspan style="font-size: 12.50px; " x="-40.830002" y="33.759998"> </t年代pan> <tspan style="font-size: 12.50px; " x="-40.830002" y="40.810001"> </t年代pan> <tspan style="font-size: 12.50px; " x="-40.830002" y="63.110001"> ⎷</t年代pan> </text> <g> <path d="m 83.39,46.37 287.13,0" style="fill:none;stroke:#000000;stroke-width:0.82499999;stroke-linecap:butt;stroke-linejoin:miter;stroke-miterlimit:10;stroke-opacity:1;stroke-dasharray:none"></path> </g> <text transform="matrix(1,0,0,-1,86.45,31.52)"> <tspan style="font-size: 12.50px; " x="0" y="0"> ∑</t年代pan> </text> <text transform="matrix(1,0,0,-1,97.88,37.78)"> <tspan style="font-size: 8.75px; " x="0" y="0"> </t年代pan> <tspan style="font-size: 8.75px; " x="0" y="9.9300003"> </t年代pan> <tspan style="font-size: 8.75px; " x="2.7218721" y="9.9300003"> =</t年代pan> <tspan style="font-size: 8.75px; " x="8.7169924" y="9.9300003"> 1</t年代pan> </text> <text transform="matrix(1,0,0,-1,113.56,29.04)"> <tspan style="font-size: 12.50px; " x="0" y="0"> </t年代pan> <tspan style="font-size: 12.50px; " x="5.8499999" y="-2.51"> </t年代pan> </text> <text transform="matrix(1,0,0,-1,126.83,28.42)"> <tspan style="font-size: 8.75px; " x="0" y="0"> </t年代pan> </text> <text transform="matrix(1,0,0,-1,130.05,31.55)"> <tspan style="font-size: 12.50px; " x="0" y="0"> </t年代pan> </text> <text transform="matrix(1,0,0,-1,139.31,28.42)"> <tspan style="font-size: 8.75px; " x="0" y="0"> </t年代pan> </text> <text transform="matrix(1,0,0,-1,142.53,29.04)"> <tspan style="font-size: 12.50px; " x="0" y="0"> </t年代pan> </text> <g> <path d="m 84.58,24.1 65.67,0" style="fill:none;stroke:#000000;stroke-width:0.82499999;stroke-linecap:butt;stroke-linejoin:miter;stroke-miterlimit:10;stroke-opacity:1;stroke-dasharray:none"></path> </g> <text transform="matrix(1,0,0,-1,84.58,3.92)"> <tspan style="font-size: 12.50px; " x="0" y="0"> 2</t年代pan> <tspan style="font-size: 12.50px; " x="6.25" y="4.9200001"> </t年代pan> <tspan style="font-size: 12.50px; " x="13.62" y="0.029999999"> ∑</t年代pan> </text> <text transform="matrix(1,0,0,-1,109.63,10.15)"> <tspan style="font-size: 8.75px; " x="0" y="0"> </t年代pan> <tspan style="font-size: 8.75px; " x="0" y="9.9399996"> </t年代pan> <tspan style="font-size: 8.75px; " x="2.7218721" y="9.9399996"> =</t年代pan> <tspan style="font-size: 8.75px; " x="8.7169924" y="9.9399996"> 1</t年代pan> </text> <text transform="matrix(1,0,0,-1,125.3,3.92)"> <tspan style="font-size: 12.50px; " x="0" y="0"> </t年代pan> </text> <text transform="matrix(1,0,0,-1,134.55,0.79)"> <tspan style="font-size: 8.75px; " x="0" y="0"> </t年代pan> </text> <text transform="matrix(1,0,0,-1,137.77,-1)"> <tspan style="font-size: 12.50px; " x="0" y="0"> </t年代pan> </text> <text transform="matrix(1,0,0,-1,145.38,15.29)"> <tspan style="font-size: 8.75px; " x="0" y="0"> 2</t年代pan> </text> <text transform="matrix(1,0,0,-1,154.22,20.97)"> <tspan style="font-size: 12.50px; " x="0" y="0"> +</t年代pan> <tspan style="font-size: 12.50px; " x="21.540001" y="-10.55"> ∑</t年代pan> </text> <text transform="matrix(1,0,0,-1,187.19,37.78)"> <tspan style="font-size: 8.75px; " x="0" y="0"> </t年代pan> <tspan style="font-size: 8.75px; " x="0" y="9.9300003"> </t年代pan> <tspan style="font-size: 8.75px; " x="2.7218721" y="9.9300003"> =</t年代pan> <tspan style="font-size: 8.75px; " x="8.7169924" y="9.9300003"> 1</t年代pan> </text> <text transform="matrix(1,0,0,-1,202.86,29.04)"> <tspan style="font-size: 12.50px; " x="0" y="0"> </t年代pan> <tspan style="font-size: 12.50px; " x="5.8600001" y="-2.51"> </t年代pan> </text> <text transform="matrix(1,0,0,-1,216.14,28.42)"> <tspan style="font-size: 8.75px; " x="0" y="0"> </t年代pan> </text> <text transform="matrix(1,0,0,-1,219.36,31.55)"> <tspan style="font-size: 12.50px; " x="0" y="0"> </t年代pan> </text> <text transform="matrix(1,0,0,-1,229.05,28.42)"> <tspan style="font-size: 8.75px; " x="0" y="0"> </t年代pan> </text> <text transform="matrix(1,0,0,-1,235.05,31.55)"> <tspan style="font-size: 12.50px; " x="0" y="0"> +</t年代pan> <tspan style="font-size: 12.50px; " x="11.340221" y="0"> </t年代pan> </text> <text transform="matrix(1,0,0,-1,256.16,28.42)"> <tspan style="font-size: 8.75px; " x="0" y="0"> </t年代pan> </text> <text transform="matrix(1,0,0,-1,259.38,31.55)"> <tspan style="font-size: 12.50px; " x="0" y="0"> </t年代pan> </text> <text transform="matrix(1,0,0,-1,268.63,28.42)"> <tspan style="font-size: 8.75px; " x="0" y="0"> </t年代pan> </text> <text transform="matrix(1,0,0,-1,271.85,29.04)"> <tspan style="font-size: 12.50px; " x="0" y="0"> </t年代pan> </text> <g> <path d="m 166.76,24.1 119.94,0" style="fill:none;stroke:#000000;stroke-width:0.82499999;stroke-linecap:butt;stroke-linejoin:miter;stroke-miterlimit:10;stroke-opacity:1;stroke-dasharray:none"></path> </g> <text transform="matrix(1,0,0,-1,166.76,6.55)"> <tspan style="font-size: 12.50px; " x="0" y="0"> 2</t年代pan> <tspan style="font-size: 12.50px; " x="8.3400002" y="4.9200001"> </t年代pan> <tspan style="font-size: 12.50px; " x="15.7" y="0.029999999"> ∑</t年代pan> </text> <text transform="matrix(1,0,0,-1,193.89,12.78)"> <tspan style="font-size: 8.75px; " x="0" y="0"> </t年代pan> <tspan style="font-size: 8.75px; " x="0" y="9.9300003"> </t年代pan> <tspan style="font-size: 8.75px; " x="2.7218721" y="9.9300003"> =</t年代pan> <tspan style="font-size: 8.75px; " x="8.7169924" y="9.9300003"> 1</t年代pan> </text> <text transform="matrix(1,0,0,-1,209.57,6.55)"> <tspan style="font-size: 12.50px; " x="0" y="0"> </t年代pan> </text> <text transform="matrix(1,0,0,-1,218.82,3.42)"> <tspan style="font-size: 8.75px; " x="0" y="0"> </t年代pan> </text> <text transform="matrix(1,0,0,-1,222.04,1.63)"> <tspan style="font-size: 12.50px; " x="17.049999" y="-4.8899999"> ∑</t年代pan> <tspan style="font-size: 12.50px; " x="0" y="0"> </t年代pan> <tspan style="font-size: 12.50px; " x="9.6773224" y="0"> </t年代pan> </text> <text transform="matrix(1,0,0,-1,250.52,12.78)"> <tspan style="font-size: 8.75px; " x="0" y="0"> </t年代pan> <tspan style="font-size: 8.75px; " x="0" y="9.9300003"> </t年代pan> <tspan style="font-size: 8.75px; " x="2.7218721" y="9.9300003"> =</t年代pan> <tspan style="font-size: 8.75px; " x="8.7169924" y="9.9300003"> 1</t年代pan> </text> <text transform="matrix(1,0,0,-1,266.19,6.55)"> <tspan style="font-size: 12.50px; " x="0" y="0"> </t年代pan> </text> <text transform="matrix(1,0,0,-1,275.88,3.42)"> <tspan style="font-size: 8.75px; " x="0" y="0"> </t年代pan> </text> <text transform="matrix(1,0,0,-1,279.1,1.63)"> <tspan style="font-size: 12.50px; " x="0" y="0"> </t年代pan> <tspan style="font-size: 12.50px; " x="11.58" y="-19.34"> +</t年代pan> <tspan style="font-size: 12.50px; " x="24.82" y="-29.889999"> ∑</t年代pan> </text> <text transform="matrix(1,0,0,-1,315.35,37.78)"> <tspan style="font-size: 8.75px; " x="0" y="0"> </t年代pan> <tspan style="font-size: 8.75px; " x="0" y="9.9300003"> </t年代pan> <tspan style="font-size: 8.75px; " x="2.7218721" y="9.9300003"> =</t年代pan> <tspan style="font-size: 8.75px; " x="8.7169924" y="9.9300003"> 1</t年代pan> </text> <text transform="matrix(1,0,0,-1,331.02,29.04)"> <tspan style="font-size: 12.50px; " x="0" y="0"> </t年代pan> <tspan style="font-size: 12.50px; " x="5.8499999" y="-2.51"> </t年代pan> </text> <text transform="matrix(1,0,0,-1,346.64,28.42)"> <tspan style="font-size: 8.75px; " x="0" y="0"> </t年代pan> </text> <text transform="matrix(1,0,0,-1,349.86,31.55)"> <tspan style="font-size: 12.50px; " x="0" y="0"> </t年代pan> </text> <text transform="matrix(1,0,0,-1,359.55,28.42)"> <tspan style="font-size: 8.75px; " x="0" y="0"> </t年代pan> </text> <text transform="matrix(1,0,0,-1,362.77,29.04)"> <tspan style="font-size: 12.50px; " x="0" y="0"> </t年代pan> </text> <g> <path d="m 303.22,24.1 66.1,0" style="fill:none;stroke:#000000;stroke-width:0.82499999;stroke-linecap:butt;stroke-linejoin:miter;stroke-miterlimit:10;stroke-opacity:1;stroke-dasharray:none"></path> </g> <text transform="matrix(1,0,0,-1,303.22,3.92)"> <tspan style="font-size: 12.50px; " x="0" y="0"> 2</t年代pan> <tspan style="font-size: 12.50px; " x="6.25" y="4.9200001"> </t年代pan> <tspan style="font-size: 12.50px; " x="13.61" y="0.029999999"> ∑</t年代pan> </text> <text transform="matrix(1,0,0,-1,328.26,10.15)"> <tspan style="font-size: 8.75px; " x="0" y="0"> </t年代pan> <tspan style="font-size: 8.75px; " x="0" y="9.9399996"> </t年代pan> <tspan style="font-size: 8.75px; " x="2.7218721" y="9.9399996"> =</t年代pan> <tspan style="font-size: 8.75px; " x="8.7169924" y="9.9399996"> 1</t年代pan> </text> <text transform="matrix(1,0,0,-1,343.93,3.92)"> <tspan style="font-size: 12.50px; " x="0" y="0"> </t年代pan> </text> <text transform="matrix(1,0,0,-1,353.62,0.79)"> <tspan style="font-size: 8.75px; " x="0" y="0"> </t年代pan> </text> <text transform="matrix(1,0,0,-1,356.84,-1)"> <tspan style="font-size: 12.50px; " x="0" y="0"> </t年代pan> </text> <text transform="matrix(1,0,0,-1,364.45,15.29)"> <tspan style="font-size: 8.75px; " x="0" y="0"> 2</t年代pan> </text> <text transform="matrix(1,0,0,-1,370.52,20.97)"> <tspan style="font-size: 12.50px; " x="0" y="0"> ,</t年代pan> <tspan style="font-size: 12.50px; " x="103.6" y="-9.6300001"> (</t年代pan> <tspan style="font-size: 12.50px; " x="107.7635" y="-9.6300001"> 2</t年代pan> <tspan style="font-size: 12.50px; " x="114.015" y="-9.6300001"> )</t年代pan> </text> </g> </g> </svg></span>在哪里<年代pan class="equation" id="EEq3"> <svg height="85.237503" id="M13" preserveaspectratio="xMaxYMin" style="vertical-align:-0pt;width:700.9375px;" version="1.1" viewbox="0 0 700.9375 85.237503" width="700.9375" xmlns="http://www.w3.org/2000/svg"> <g transform="matrix(1.25,0,0,-1.25,0,85.2375)"> <g transform="translate(72,-3.81)"> <text transform="matrix(1,0,0,-1,133.01,54.36)"> <tspan style="font-size: 12.50px; " x="0" y="0"> </t年代pan> </text> <text transform="matrix(1,0,0,-1,140.44,51.24)"> <tspan style="font-size: 8.75px; " x="0" y="0"> </t年代pan> </text> <text transform="matrix(1,0,0,-1,147.13,54.36)"> <tspan style="font-size: 12.50px; " x="0" y="0"> =</t年代pan> <tspan style="font-size: 12.50px; " x="13.23" y="-9.2399998"> </t年代pan> </text> <text transform="matrix(1,0,0,-1,166.64,60.47)"> <tspan style="font-size: 8.75px; " x="0" y="0"> </t年代pan> </text> <text transform="matrix(1,0,0,-1,172.64,63.6)"> <tspan style="font-size: 12.50px; " x="0" y="0"> +</t年代pan> <tspan style="font-size: 12.50px; " x="11.340221" y="0"> </t年代pan> </text> <text transform="matrix(1,0,0,-1,190.63,60.47)"> <tspan style="font-size: 8.75px; " x="0" y="0"> </t年代pan> </text> <g> <path d="m 160.36,57.49 33.49,0" style="fill:none;stroke:#000000;stroke-width:0.82499999;stroke-linecap:butt;stroke-linejoin:miter;stroke-miterlimit:10;stroke-opacity:1;stroke-dasharray:none"></path> </g> <text transform="matrix(1,0,0,-1,170.18,45.61)"> <tspan style="font-size: 12.50px; " x="0" y="0"> </t年代pan> </text> <text transform="matrix(1,0,0,-1,180.82,42.48)"> <tspan style="font-size: 8.75px; " x="0" y="0"> </t年代pan> </text> <text transform="matrix(1,0,0,-1,195.05,54.36)"> <tspan style="font-size: 12.50px; " x="0" y="0"> ,</t年代pan> <tspan style="font-size: 12.50px; " x="25.131029" y="0"> </t年代pan> </text> <text transform="matrix(1,0,0,-1,229.95,51.24)"> <tspan style="font-size: 8.75px; " x="0" y="0"> </t年代pan> </text> <text transform="matrix(1,0,0,-1,236.64,54.36)"> <tspan style="font-size: 12.50px; " x="0" y="0"> =</t年代pan> <tspan style="font-size: 12.50px; " x="13.24" y="-9.2399998"> </t年代pan> </text> <text transform="matrix(1,0,0,-1,255.75,60.47)"> <tspan style="font-size: 8.75px; " x="0" y="0"> </t年代pan> </text> <text transform="matrix(1,0,0,-1,261.75,63.6)"> <tspan style="font-size: 12.50px; " x="0" y="0"> +</t年代pan> <tspan style="font-size: 12.50px; " x="11.340221" y="0"> </t年代pan> </text> <text transform="matrix(1,0,0,-1,278.28,60.47)"> <tspan style="font-size: 8.75px; " x="0" y="0"> </t年代pan> </text> <g> <path d="m 249.88,57.49 31.62,0" style="fill:none;stroke:#000000;stroke-width:0.82499999;stroke-linecap:butt;stroke-linejoin:miter;stroke-miterlimit:10;stroke-opacity:1;stroke-dasharray:none"></path> </g> <text transform="matrix(1,0,0,-1,258.76,45.61)"> <tspan style="font-size: 12.50px; " x="0" y="0"> </t年代pan> </text> <text transform="matrix(1,0,0,-1,269.4,42.48)"> <tspan style="font-size: 8.75px; " x="0" y="0"> </t年代pan> </text> <text transform="matrix(1,0,0,-1,282.7,54.36)"> <tspan style="font-size: 12.50px; " x="0" y="0"> ,</t年代pan> <tspan style="font-size: 12.50px; " x="-150" y="38.529999"> </t年代pan> </text> <text transform="matrix(1,0,0,-1,141.95,12.71)"> <tspan style="font-size: 8.75px; " x="0" y="0"> </t年代pan> </text> <text transform="matrix(1,0,0,-1,148.64,15.83)"> <tspan style="font-size: 12.50px; " x="0" y="0"> =</t年代pan> <tspan style="font-size: 12.50px; " x="13.24" y="-9.2399998"> </t年代pan> </text> <text transform="matrix(1,0,0,-1,168.15,21.94)"> <tspan style="font-size: 8.75px; " x="0" y="0"> </t年代pan> </text> <text transform="matrix(1,0,0,-1,174.15,25.07)"> <tspan style="font-size: 12.50px; " x="0" y="0"> ×</t年代pan> <tspan style="font-size: 12.50px; " x="10.777586" y="0"> </t年代pan> </text> <text transform="matrix(1,0,0,-1,191.58,21.94)"> <tspan style="font-size: 8.75px; " x="0" y="0"> </t年代pan> </text> <g> <path d="m 161.88,18.96 32.92,0" style="fill:none;stroke:#000000;stroke-width:0.82499999;stroke-linecap:butt;stroke-linejoin:miter;stroke-miterlimit:10;stroke-opacity:1;stroke-dasharray:none"></path> </g> <text transform="matrix(1,0,0,-1,171.41,7.08)"> <tspan style="font-size: 12.50px; " x="0" y="0"> </t年代pan> </text> <text transform="matrix(1,0,0,-1,182.05,3.95)"> <tspan style="font-size: 8.75px; " x="0" y="0"> </t年代pan> </text> <text transform="matrix(1,0,0,-1,196,15.83)"> <tspan style="font-size: 12.50px; " x="0" y="0"> ,</t年代pan> <tspan style="font-size: 12.50px; " x="25.131029" y="0"> </t年代pan> </text> <text transform="matrix(1,0,0,-1,230.82,12.71)"> <tspan style="font-size: 8.75px; " x="0" y="0"> </t年代pan> </text> <text transform="matrix(1,0,0,-1,237.52,15.83)"> <tspan style="font-size: 12.50px; " x="0" y="0"> =</t年代pan> <tspan style="font-size: 12.50px; " x="13.23" y="-9.2399998"> </t年代pan> </text> <text transform="matrix(1,0,0,-1,256.63,21.94)"> <tspan style="font-size: 8.75px; " x="0" y="0"> </t年代pan> </text> <text transform="matrix(1,0,0,-1,262.63,25.07)"> <tspan style="font-size: 12.50px; " x="0" y="0"> ×</t年代pan> <tspan style="font-size: 12.50px; " x="10.765083" y="0"> </t年代pan> </text> <text transform="matrix(1,0,0,-1,278.6,21.94)"> <tspan style="font-size: 8.75px; " x="0" y="0"> </t年代pan> </text> <g> <path d="m 250.75,18.96 31.07,0" style="fill:none;stroke:#000000;stroke-width:0.82499999;stroke-linecap:butt;stroke-linejoin:miter;stroke-miterlimit:10;stroke-opacity:1;stroke-dasharray:none"></path> </g> <text transform="matrix(1,0,0,-1,259.35,7.08)"> <tspan style="font-size: 12.50px; " x="0" y="0"> </t年代pan> </text> <text transform="matrix(1,0,0,-1,269.99,3.95)"> <tspan style="font-size: 8.75px; " x="0" y="0"> </t年代pan> </text> <text transform="matrix(1,0,0,-1,283.01,15.83)"> <tspan style="font-size: 12.50px; " x="0" y="0"> 。</t年代pan> <tspan style="font-size: 12.50px; " x="191.11" y="-18.950001"> (</t年代pan> <tspan style="font-size: 12.50px; " x="195.2735" y="-18.950001"> 3</t年代pan> <tspan style="font-size: 12.50px; " x="201.52499" y="-18.950001"> )</t年代pan> </text> </g> </g> </svg></span>meta-analyzed 95%置信水平(CI)然后计算自然对数(ln)匹配的规模或范围:<年代pan class="equation" id="EEq4"> <svg height="16.5875" id="M14" preserveaspectratio="xMaxYMin" style="vertical-align:-0pt;width:700.9375px;" version="1.1" viewbox="0 0 700.9375 16.5875" width="700.9375" xmlns="http://www.w3.org/2000/svg"> <g transform="matrix(1.25,0,0,-1.25,0,16.5875)"> <g transform="translate(72,-58.73)"> <text transform="matrix(1,0,0,-1,87.3,63.12)"> <tspan style="font-size: 12.50px; " x="139" y="0.029999999"> (</t年代pan> <tspan style="font-size: 12.50px; " x="232.78" y="0.029999999"> ]</t年代pan> <tspan style="font-size: 12.50px; " x="239.03" y="0"> 。</t年代pan> <tspan style="font-size: 12.50px; " x="0" y="0"> 9</t年代pan> <tspan style="font-size: 12.50px; " x="6.2515001" y="0"> 5</t年代pan> <tspan style="font-size: 12.50px; " x="12.503" y="0"> %</t年代pan> <tspan style="font-size: 12.50px; " x="26.006241" y="0"> C</t年代pan> <tspan style="font-size: 12.50px; " x="34.345741" y="0"> 我</t年代pan> <tspan style="font-size: 12.50px; " x="40.58474" y="0"> (</t年代pan> <tspan style="font-size: 12.50px; " x="44.748238" y="0"> l</t年代pan> <tspan style="font-size: 12.50px; " x="48.224072" y="0"> n</t年代pan> <tspan style="font-size: 12.50px; " x="56.563572" y="0"> O</t年代pan> <tspan style="font-size: 12.50px; " x="65.590736" y="0"> R</t年代pan> <tspan style="font-size: 12.50px; " x="73.930237" y="0"> )</t年代pan> <tspan style="font-size: 12.50px; " x="81.569572" y="0"> =</t年代pan> <tspan style="font-size: 12.50px; " x="93.609962" y="0"> l</t年代pan> <tspan style="font-size: 12.50px; " x="97.085793" y="0"> n</t年代pan> <tspan style="font-size: 12.50px; " x="105.4128" y="0"> O</t年代pan> <tspan style="font-size: 12.50px; " x="114.43996" y="0"> R</t年代pan> <tspan style="font-size: 12.50px; " x="125.56763" y="0"> ±</t年代pan> <tspan style="font-size: 12.50px; " x="143.16" y="0"> 1</t年代pan> <tspan style="font-size: 12.50px; " x="149.4115" y="0"> 。</t年代pan> <tspan style="font-size: 12.50px; " x="152.53725" y="0"> 9</t年代pan> <tspan style="font-size: 12.50px; " x="158.78876" y="0"> 6</t年代pan> <tspan style="font-size: 12.50px; " x="167.81592" y="0"> ×</t年代pan> <tspan style="font-size: 12.50px; " x="178.59351" y="0"> 年代</t年代pan> <tspan style="font-size: 12.50px; " x="185.54517" y="0"> E</t年代pan> <tspan style="font-size: 12.50px; " x="195.27251" y="0"> (</t年代pan> <tspan style="font-size: 12.50px; " x="199.436" y="0"> l</t年代pan> <tspan style="font-size: 12.50px; " x="202.91183" y="0"> n</t年代pan> <tspan style="font-size: 12.50px; " x="211.23883" y="0"> O</t年代pan> <tspan style="font-size: 12.50px; " x="220.26601" y="0"> R</t年代pan> <tspan style="font-size: 12.50px; " x="228.6055" y="0"> )</t年代pan> <tspan style="font-size: 12.50px; " x="386.82001" y="0.57999998"> (</t年代pan> <tspan style="font-size: 12.50px; " x="390.98349" y="0.57999998"> 4</t年代pan> <tspan style="font-size: 12.50px; " x="397.23499" y="0.57999998"> )</t年代pan> </text> </g> </g> </svg></span></p> <div class="floats-partial-section partial-other-wrapper" data-section="tab3"> <div class="floats-partial-footer"> <div class="floats-partial-caption"> <span class="caption-text">表3</年代pan> <a aria-label="View full page" class="caption-partial-url" href="//www.newsama.com/journals/jeph/2012/258981/tab3/" title="" target="_blank"></a> </div> <div class="floats-partial-caption-text"> 符号计算Mantel-Haenszel-adjusted病例对照研究报告出版协会的优势比NHL和PCB血内容为特定的副产品。在这里,“暴露”和“未曝光的“人口指出在传统的荟萃分析被替换为“上”和“低”承认上下百分位数的暴露在文献中报道,分别。下标“<年代vg height="9.9250002" id="M15" style="vertical-align:-0.13794pt;width:4.9875002px;" version="1.1" viewbox="0 0 4.9875002 9.9250002" width="4.9875002" xmlns="http://www.w3.org/2000/svg"> <g transform="matrix(1.25,0,0,-1.25,0,9.925)"> <g transform="translate(72,-64.06)"> <text transform="matrix(1,0,0,-1,-71.95,64.25)"> <tspan style="font-size: 12.50px; " x="0" y="0"> </t年代pan> </text> </g> </g> </svg>”表示每个地层(同类)出版。</div> <a class="table-thumb-overlay" href="//www.newsama.com/journals/jeph/2012/258981/tab3" target="_blank" aria-label="View full page"></a> </div> </div> <p>均匀性测试也进行了评估应用程序固定效应模型的应用来发表<年代vg height="10.9125" id="M25" style="vertical-align:-0.17554pt;width:27.9125px;" version="1.1" viewbox="0 0 27.9125 10.9125" width="27.9125" xmlns="http://www.w3.org/2000/svg"> <g transform="matrix(1.25,0,0,-1.25,0,10.9125)"> <g transform="translate(72,-63.27)"> <text transform="matrix(1,0,0,-1,-71.95,63.5)"> <tspan style="font-size: 12.50px; " x="0" y="0"> O</t年代pan> <tspan style="font-size: 12.50px; " x="9.0271664" y="0"> R</t年代pan> <tspan style="font-size: 12.50px; " x="17.366667" y="0"> 年代</t年代pan> </text> </g> </g> </svg>。这种方法应用于测试是否人口<年代vg height="10.9125" id="M26" style="vertical-align:-0.17554pt;width:27.9125px;" version="1.1" viewbox="0 0 27.9125 10.9125" width="27.9125" xmlns="http://www.w3.org/2000/svg"> <g transform="matrix(1.25,0,0,-1.25,0,10.9125)"> <g transform="translate(72,-63.27)"> <text transform="matrix(1,0,0,-1,-71.95,63.5)"> <tspan style="font-size: 12.50px; " x="0" y="0"> O</t年代pan> <tspan style="font-size: 12.50px; " x="9.0271664" y="0"> R</t年代pan> <tspan style="font-size: 12.50px; " x="17.366667" y="0"> 年代</t年代pan> </text> </g> </g> </svg>实际上是常数在不同地层(<一个href="#B70">70年</一个>]。如果测试失败,<年代vg height="10.9125" id="M27" style="vertical-align:-0.17554pt;width:27.9125px;" version="1.1" viewbox="0 0 27.9125 10.9125" width="27.9125" xmlns="http://www.w3.org/2000/svg"> <g transform="matrix(1.25,0,0,-1.25,0,10.9125)"> <g transform="translate(72,-63.27)"> <text transform="matrix(1,0,0,-1,-71.95,63.5)"> <tspan style="font-size: 12.50px; " x="0" y="0"> O</t年代pan> <tspan style="font-size: 12.50px; " x="9.0271664" y="0"> R</t年代pan> <tspan style="font-size: 12.50px; " x="17.366667" y="0"> 年代</t年代pan> </text> </g> </g> </svg>只是报告为不同的值,或者可以用一种随机影响模型进一步meta-analyzed [<一个href="#B27">27</一个>,<一个href="#B72">71年</一个>]。同质性评估零假设测试(<年代vg height="14.3625" id="M28" style="vertical-align:-3.2316pt;width:19.4px;" version="1.1" viewbox="0 0 19.4 14.3625" width="19.4" xmlns="http://www.w3.org/2000/svg"> <g transform="matrix(1.25,0,0,-1.25,0,14.3625)"> <g transform="translate(72,-60.51)"> <text transform="matrix(1,0,0,-1,-71.95,63.79)"> <tspan style="font-size: 12.50px; " x="0" y="0"> </t年代pan> </text> <text transform="matrix(1,0,0,-1,-61.03,60.66)"> <tspan style="font-size: 8.75px; " x="0" y="0"> </t年代pan> </text> </g> </g> </svg>)的人口优势比<年代vg height="9.9375" id="M29" style="vertical-align:-2.34499pt;width:8.4375px;" version="1.1" viewbox="0 0 8.4375 9.9375" width="8.4375" xmlns="http://www.w3.org/2000/svg"> <g transform="matrix(1.25,0,0,-1.25,0,9.9375)"> <g transform="translate(72,-64.05)"> <text transform="matrix(1,0,0,-1,-71.95,66.44)"> <tspan style="font-size: 12.50px; " x="0" y="0"> </t年代pan> </text> </g> </g> </svg>表以为统计相同,或者说,<年代vg height="16.637501" id="M30" style="vertical-align:-4.77652pt;width:279.375px;" version="1.1" viewbox="0 0 279.375 16.637501" width="279.375" xmlns="http://www.w3.org/2000/svg"> <g transform="matrix(1.25,0,0,-1.25,0,16.6375)"> <g transform="translate(72,-58.69)"> <text transform="matrix(1,0,0,-1,-71.95,63.5)"> <tspan style="font-size: 12.50px; " x="0" y="0"> </t年代pan> </text> <text transform="matrix(1,0,0,-1,-61.03,60.37)"> <tspan style="font-size: 8.75px; " x="0" y="0"> </t年代pan> </text> <text transform="matrix(1,0,0,-1,-53.06,63.5)"> <tspan style="font-size: 12.50px; " x="0" y="0"> =</t年代pan> <tspan style="font-size: 12.50px; " x="12.040389" y="0"> O</t年代pan> <tspan style="font-size: 12.50px; " x="21.067554" y="0"> R</t年代pan> </text> <text transform="matrix(1,0,0,-1,-23.65,60.37)"> <tspan style="font-size: 8.75px; " x="0" y="0"> 1</t年代pan> </text> <text transform="matrix(1,0,0,-1,-15.3,63.5)"> <tspan style="font-size: 12.50px; " x="0" y="0"> =</t年代pan> <tspan style="font-size: 12.50px; " x="12.027886" y="0"> O</t年代pan> <tspan style="font-size: 12.50px; " x="21.055052" y="0"> R</t年代pan> </text> <text transform="matrix(1,0,0,-1,14.1,60.37)"> <tspan style="font-size: 8.75px; " x="0" y="0"> 2</t年代pan> </text> <text transform="matrix(1,0,0,-1,22.45,63.5)"> <tspan style="font-size: 12.50px; " x="0" y="0"> =</t年代pan> <tspan style="font-size: 12.50px; " x="12.027886" y="0"> ⋯</t年代pan> <tspan style="font-size: 12.50px; " x="29.169498" y="0"> =</t年代pan> <tspan style="font-size: 12.50px; " x="41.197384" y="0"> O</t年代pan> <tspan style="font-size: 12.50px; " x="50.224552" y="0"> R</t年代pan> </text> <text transform="matrix(1,0,0,-1,81.03,60.37)"> <tspan style="font-size: 8.75px; " x="0" y="0"> </t年代pan> </text> <text transform="matrix(1,0,0,-1,87.72,63.5)"> <tspan style="font-size: 12.50px; " x="0" y="0"> =</t年代pan> <tspan style="font-size: 12.50px; " x="12.027886" y="0"> ⋯</t年代pan> <tspan style="font-size: 12.50px; " x="29.169498" y="0"> =</t年代pan> <tspan style="font-size: 12.50px; " x="41.197384" y="0"> O</t年代pan> <tspan style="font-size: 12.50px; " x="50.224552" y="0"> R</t年代pan> </text> <text transform="matrix(1,0,0,-1,146.3,60.37)"> <tspan style="font-size: 8.75px; " x="0" y="0"> </t年代pan> </text> </g> </g> </svg>。执行这个测试,我们计算卡方统计量(<年代vg height="16.924999" id="M31" style="vertical-align:-2.53308pt;width:52.5625px;" version="1.1" viewbox="0 0 52.5625 16.924999" width="52.5625" xmlns="http://www.w3.org/2000/svg"> <g transform="matrix(1.25,0,0,-1.25,0,16.925)"> <g transform="translate(72,-58.46)"> <text transform="matrix(1,0,0,-1,-71.95,61.03)"> <tspan style="font-size: 12.50px; " x="0" y="0"> </t年代pan> <tspan style="font-size: 12.50px; " x="13.928342" y="0"> o</t年代pan> <tspan style="font-size: 12.50px; " x="20.179842" y="0"> r</t年代pan> <tspan style="font-size: 12.50px; " x="28.50684" y="0"> </t年代pan> </text> <text transform="matrix(1,0,0,-1,-34.87,66.03)"> <tspan style="font-size: 8.75px; " x="0" y="0"> 2</t年代pan> </text> </g> </g> </svg>):<年代pan class="equation" id="EEq5"> <svg height="48.349998" id="M32" preserveaspectratio="xMaxYMin" style="vertical-align:-0pt;width:700.9375px;" version="1.1" viewbox="0 0 700.9375 48.349998" width="700.9375" xmlns="http://www.w3.org/2000/svg"> <g transform="matrix(1.25,0,0,-1.25,0,48.35)"> <g transform="translate(72,-33.32)"> <text transform="matrix(1,0,0,-1,139.47,49.67)"> <tspan style="font-size: 12.50px; " x="0" y="0"> </t年代pan> <tspan style="font-size: 12.50px; " x="13.228174" y="0"> =</t年代pan> <tspan style="font-size: 12.50px; " x="25.268562" y="0"> </t年代pan> </text> <text transform="matrix(1,0,0,-1,173.31,54.67)"> <tspan style="font-size: 8.75px; " x="0" y="0"> 2</t年代pan> </text> <text transform="matrix(1,0,0,-1,181.66,49.67)"> <tspan style="font-size: 12.50px; " x="0" y="0"> =</t年代pan> </text> <text transform="matrix(1,0,0,-1,199.45,65.61)"> <tspan style="font-size: 8.75px; " x="0" y="0"> </t年代pan> </text> <text transform="matrix(1,0,0,-1,193.7,43.12)"> <tspan style="font-size: 12.50px; " x="0" y="0"> </t年代pan> </text> <text transform="matrix(1,0,0,-1,195.23,35.94)"> <tspan style="font-size: 8.75px; " x="0" y="0"> </t年代pan> <tspan style="font-size: 8.75px; " x="2.7218721" y="0"> =</t年代pan> <tspan style="font-size: 8.75px; " x="8.7169924" y="0"> 1</t年代pan> </text> <text transform="matrix(1,0,0,-1,211.93,49.67)"> <tspan style="font-size: 12.50px; " x="0" y="0"> </t年代pan> </text> <text transform="matrix(1,0,0,-1,221.62,46.55)"> <tspan style="font-size: 8.75px; " x="0" y="0"> </t年代pan> </text> <text transform="matrix(1,0,0,-1,224.84,47.16)"> <tspan style="font-size: 12.50px; " x="0" y="0"> </t年代pan> <tspan style="font-size: 12.50px; " x="5.8600001" y="-2.51"> </t年代pan> </text> <text transform="matrix(1,0,0,-1,236.9,46.55)"> <tspan style="font-size: 8.75px; " x="0" y="0"> </t年代pan> </text> <text transform="matrix(1,0,0,-1,242.9,49.67)"> <tspan style="font-size: 12.50px; " x="20.530001" y="2.51"> </t年代pan> <tspan style="font-size: 12.50px; " x="0" y="0"> −</t年代pan> <tspan style="font-size: 12.50px; " x="11.327718" y="0"> </t年代pan> </text> <text transform="matrix(1,0,0,-1,269.28,57.21)"> <tspan style="font-size: 8.75px; " x="0" y="0"> 2</t年代pan> </text> <text transform="matrix(1,0,0,-1,274.15,49.67)"> <tspan style="font-size: 12.50px; " x="0" y="0"> 。</t年代pan> <tspan style="font-size: 12.50px; " x="199.97" y="0"> (</t年代pan> <tspan style="font-size: 12.50px; " x="204.1335" y="0"> 5</t年代pan> <tspan style="font-size: 12.50px; " x="210.38499" y="0"> )</t年代pan> </text> </g> </g> </svg></span>这里每个估计或决定的自然对数:<年代pan class="equation" id="EEq6"> <svg height="15.75" id="M33" preserveaspectratio="xMaxYMin" style="vertical-align:-0pt;width:700.9375px;" version="1.1" viewbox="0 0 700.9375 15.75" width="700.9375" xmlns="http://www.w3.org/2000/svg"> <g transform="matrix(1.25,0,0,-1.25,0,15.75)"> <g transform="translate(72,-59.4)"> <text transform="matrix(1,0,0,-1,179.71,63.2)"> <tspan style="font-size: 12.50px; " x="0" y="0"> </t年代pan> </text> <text transform="matrix(1,0,0,-1,185.91,60.07)"> <tspan style="font-size: 8.75px; " x="0" y="0"> </t年代pan> </text> <text transform="matrix(1,0,0,-1,192.61,63.2)"> <tspan style="font-size: 12.50px; " x="0" y="0"> =</t年代pan> <tspan style="font-size: 12.50px; " x="12.027886" y="0"> l</t年代pan> <tspan style="font-size: 12.50px; " x="15.50372" y="0"> n</t年代pan> <tspan style="font-size: 12.50px; " x="23.843222" y="0"> O</t年代pan> <tspan style="font-size: 12.50px; " x="32.870388" y="0"> R</t年代pan> </text> <text transform="matrix(1,0,0,-1,233.82,60.07)"> <tspan style="font-size: 8.75px; " x="0" y="0"> </t年代pan> </text> <text transform="matrix(1,0,0,-1,474.12,63.2)"> <tspan style="font-size: 12.50px; " x="0" y="0"> (</t年代pan> <tspan style="font-size: 12.50px; " x="4.1634989" y="0"> 6</t年代pan> <tspan style="font-size: 12.50px; " x="10.414999" y="0"> )</t年代pan> </text> </g> </g> </svg></span>和用于生产加权平均(<年代vg height="10.325" id="M34" style="vertical-align:-0.0pt;width:11.6125px;" version="1.1" viewbox="0 0 11.6125 10.325" width="11.6125" xmlns="http://www.w3.org/2000/svg"> <g transform="matrix(1.25,0,0,-1.25,0,10.325)"> <g transform="translate(72,-63.74)"> <text transform="matrix(1,0,0,-1,-71.95,63.79)"> <tspan style="font-size: 12.50px; " x="0" y="0"> </t年代pan> </text> </g> </g> </svg>)应用描述的权重值(<一个href="#EEq1">1</一个>),这样:<年代pan class="equation" id="EEq7"> <svg height="44.375" id="M35" preserveaspectratio="xMaxYMin" style="vertical-align:-0pt;width:700.9375px;" version="1.1" viewbox="0 0 700.9375 44.375" width="700.9375" xmlns="http://www.w3.org/2000/svg"> <g transform="matrix(1.25,0,0,-1.25,0,44.375)"> <g transform="translate(72,-36.5)"> <text transform="matrix(1,0,0,-1,169.8,51.13)"> <tspan style="font-size: 12.50px; " x="23.4" y="-10.7"> ∑</t年代pan> <tspan style="font-size: 12.50px; " x="0" y="0"> </t年代pan> <tspan style="font-size: 12.50px; " x="10.152436" y="0"> =</t年代pan> </text> <text transform="matrix(1,0,0,-1,204.62,68.09)"> <tspan style="font-size: 8.75px; " x="0" y="0"> </t年代pan> <tspan style="font-size: 8.75px; " x="0" y="10.85"> </t年代pan> <tspan style="font-size: 8.75px; " x="2.7218721" y="10.85"> =</t年代pan> <tspan style="font-size: 8.75px; " x="8.7169924" y="10.85"> 1</t年代pan> </text> <text transform="matrix(1,0,0,-1,220.3,61.86)"> <tspan style="font-size: 12.50px; " x="0" y="0"> </t年代pan> </text> <text transform="matrix(1,0,0,-1,229.99,58.73)"> <tspan style="font-size: 8.75px; " x="0" y="0"> </t年代pan> </text> <text transform="matrix(1,0,0,-1,233.21,61.86)"> <tspan style="font-size: 12.50px; " x="0" y="0"> </t年代pan> </text> <text transform="matrix(1,0,0,-1,239.41,58.73)"> <tspan style="font-size: 8.75px; " x="0" y="0"> </t年代pan> </text> <g> <path d="m 193.2,54.25 49.43,0" style="fill:none;stroke:#000000;stroke-width:0.82499999;stroke-linecap:butt;stroke-linejoin:miter;stroke-miterlimit:10;stroke-opacity:1;stroke-dasharray:none"></path> </g> <text transform="matrix(1,0,0,-1,197.91,41.25)"> <tspan style="font-size: 12.50px; " x="0" y="0"> ∑</t年代pan> </text> <text transform="matrix(1,0,0,-1,209.33,47.5)"> <tspan style="font-size: 8.75px; " x="0" y="0"> </t年代pan> <tspan style="font-size: 8.75px; " x="0" y="10.85"> </t年代pan> <tspan style="font-size: 8.75px; " x="2.7218721" y="10.85"> =</t年代pan> <tspan style="font-size: 8.75px; " x="8.7169924" y="10.85"> 1</t年代pan> </text> <text transform="matrix(1,0,0,-1,225.01,41.27)"> <tspan style="font-size: 12.50px; " x="0" y="0"> </t年代pan> </text> <text transform="matrix(1,0,0,-1,234.7,38.15)"> <tspan style="font-size: 8.75px; " x="0" y="0"> </t年代pan> </text> <text transform="matrix(1,0,0,-1,243.83,51.13)"> <tspan style="font-size: 12.50px; " x="0" y="0"> 。</t年代pan> <tspan style="font-size: 12.50px; " x="230.28999" y="0"> (</t年代pan> <tspan style="font-size: 12.50px; " x="234.45351" y="0"> 7</t年代pan> <tspan style="font-size: 12.50px; " x="240.705" y="0"> )</t年代pan> </text> </g> </g> </svg></span>由此产生的数据(<一个href="#EEq5">5</一个>)有一个约卡方分布,g1的自由度。卡方分布表为每个测试咨询,生产一个<年代vg height="10.325" id="M36" style="vertical-align:-0.0pt;width:11.75px;" version="1.1" viewbox="0 0 11.75 10.325" width="11.75" xmlns="http://www.w3.org/2000/svg"> <g transform="matrix(1.25,0,0,-1.25,0,10.325)"> <g transform="translate(72,-63.74)"> <text transform="matrix(1,0,0,-1,-71.95,63.79)"> <tspan style="font-size: 12.50px; " x="0" y="0"> </t年代pan> </text> </g> </g> </svg>零假设的价值评估<年代vg height="11.25" id="M37" style="vertical-align:-0.30096pt;width:56.150002px;" version="1.1" viewbox="0 0 56.150002 11.25" width="56.150002" xmlns="http://www.w3.org/2000/svg"> <g transform="matrix(1.25,0,0,-1.25,0,11.25)"> <g transform="translate(72,-63)"> <text transform="matrix(1,0,0,-1,-71.95,63.35)"> <tspan style="font-size: 12.50px; " x="0" y="0"> </t年代pan> <tspan style="font-size: 12.50px; " x="10.890113" y="0"> <</t年代pan> <tspan style="font-size: 12.50px; " x="22.930502" y="0"> 0</t年代pan> <tspan style="font-size: 12.50px; " x="29.182001" y="0"> 。</t年代pan> <tspan style="font-size: 12.50px; " x="32.307751" y="0"> 0</t年代pan> <tspan style="font-size: 12.50px; " x="38.559254" y="0"> 5</t年代pan> </text> </g> </g> </svg>被认为是拒绝的零<一个href="#B70">70年</一个>]。另一种评估同质性是似然比检验统计量测试,计算更麻烦<年代vg height="12.925" id="M38" style="vertical-align:-1.90608pt;width:12.325px;" version="1.1" viewbox="0 0 12.325 12.925" width="12.325" xmlns="http://www.w3.org/2000/svg"> <g transform="matrix(1.25,0,0,-1.25,0,12.925)"> <g transform="translate(72,-61.66)"> <text transform="matrix(1,0,0,-1,-71.95,63.61)"> <tspan style="font-size: 12.50px; " x="0" y="0"> </t年代pan> </text> </g> </g> </svg>统计应用这里(<一个href="#B73">72年</一个>]。</p> <h5 id="sec2.3">2.3。生态分析</h5> <p>为了解释环境变化之间的相关性程度的多氯联苯和发病率的变化NHL的生态效应进行了分析。从国家癌症研究所获得的数据(<一个href="#B32">32</一个>和PCB生产和销售水平相比<一个href="#B6">6</一个>,<一个href="#B71">73年</一个>]。时间积累多氯联苯的年度销售数据计算开源材料包括传热产品,液压/润滑剂、杂项工业产品、增塑剂、石油添加剂。环境PCB积累数据提出了三种形式:第一,随着时间的推移只有销售数据绘制;第二,销售数据在时间上扩展,假设一个静态积累水平的环境中最大的PCB生产停止后仍然是固定和不变;第三,使用销售数据为基础的假设PCB的动态积累,环境水平增加设备和材料分解,不断向环境释放同系物。这最后一种方法需要预测的积累后生产以下类似的初始生长曲线走向未来。一个多项式curvefit产生一个强大的现象学模型代表kilo-lbs(单位时间积累的<年代vg height="14.1125" id="M39" style="vertical-align:-0.27588pt;width:80.150002px;" version="1.1" viewbox="0 0 80.150002 14.1125" width="80.150002" xmlns="http://www.w3.org/2000/svg"> <g transform="matrix(1.25,0,0,-1.25,0,14.1125)"> <g transform="translate(72,-60.71)"> <text transform="matrix(1,0,0,-1,-71.95,61.03)"> <tspan style="font-size: 12.50px; " x="0" y="0"> </t年代pan> </text> <text transform="matrix(1,0,0,-1,-62.7,66.03)"> <tspan style="font-size: 8.75px; " x="0" y="0"> 2</t年代pan> </text> <text transform="matrix(1,0,0,-1,-54.35,61.03)"> <tspan style="font-size: 12.50px; " x="0" y="0"> =</t年代pan> <tspan style="font-size: 12.50px; " x="12.027886" y="0"> 0</t年代pan> <tspan style="font-size: 12.50px; " x="18.279387" y="0"> 。</t年代pan> <tspan style="font-size: 12.50px; " x="21.405136" y="0"> 9</t年代pan> <tspan style="font-size: 12.50px; " x="27.656635" y="0"> 7</t年代pan> <tspan style="font-size: 12.50px; " x="33.908134" y="0"> 7</t年代pan> <tspan style="font-size: 12.50px; " x="40.159637" y="0"> 2</t年代pan> </text> </g> </g> </svg>年),随着时间的测量:<年代pan class="equation" id="EEq8"> <svg height="18.775" id="M40" preserveaspectratio="xMaxYMin" style="vertical-align:-0pt;width:700.9375px;" version="1.1" viewbox="0 0 700.9375 18.775" width="700.9375" xmlns="http://www.w3.org/2000/svg"> <g transform="matrix(1.25,0,0,-1.25,0,18.775)"> <g transform="translate(72,-56.98)"> <text transform="matrix(1,0,0,-1,81.31,60.78)"> <tspan style="font-size: 12.50px; " x="0" y="0"> P</t年代pan> <tspan style="font-size: 12.50px; " x="6.9641709" y="0"> C</t年代pan> <tspan style="font-size: 12.50px; " x="15.303672" y="0"> B</t年代pan> <tspan style="font-size: 12.50px; " x="26.768923" y="0"> 一个</t年代pan> <tspan style="font-size: 12.50px; " x="35.683563" y="0"> c</t年代pan> <tspan style="font-size: 12.50px; " x="41.234894" y="0"> c</t年代pan> <tspan style="font-size: 12.50px; " x="46.786224" y="0"> u</t年代pan> <tspan style="font-size: 12.50px; " x="53.037727" y="0"> 米</t年代pan> <tspan style="font-size: 12.50px; " x="62.76506" y="0"> u</t年代pan> <tspan style="font-size: 12.50px; " x="69.016563" y="0"> l</t年代pan> <tspan style="font-size: 12.50px; " x="72.492393" y="0"> 一个</t年代pan> <tspan style="font-size: 12.50px; " x="78.043724" y="0"> t</t年代pan> <tspan style="font-size: 12.50px; " x="81.519562" y="0"> 我</t年代pan> <tspan style="font-size: 12.50px; " x="84.995392" y="0"> o</t年代pan> <tspan style="font-size: 12.50px; " x="91.246895" y="0"> n</t年代pan> <tspan style="font-size: 12.50px; " x="100.96172" y="0"> =</t年代pan> <tspan style="font-size: 12.50px; " x="112.98961" y="0"> 1</t年代pan> <tspan style="font-size: 12.50px; " x="119.24111" y="0"> 6</t年代pan> <tspan style="font-size: 12.50px; " x="125.49261" y="0"> ,</t年代pan> <tspan style="font-size: 12.50px; " x="130.70636" y="0"> 4</t年代pan> <tspan style="font-size: 12.50px; " x="136.95786" y="0"> 8</t年代pan> <tspan style="font-size: 12.50px; " x="143.20937" y="0"> 8</t年代pan> <tspan style="font-size: 12.50px; " x="149.46086" y="0"> 。</t年代pan> <tspan style="font-size: 12.50px; " x="152.58661" y="0"> 2</t年代pan> <tspan style="font-size: 12.50px; " x="161.61378" y="0"> +</t年代pan> <tspan style="font-size: 12.50px; " x="172.95399" y="0"> 1</t年代pan> <tspan style="font-size: 12.50px; " x="179.20551" y="0"> 0</t年代pan> <tspan style="font-size: 12.50px; " x="185.457" y="0"> 4</t年代pan> <tspan style="font-size: 12.50px; " x="191.7085" y="0"> 8</t年代pan> <tspan style="font-size: 12.50px; " x="197.95999" y="0"> 。</t年代pan> <tspan style="font-size: 12.50px; " x="201.08575" y="0"> 9</t年代pan> <tspan style="font-size: 12.50px; " x="211.51324" y="0"> (</t年代pan> <tspan style="font-size: 12.50px; " x="215.67674" y="0"> T</t年代pan> <tspan style="font-size: 12.50px; " x="223.21606" y="0"> 我</t年代pan> <tspan style="font-size: 12.50px; " x="226.69189" y="0"> 米</t年代pan> <tspan style="font-size: 12.50px; " x="236.41922" y="0"> e</t年代pan> <tspan style="font-size: 12.50px; " x="241.97057" y="0"> )</t年代pan> </text> <text transform="matrix(1,0,0,-1,327.44,66.03)"> <tspan style="font-size: 8.75px; " x="0" y="0"> 2</t年代pan> </text> <text transform="matrix(1,0,0,-1,332.31,60.78)"> <tspan style="font-size: 12.50px; " x="0" y="0"> 。</t年代pan> <tspan style="font-size: 12.50px; " x="141.81" y="0"> (</t年代pan> <tspan style="font-size: 12.50px; " x="145.9735" y="0"> 8</t年代pan> <tspan style="font-size: 12.50px; " x="152.22501" y="0"> )</t年代pan> </text> </g> </g> </svg></span>该模型应用于年超出了销售期结束,扩展到未来积累数据,匹配NHL发病率的监测周期。绘制的比较,在实际日期(日历年)以及相对时间从发放(包括销售和癌症发病率监测)。</p> <p>环境PCB积累模型并列的发病率随着时间的推移,一些主要的癌症类型。相关系数计算为每个NHL和non-NHL协会<年代vg height="14.15" id="M41" style="vertical-align:-0.30096pt;width:64.525002px;" version="1.1" viewbox="0 0 64.525002 14.15" width="64.525002" xmlns="http://www.w3.org/2000/svg"> <g transform="matrix(1.25,0,0,-1.25,0,14.15)"> <g transform="translate(72,-60.68)"> <text transform="matrix(1,0,0,-1,-71.95,61.03)"> <tspan style="font-size: 12.50px; " x="0" y="0"> </t年代pan> </text> <text transform="matrix(1,0,0,-1,-62.7,66.03)"> <tspan style="font-size: 8.75px; " x="0" y="0"> 2</t年代pan> </text> <text transform="matrix(1,0,0,-1,-54.35,61.03)"> <tspan style="font-size: 12.50px; " x="0" y="0"> ></t年代pan> <tspan style="font-size: 12.50px; " x="12.027886" y="0"> 0</t年代pan> <tspan style="font-size: 12.50px; " x="18.279387" y="0"> 。</t年代pan> <tspan style="font-size: 12.50px; " x="21.405136" y="0"> 8</t年代pan> <tspan style="font-size: 12.50px; " x="27.656635" y="0"> 0</t年代pan> </text> </g> </g> </svg>被认为是一种强大的统计相关性。</p> <h4 id="results">3所示。结果</h4> <h5 id="sec3.1">3.1。评估的因果关系的标准</h5> <h6 id="sec3.1.1">3.1.1。合理性</h6> <p>在现在的环境下,合理性并不指山狭窄的使用术语作为九因果条件之一,他指的是特定的生物行为的环境因素引起的一种疾病,而是一组标准(除了暂时性和协会的力量),回答这个问题“<我>能暴露导致的结果吗</我>希尔?”有趣的是,没有考虑生物合理性标准特别关键的发现因果关系,称他是“<我>相信这是一个功能,我们无法要求</我>“(<一个href="#B61">62年</一个>]。这是由于认识到环境毒素,事实上,引起的疾病,目前unexplicated机制可能在未来被描述。</p> <p>的合理性检查印刷电路板曝光和NHL之间的因果关系,有大量的出版信息依赖的关系表明,确实是合理的。类比是强烈支持NHL的PCB曝光的原因,因为他们属于同一化学家庭有机氯的其他化学物质,在之前与NHL流行病学研究(<一个href="#B27">27</一个>]。从生物合理性的角度来看,NHL是一种疾病,一再显示出与妥协的免疫反应(<一个href="#B24">24</一个>,<一个href="#B25">25</一个>),有很多的PCB同系物认为immunotoxic [<一个href="#B74">74年</一个>]。此外,二恶英类多氯联苯同系物有能力与芳基碳氢化合物受体结合,通常不活跃转录因子,当绑定可以改变基因转录。</p> <p>一致性的关系被认为与发表的流行病学研究,病例对照和队列的设计,各种人群在各种设置的PCB同类效价水平之间的关联与NHL风险(表<一个href="//www.newsama.com/journals/jeph/2012/258981/tab1/" target="_blank">1</一个>和<一个href="//www.newsama.com/journals/jeph/2012/258981/tab2/" target="_blank">2</一个>)。</p> <h6 id="sec3.1.2">3.1.2。世事</h6> <p>因为无处不在的自然环境和多氯联苯的体内,他们积聚了一段时间,以及NHL的本质作为一种疾病,其最大增加的人口年龄在55岁,除了最小的NHL患者(通常是那些显而易见的解释的疾病,如免疫抑制感染),暂时性被认为是适当的在大多数情况下NHL的PCB滴度高。</p> <h6 id="sec3.1.3">3.1.3。通过分析强度协会(因果的贡献)</h6> <p>11个病例对照研究报告发表在NHL和PCB水平之间的关系被认为是荟萃分析(表<一个href="//www.newsama.com/journals/jeph/2012/258981/tab1/" target="_blank">1</一个>)。这些出版物,六文章描述七独特的人口将10同系物的影响(28,99,118,138,153,156,170,180,183和187年)在NHL发病和荟萃分析下被认为有资格入选标准。点估计的优势比结果发表的所有研究的副产品从每个病例对照研究通过水平描述森林情节的总结先前发表的结果(图<一个href="//www.newsama.com/journals/jeph/2012/258981/fig1/" target="_blank">1</一个>)。这些结果被meta-analyzed根据前面描述的方法(图<一个href="//www.newsama.com/journals/jeph/2012/258981/fig2/" target="_blank">2</一个>)。</p> <div class="partial-carousel-wrapper"> <div class="floats-partial-section"> <div class="floats-partial-content"> <div class="partial-carousel--full-image partial-carousel-a3a57315abe9c8912a35ca8e49ac1206"> <div class="partial-carousel--single-image"> <img loading="lazy" alt="" src="https://static.hindawi.com/articles/jeph/volume-2012/258981/figures/258981.fig.001.jpg"> <br> <strong></strong> </div> </div> </div> <div class="floats-partial-middle"> <div class="floats-partial-middle--thumbs"> <div class="partial-carousel-dots-a3a57315abe9c8912a35ca8e49ac1206 partial-carousel-thumbnail"> <button aria-label="Slide to " class="partial-carousel-dot"><img loading="lazy" alt="" src="https://static.hindawi.com/articles/jeph/volume-2012/258981/thumbnails/258981.fig.001_th.jpg"><br><strong></strong></button> </div> </div> <div class="floats-partial-middle--nav"> <div class="partial-carousel-next-prev-a3a57315abe9c8912a35ca8e49ac1206 partial-carousel-next-prev"> <button aria-label="Previous" class="carousel-prev"></button> <button aria-label="Next" class="carousel-next"></button> </div> </div> </div> <div class="floats-partial-footer"> <div class="floats-partial-caption"> <span class="caption-text">图1</年代pan> <a aria-label="View full page" class="caption-partial-url" href="//www.newsama.com/journals/jeph/2012/258981/fig1/" title="" target="_blank"></a> </div> <div class="floats-partial-caption-text"> <table> <tbody> <tr> <td>优势比和95%置信区间为PCB血液水平有效杂质与NHL和六个病例对照研究报道。</td> </tr> </tbody> </table> </div> </div> </div> </div> <div class="partial-carousel-wrapper"> <div class="floats-partial-section"> <div class="floats-partial-content"> <div class="partial-carousel--full-image partial-carousel-d66d81ff2cb03d2819d7810dc86546e0"> <div class="partial-carousel--single-image"> <img loading="lazy" alt="" src="https://static.hindawi.com/articles/jeph/volume-2012/258981/figures/258981.fig.002.jpg"> <br> <strong></strong> </div> </div> </div> <div class="floats-partial-middle"> <div class="floats-partial-middle--thumbs"> <div class="partial-carousel-dots-d66d81ff2cb03d2819d7810dc86546e0 partial-carousel-thumbnail"> <button aria-label="Slide to " class="partial-carousel-dot"><img loading="lazy" alt="" src="https://static.hindawi.com/articles/jeph/volume-2012/258981/thumbnails/258981.fig.002_th.jpg"><br><strong></strong></button> </div> </div> <div class="floats-partial-middle--nav"> <div class="partial-carousel-next-prev-d66d81ff2cb03d2819d7810dc86546e0 partial-carousel-next-prev"> <button aria-label="Previous" class="carousel-prev"></button> <button aria-label="Next" class="carousel-next"></button> </div> </div> </div> <div class="floats-partial-footer"> <div class="floats-partial-caption"> <span class="caption-text">图2</年代pan> <a aria-label="View full page" class="caption-partial-url" href="//www.newsama.com/journals/jeph/2012/258981/fig2/" title="" target="_blank"></a> </div> <div class="floats-partial-caption-text"> <table> <tbody> <tr> <td>Meta-analyzed同系物指示Mantel-Haenszel-adjusted优势比和95%置信区间与两个或两个以上的PCB血液水平有效杂质层包括或<年代ub>MH</年代ub>对于所有同系物的总和。与单一的研究分析还包括副产品(副产品99、156、183和187年)。统计上显著的置信区间(*)表示。Meta-analyzed上百分位截止还包括PCB血液水平值为每个同类(ng / g脂质)。</td> </tr> </tbody> </table> </div> </div> </div> </div> <p>她的体重调整一下给优势比(或<年代ub>MH</年代ub>集体所有10个同系物)为1.43 (95% CI 1.31 - -1.55)。每个10的副产品导致自己的congener-specific荟萃分析以及向all-congener或<年代ub>MH</年代ub>。或<年代ub>MH</年代ub>结果七副产品(118、138、153、156、170、180和187年)在统计学上意义重大,而结果三副产品(28日,99年和183年)没有(图<一个href="//www.newsama.com/journals/jeph/2012/258981/fig2/" target="_blank">2</一个>和表<一个href="//www.newsama.com/journals/jeph/2012/258981/tab4/" target="_blank">4</一个>)。所有的七个同系物和重要的荟萃分析结果之前immunotoxic特征,描述和一个(118)也认为是二恶英。</p> <div class="floats-partial-section partial-other-wrapper" data-section="tab4"> <div class="floats-partial-footer"> <div class="floats-partial-caption"> <span class="caption-text">表4</年代pan> <a aria-label="View full page" class="caption-partial-url" href="//www.newsama.com/journals/jeph/2012/258981/tab4/" title="" target="_blank"></a> </div> <div class="floats-partial-caption-text"> 造成地层和列表或指标满足荟萃分析标准。卡方检验的结果为同质性(<年代vg height="10.325" id="M42" style="vertical-align:-0.0pt;width:11.75px;" version="1.1" viewbox="0 0 11.75 10.325" width="11.75" xmlns="http://www.w3.org/2000/svg"> <g transform="matrix(1.25,0,0,-1.25,0,10.325)"> <g transform="translate(72,-63.74)"> <text transform="matrix(1,0,0,-1,-71.95,63.79)"> <tspan style="font-size: 12.50px; " x="0" y="0"> </t年代pan> </text> </g> </g> </svg>价值观和自由度,每个meta-analyzed同类景深)所示。注意,同类118是统计上异构(<年代vg height="11.25" id="M43" style="vertical-align:-0.30096pt;width:63.962502px;" version="1.1" viewbox="0 0 63.962502 11.25" width="63.962502" xmlns="http://www.w3.org/2000/svg"> <g transform="matrix(1.25,0,0,-1.25,0,11.25)"> <g transform="translate(72,-63)"> <text transform="matrix(1,0,0,-1,-71.95,63.35)"> <tspan style="font-size: 12.50px; " x="0" y="0"> </t年代pan> <tspan style="font-size: 12.50px; " x="10.890113" y="0"> <</t年代pan> <tspan style="font-size: 12.50px; " x="22.930502" y="0"> 0</t年代pan> <tspan style="font-size: 12.50px; " x="29.182001" y="0"> 。</t年代pan> <tspan style="font-size: 12.50px; " x="32.307751" y="0"> 0</t年代pan> <tspan style="font-size: 12.50px; " x="38.559254" y="0"> 2</t年代pan> <tspan style="font-size: 12.50px; " x="44.810753" y="0"> 5</t年代pan> </text> </g> </g> </svg>)。然而,切除加权离群值(<一个href="#B49">46</一个>]表示剩余层的均匀性。联合测试的副产品表示总体的同质性(<年代vg height="11.0625" id="M44" style="vertical-align:-0.30096pt;width:56.150002px;" version="1.1" viewbox="0 0 56.150002 11.0625" width="56.150002" xmlns="http://www.w3.org/2000/svg"> <g transform="matrix(1.25,0,0,-1.25,0,11.0625)"> <g transform="translate(72,-63.15)"> <text transform="matrix(1,0,0,-1,-71.95,63.5)"> <tspan style="font-size: 12.50px; " x="0" y="0"> </t年代pan> <tspan style="font-size: 12.50px; " x="10.890113" y="0"> ></t年代pan> <tspan style="font-size: 12.50px; " x="22.930502" y="0"> 0</t年代pan> <tspan style="font-size: 12.50px; " x="29.182001" y="0"> 。</t年代pan> <tspan style="font-size: 12.50px; " x="32.307751" y="0"> 1</t年代pan> <tspan style="font-size: 12.50px; " x="38.559254" y="0"> 0</t年代pan> </text> </g> </g> </svg>和37景深)。</div> <a class="table-thumb-overlay" href="//www.newsama.com/journals/jeph/2012/258981/tab4" target="_blank" aria-label="View full page"></a> </div> </div> <h5 id="sec3.2">3.2。生态的影响</h5> <p>生态数据代表NHL和PCB的发生率随着时间积累表示统计强相关性(<年代vg height="14.15" id="M55" style="vertical-align:-0.30096pt;width:64.525002px;" version="1.1" viewbox="0 0 64.525002 14.15" width="64.525002" xmlns="http://www.w3.org/2000/svg"> <g transform="matrix(1.25,0,0,-1.25,0,14.15)"> <g transform="translate(72,-60.68)"> <text transform="matrix(1,0,0,-1,-71.95,61.03)"> <tspan style="font-size: 12.50px; " x="0" y="0"> </t年代pan> </text> <text transform="matrix(1,0,0,-1,-62.7,66.03)"> <tspan style="font-size: 8.75px; " x="0" y="0"> 2</t年代pan> </text> <text transform="matrix(1,0,0,-1,-54.35,61.03)"> <tspan style="font-size: 12.50px; " x="0" y="0"> ></t年代pan> <tspan style="font-size: 12.50px; " x="12.027886" y="0"> 0</t年代pan> <tspan style="font-size: 12.50px; " x="18.279387" y="0"> 。</t年代pan> <tspan style="font-size: 12.50px; " x="21.405136" y="0"> 9</t年代pan> <tspan style="font-size: 12.50px; " x="27.656635" y="0"> 4</t年代pan> </text> </g> </g> </svg>(图)无论认为积累模型<一个href="//www.newsama.com/journals/jeph/2012/258981/fig3/" target="_blank">3</一个>)。高度的相关性(<年代vg height="14.15" id="M56" style="vertical-align:-0.30096pt;width:56.712502px;" version="1.1" viewbox="0 0 56.712502 14.15" width="56.712502" xmlns="http://www.w3.org/2000/svg"> <g transform="matrix(1.25,0,0,-1.25,0,14.15)"> <g transform="translate(72,-60.68)"> <text transform="matrix(1,0,0,-1,-71.95,61.03)"> <tspan style="font-size: 12.50px; " x="0" y="0"> </t年代pan> </text> <text transform="matrix(1,0,0,-1,-62.7,66.03)"> <tspan style="font-size: 8.75px; " x="0" y="0"> 2</t年代pan> </text> <text transform="matrix(1,0,0,-1,-54.35,61.03)"> <tspan style="font-size: 12.50px; " x="0" y="0"> ></t年代pan> <tspan style="font-size: 12.50px; " x="12.027886" y="0"> 0</t年代pan> <tspan style="font-size: 12.50px; " x="18.279387" y="0"> 。</t年代pan> <tspan style="font-size: 12.50px; " x="21.405136" y="0"> 8</t年代pan> </text> </g> </g> </svg>NHL之间)发病率和PCB观察积累几个其他癌症的一个或两个积累模型,包括乳腺癌、肝癌和胆管,肾、皮肤、软组织和心脏,然而这些其他癌症始终表现出高度的相关性值在所有三个模型(表<一个href="//www.newsama.com/journals/jeph/2012/258981/tab5/" target="_blank">5</一个>)。</p> <div class="floats-partial-section partial-other-wrapper" data-section="tab5"> <div class="floats-partial-footer"> <div class="floats-partial-caption"> <span class="caption-text">表5</年代pan> <a aria-label="View full page" class="caption-partial-url" href="//www.newsama.com/journals/jeph/2012/258981/tab5/" title="" target="_blank"></a> </div> <div class="floats-partial-caption-text"> 总结的剂量反应之间的相关性同步多氯联苯(PCB)生物体内积累和癌症的发病率。积累表示为基于单独销售(销售增长),环境暴露(静态增长)和生理接触(动态增长)。</div> <a class="table-thumb-overlay" href="//www.newsama.com/journals/jeph/2012/258981/tab5" target="_blank" aria-label="View full page"></a> </div> </div> <div class="partial-carousel-wrapper"> <div class="floats-partial-section"> <div class="floats-partial-content"> <div class="partial-carousel--full-image partial-carousel-5e2a67d5ec5d81226de41ec108f96b89"> <div class="partial-carousel--single-image"> <img loading="lazy" alt="(一)" src="https://static.hindawi.com/articles/jeph/volume-2012/258981/figures/258981.fig.003a.jpg"> <br> <strong>(一)</年代trong> </div> <div class="partial-carousel--single-image"> <img loading="lazy" alt="(b)" src="https://static.hindawi.com/articles/jeph/volume-2012/258981/figures/258981.fig.003b.jpg"> <br> <strong>(b)</年代trong> </div> <div class="partial-carousel--single-image"> <img loading="lazy" alt="(c)" src="https://static.hindawi.com/articles/jeph/volume-2012/258981/figures/258981.fig.003c.jpg"> <br> <strong>(c)</年代trong> </div> </div> </div> <div class="floats-partial-middle"> <div class="floats-partial-middle--thumbs"> <div class="partial-carousel-dots-5e2a67d5ec5d81226de41ec108f96b89 partial-carousel-thumbnail"> <button aria-label="Slide to (a) " class="partial-carousel-dot"><img loading="lazy" alt="(一)" src="https://static.hindawi.com/articles/jeph/volume-2012/258981/thumbnails/258981.fig.003a_th.jpg"><br><strong>(一)</年代trong></button> <button aria-label="Slide to (b) " class="partial-carousel-dot"><img loading="lazy" alt="(b)" src="https://static.hindawi.com/articles/jeph/volume-2012/258981/thumbnails/258981.fig.003b_th.jpg"><br><strong>(b)</年代trong></button> <button aria-label="Slide to (c) " class="partial-carousel-dot"><img loading="lazy" alt="(c)" src="https://static.hindawi.com/articles/jeph/volume-2012/258981/thumbnails/258981.fig.003c_th.jpg"><br><strong>(c)</年代trong></button> </div> </div> <div class="floats-partial-middle--nav"> <div class="partial-carousel-next-prev-5e2a67d5ec5d81226de41ec108f96b89 partial-carousel-next-prev"> <button aria-label="Previous" class="carousel-prev"></button> <button aria-label="Next" class="carousel-next"></button> </div> </div> </div> <div class="floats-partial-footer"> <div class="floats-partial-caption"> <span class="caption-text">图3</年代pan> <a aria-label="View full page" class="caption-partial-url" href="//www.newsama.com/journals/jeph/2012/258981/fig3/" title="" target="_blank"></a> </div> <div class="floats-partial-caption-text"> <table> <tbody> <tr> <td>生态PCB积累和NHL的国家发病率之间的相关性在日历年和相对年相比基于的假设(a)、接触(销售模式);(b)环境暴露(静态模型);(c)生理接触(动态模型)。</td> </tr> </tbody> </table> </div> </div> </div> </div> <h4 id="discussion">4所示。讨论</h4> <p>的结果(nonexhaustive)应用程序的标准知识的当前状态对血液中的多氯联苯和NHL风险之间的关系表明合理的因果关联。所述多个病例对照研究也不断证明一个强大的协会之间的PCB水平升高和NHL足以断定(通用)两者之间存在因果关系,如果从环境中多氯联苯将被取消,一定比例的NHL的情况下同样会消除。</p> <p>进一步证明了这一结论的生态分析的结果报告,环境中的PCB水平之间的关系随着时间的推移,似乎更加独特和强烈与NHL发病率比其他类型的癌症。NHL的multicause性质意味着,这些数据应该被谨慎甚至怀疑,但观察到的关系至少符合其他理论关于无度地大幅增加NHL发病率在过去大约40年。</p> <p>基于这些结果和NHL的多因子的性质,它是合理的得出一定比例NHL的个案发生<我>只有</我>因为PCB水平升高;在另一个比例,PCB水平升高<我>做出了贡献</我>NHL的原因在与其他原因但不能说完全必要的原因;在另一个比例的身体负担多氯联苯既不完全或部分分摊NHL发生。我们认为如果一个人发现NHL PCB同系物的效价118,138,153,156,170,180或187年,超过75%的相同年龄和时代的可比一般人群(<一个href="#B69">75年</一个>),那么它可以得出结论,多氯联苯的升高身体负担疾病导致NHL的发生。</p> <p>鉴于这一结论,> 2.0相对风险的问题必须解决特定的因果关系的阈值。设置中有一个确认未曝光的对照组,相对风险为1.43(这里定义为一个或较小的暴露)将意味着143 hazard-exposed主题感兴趣的疾病,43岁获得的疾病是因为曝光,和100年开发出独立于暴露在危险的疾病。为了一个特定的因果关系评估、随机选择的一个暴露的情况下会导致因果关系的概率为30%(43/143),从而得出结论,个人的疾病不是暴露有关,更可能的基础上。这种方法可能是有问题的,因为这将导致一个错误的确定没有危险暴露与疾病之间的因果关系在30%的特定的因果关系评估(<一个href="#B75">76年</一个>]。2.0相对风险的方法成为不切实际的问题当评估多氯联苯和NHL的具体原因。考虑到143年的最高PCB效价percentile-exposed科目NHL (meta-analyzed 1.43或代表<年代ub>MH</年代ub>这里描述),将会有43人的疾病是因为PCB曝光,和100位受试者在他们的PCB水平升高可能会或可能不会导致NHL,因为现实中所有的“未曝光”主题只是“小暴露”科目。这一事实没有未曝光的对比组(零PCB的身体负担)的情况下可以相比meta-analyzed研究有效地降低由此产生的优势比到一个不太为人所知的程度。一些迹象表明这一效应的大小可以从生态资料推断,有一个近似两倍的NHL的发病率超过30年的时间内,暂时与多氯联苯的引入到环境中。可能是一个合理的假设,一些比例的病例是指数增长环境之前多氯联苯NHL的速度急剧增加,这表示在所有PCB暴露的百分位数。</p> <p>此外,似乎有几个因素会降低体内PCB水平可能与NHL的存在或诊断有关,导致低post-NHL-diagnosis浓度比之前可能已经提出了诊断。身体质量指数(BMI)水平较高的个体代谢和消除多氯联苯的更慢,因为NHL的减肥是一个常见的特性,这个特性的疾病会减少身体的负担多氯联苯随着疾病的进展(<一个href="#B76">77年</一个>]。此外,化疗,一个常见的医学治疗NHL,已经观察到体内潜在的降低PCB水平近30% (<一个href="#B77">78年</一个>]。</p> <p>综上所述,所有这些因素表明,2.0相对风险或优势比阈值不能合理地应用于PCB和NHL。正是因为这一原因,使用上百分位截止值与最大与最小或有关<年代ub>MH</年代ub>得出存在因果的贡献被认为是一个合理可行的替代评估环境毒素无处不在的因果关系不存在未曝光的组进行比较。</p> <h4 id="conclusions">5。结论</h4> <p>应用程序的标准知识的当前状态对环境多氯联苯和NHL之间的关系揭示了令人信服的证据的可信性,以及一个强大的通用因果关联,与meta-analyzed优势比表明43%的文献研究协会NHL总PCB含量百分比最高,相对于比较人口百分位数的PCB水平最低。因果的贡献的评价多氯联苯NHL的个案,meta-analyzed值七immunotoxic副产品(118、138、153、156、170、180和187年),而相关的人口调查数据。当个案NHL礼物的这七个同类滴度分为最高四分位数一般人群的代表,它是合理的结论的又一个因果关系存在,更可能的基础上。</p> <h4 id="disclosure">信息披露</h4> <p>两位作者为环境毒素诉讼提供法律咨询服务。</p> <h4 id="acknowledgments">确认</h4> <p>部分支持由美国国立卫生研究院(构造论)。作者欣赏价值的技术评论温迪·m·利思。</p> </div> </div> <div class="ArticleReferences_xmlContent__p_40j"> <h4 class="ArticleReferences_references__GH2t_" id="references">引用</h4> <ol class="ArticleReferences_orderedReferences__mJr9M"> <li class="ArticleReferences_articleReference__ouEuh" id="B1"> <div class="referenceContent"> <p class="referenceText">有毒物质与疾病登记处联合机构(有毒物质),<我>毒理学资料对多氯联苯(PCBs)</我>卫生和人类服务部,亚特兰大,乔治亚州,美国,2000年。</p> </div></li> <li 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