血液病与血栓栓塞疾病杂志
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Bitumen Exposure and Risk of Leukemia: A Protocol of Systematic Review and Meta-Analysis

Yaser Soleimani1*, Mohammad Arshia Naseri1, Maryam Yadollahi Farsi1, Ali Hosseini Sani1, Mohammadreza Mahdavi1, Faezeh Mohammadi1, Alireza Khazali1, Mahdi Daraei1, Alireza Mosavi Jarrahi2

Background: Occupational exposure to bitumen is a widely used material in industry and raises concerns about health risks. Although preliminary evidence suggests a link between bitumen exposure and adverse health outcomes, the link to leukemia remains unclear. This systemic review and meta-analysis aimed to provide a comprehensive assessment of the existing literature to identify the relationship between bitumen exposure and leukemia risk.

Methods: The search was conducted in electronic databases (PubMed, WOS, and Scopus) from inception to 8^th December 2023 in accordance with PRISMA guidelines. These include studies investigating the relationship between bitumen exposure and leukemia. Two independent reviewers performed the qualitative assessment, and data extraction. Random effects meta-analysis was used to estimate the Odds Ratio (OR) and 95% Confidence Interval (CI). Subgroup analysis was performed according to relevant criteria. Sensitivity analysis and publication bias analysis were performed.

Results: Meta-analysis found a significant association between bitumen exposure and leukemia risk. Differences between subjects showed that individuals exposed to bitumen had different rates of developing leukemia. To investigate the potential for change in this organization, a focus group analysis was conducted, providing insight into the impact of various factors. A sensitivity analysis (excluding studies at high risk of bias) was performed to assess study robustness. The adjusted meta-analyses resulting from this sensitivity analysis provide a better understanding of the potential impact of bias on overall results.

Conclusion: This review and meta-analysis provides sufficient evidence to support a positive association between bitumen exposure and leukemia risk. Perceived risks are increasing and the importance of health precautions is being emphasized in businesses dealing with bitumen. However, the existence of publication bias highlights the need for better quality research to strengthen this relationship and contribute to evidence-based guidelines. The results of this study have important implications for workers and policy makers to ensure safe work in the bitumen industry.