Objective: To clarify the association between occupational exposure to wood dust and chronic obstructive pulmonary disease risk by a meta-analysis. Methods: A systematic search of the studies was conducted using 3 English databases (Pubmed, Embase, and Cochrane library) and 3 Chinese databases (CNKI, WanFang, and VIP) before March 2019. The following key words was used: 1) wood, 2) hardwood, 3) softwood, 4) saw, 5) dust, 6) chronic obstructive pulmonary disease, 7) chronic obstructive airway disease, 8) lung function. A quality score was evaluated by Newcastle-Ottawa Scale, NOS (Wells, 2012). Pooled effect value with 95% confidence interval (CI) was calculated using fixed-effect model (Heterogeneity test I(2)<25%) or random-effect model (Heterogeneity test I(2)≥25%). Meta-regression was used to explore heterogeneous source. Sensitivity analysis was used to verify the stability of the results. Publication bias was assessed by Egger＇s test. Fill and trim method was used to correct the pool effect value with 95%CI for studies which wit publication bias. The TSA threshold was calculated by the O＇Brien-Fleming loss function in the TSA data. The studies were evaluated based on the accrued information size (AIS) . Results: A total of 9 studies were included in the analysis. The occupational exposure to wood dust was not significantly associated with increased chronic obstructive pulmonary disease risk (ES=1.01, 95%CI: 0.856-1.194). TSA showed that the cumulative Z-value curve neither gone beyond the traditional (Z=1.96) threshold line, nor exceed the TSA threshold, but has reached the expected amount of information. This result was consistent with the meta-analysis. Conclusion: This study does not yet consider that COPD is associated with occupational wood dust exposure.
目的： 通过Meta分析探索木粉尘职业接触与慢性阻塞性肺疾病（COPD）的相关性。 方法： 通过在3个英文数据库（Pubmed、Embase和Cochrane library）和3个中文数据库（CNKI、万方和VIP）中系统检索相关文献，检索日期截止2019年3月。其中英文检索以"wood、hardwood、softwood、saw、dust、chronic obstructive pulmonary disease、chronic obstructive airway disease、lung function"为关键词；中文数据库检索主题词为"木粉尘、硬木尘、软木尘、木屑、慢性阻塞性肺疾病、肺功能"。文献质量评价采用纽卡斯尔－渥太华量表[Newcastle-Ottawa Scale，NOS（Wells，2012）]；采用固定效应模型（异质性检验I(2)<25%）或随机效应模型（异质性检验I(2)≥25%）评估总体效应和95%CI；采用Meta回归探索异质性来源；采用敏感性分析验证结果的稳定性；发表偏倚采用Egger检验，对于存在发表偏倚的研究，采用fill and trim法纠正总效应值和95%CI，最终通过试验序贯Meta分析（TSA）中O＇Brien-Fleming损耗函数计算TSA界值，并基于累积信息量（AIS）对研究进行评价。 结果： 共纳入9篇文献，Meta分析未发现木粉尘职业接触与COPD的相关关系（ES=1.01，95%CI：0.856~1.194）；TSA显示，累积Z值曲线未超越传统Z=1.96界值线，也未超越TSA界值线，但已到达期望信息量，与Meta分析结果一致。 结论： 尚不能认为COPD与木粉尘职业接触有关。.
Keywords: Dust; Meta-analysis; Occupational exposure; Pulmonary disease, chronic obstructive.