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A systematic review and meta-analysis was conducted to assess whether occupational DE exposure is associated with liver and pancreatic cancer risk, pooling results across cohort studies. Pooled relative risks with 95% confidence intervals were estimated using a DerSimonian and Laird random-effects model. Results included 15 pancreatic and 14 liver cancer studies, showing weakly increased pancreatic risk and suggestive liver associations.",{"@graph":69,"@context":122},[70,84,105],{"@type":71,"itemListElement":72},"BreadcrumbList",[73,77,79,82],{"item":74,"name":75,"@type":76,"position":8},"https://docshare.wps.com","Home","ListItem",{"item":78,"name":9,"@type":76,"position":14},"https://docshare.wps.com/document/",{"item":80,"name":40,"@type":76,"position":81},"https://docshare.wps.com/document/research-report/",3,{"item":83,"name":65,"@type":76,"position":19},"https://docshare.wps.com/document/occupational-exposure-to-diesel-exhausts-and-liver-and-pancreatic-cancers-a-systematic-review-and-meta-analysis/331975/",{"url":83,"name":65,"@type":85,"image":86,"author":91,"headline":65,"publisher":94,"fileFormat":97,"inLanguage":63,"description":67,"dateModified":98,"datePublished":99,"encodingFormat":97,"isAccessibleForFree":100,"interactionStatistic":101},"DigitalDocument",{"url":87,"@type":88,"width":89,"height":90},"https://docshare.wps.com/thumbnails/occupational-exposure-to-diesel-exhausts-and-liver-and-pancreatic-cancers-a-systematic-review-and-meta-analysis/331975.png","ImageObject",300,407,{"name":92,"@type":93},"Olivia Brown","Person",{"url":74,"name":95,"@type":96},"DocShare","Organization","application/pdf","2026-10-27","2026-09-21",true,{"@type":102,"interactionType":103,"userInteractionCount":52},"InteractionCounter",{"@type":104},"ViewAction",{"@type":106,"mainEntity":107},"FAQPage",[108,114,118],{"name":109,"@type":110,"acceptedAnswer":111},"What is the main objective of this systematic review?","Question",{"text":112,"@type":113},"To systematically evaluate current literature on the association between occupational diesel exhaust exposure and the risk of liver and pancreatic cancers.","Answer",{"name":115,"@type":110,"acceptedAnswer":116},"How were the pooled risk estimates calculated?",{"text":117,"@type":113},"The review pooled relative risks (RRs) and 95% confidence intervals using a DerSimonian and Laird random-effects model.",{"name":119,"@type":110,"acceptedAnswer":120},"What were the key findings for pancreatic and liver cancer?",{"text":121,"@type":113},"Pancreatic cancer showed a weakly increased risk among workers exposed to DE, while liver cancer results suggested a positive association, with stronger estimates in studies published before 2000.","https://schema.org",{"og:url":83,"og:type":124,"og:title":65,"og:site_name":95,"og:description":67},"article",{"robots":126,"canonical":83},"index,follow",{"doc_id":128,"site_id":62},331975,1790120449,{"code":4,"msg":5,"data":131},{"doc_id":128,"user_id":132,"nickname":92,"user_avatar":133,"doc_module":4,"category_id":39,"category_name":40,"doc_title":65,"doc_description":67,"doc_content":134,"file_id":135,"file_url":136,"file_type":137,"file_size":138,"view_count":52,"is_deleted":4,"is_public":8,"is_downloadable":8,"audit_status":8,"page_count":139,"language":140,"language_code":63,"site_id":62,"html_lang":63,"table_of_contents":141,"faqs":142,"seo_title":143,"seo_description":67,"update_tm":144,"read_time":145,"preview_page_count":4},16904993612988,"https://ap-avatar.wpscdn.com/davatar_a8503ba1806abce46bf441b54a3ca4cd","European Journal of Epidemiology (2024) 39:241–255  \n[https://doi.org/10.1007/s10654-024-01099-4](https://doi.org/10.1007/s10654-024-01099-4)  \nREVIEW  \nOccupational exposure to diesel exhausts and liver and pancreatic cancers: a systematic review and meta-analysis  \nMichele Sassano1 · Giulia Collatuzzo1 · FedericaTeglia1 · Paolo Boffetta1,2,3  \nReceived: 1 June 2023 / Accepted: 9 January 2024 / Published online: 30 January 2024 © The Author(s) 2024  \nAbstract  \nBackground Diesel exhaust (DE) is human carcinogen with sufficient evidence only for lung cancer. Systematic evidence on other cancer types is scarce, thus we aimed to systematically review current literature on the association between occupational DE exposure and risk of liver and pancreatic cancers.  \nMethods We performed a systematic literature review to identify cohort studies on occupational DE exposure and risk of cancers other than lung. We computed pooled relative risks (RRs) and corresponding 95% confidence intervals (CIs) for liver and pancreatic cancers using DerSimonian and Laird random-effects model.  \nResults Fifteen studies reporting results on pancreatic cancer and fourteen on liver cancer were included. We found a weakly increased risk of pancreatic cancer in workers exposed to DE (RR: 1.07, 95% CI: 1.00, 1.14), mainly driven by results on incidence (RR: 1.11, 95% CI: 1.02, 1.22) . As for liver cancer, results were suggestive of a positive association (RR: 1.09; 95% CI: 0.99, 1.19), although a significant estimate was present in studies published before 2000 (RR: 1.41; 95% CI: 1.09, 1.82). We found no compelling evidence of publication bias.  \nConclusions Our findings suggest an association between occupational DE exposure and liver and pancreatic cancer. Further studies with detailed exposure assessment, environmental monitoring data, and appropriate control for confounders are warranted.  \nKeywords Occupation · Diesel · Liver cancer · Pancreatic cancer · Meta-analysis  \nIntroduction  \nWith an estimated 905,677 and 495,773 new cases worldwide, liver and pancreatic cancers currently represent the sixth and twelfth most common cancer types, respectively [1–3] . In addition, liver and pancreatic cancers were the third (n = 830,180) and the seventh (n = 466,003) leading causes of cancer death globally, respectively, in 2020 [1– 3] . Although the highest incidence rates of liver cancer are  \n􀀍 Paolo Boffetta [paolo.boffetta@unibo.it](paolo.boffetta@unibo.it)  \n1 Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy  \n2 Stony Brook Cancer Center, Stony Brook University, Stony Brook, NY, USA  \n3 Department of Family, Population and Preventive Medicine, Renaissance School of Medicine, Stony Brook University, Stony Brook, NY, USA  \nobserved in Asian countries, they declined between 1978 and 2012 in this region, while they increased over the sametime period in many countries of Europe, the Americas, and Oceania [4] . In addition, the number of new cases of liver cancer is predicted to increase by 55% by the year 2040 [5] . Similarly, an increase of incidence rates of pancreatic cancer between 1990 and 2017 worldwide has been reported, with the largest burden recorded in high-income countries [6] .  \nAmong various potentially relevant environmental and occupational risk factors [7–9], previous research also focused on the relationship between exposure to diesel exhausts (DE) and cancer. Indeed, DE emissions contain a relevant number of suspected or confirmed carcinogens that could affect human health, including polycyclic aromatic hydrocarbons, nitroarenes, and 3-nitrobenzathrone [10–12] . DE emission has been classified as a Group 1 carcinogen by the International Agency for Research on Cancer (IARC), with sufficient evidence for lung cancer [11–13] .  \nPrevious meta-analyses of epidemiological studies mainly focused on the effect of DE exposure on lung cancer  \nrisk, with older ones showing a positive association between the two [1","cbCaihsuyDFgAQyB","https://ap.wps.com/l/cbCaihsuyDFgAQyB","pdf",3037784,15,"English","# Abstract\n# Background\n# Methods\n# Results\n## Publication bias\n# Conclusions\n# Introduction","[{\"question\":\"What is the main objective of this systematic review?\",\"answer\":\"To systematically evaluate current literature on the association between occupational diesel exhaust exposure and the risk of liver and pancreatic cancers.\"},{\"question\":\"How were the pooled risk estimates calculated?\",\"answer\":\"The review pooled relative risks (RRs) and 95% confidence intervals using a DerSimonian and Laird random-effects model.\"},{\"question\":\"What were the key findings for pancreatic and liver cancer?\",\"answer\":\"Pancreatic cancer showed a weakly increased risk among workers exposed to DE, while liver cancer results suggested a positive association, with stronger estimates in studies published before 2000.\"}]","Occupational exposure to diesel exhausts and liver and pancreatic cancers - a systematic review and meta-analysis | PDF",1789996100,38]