Non-malignant respiratory disease among workers in the rubber manufacturing industry: A systematic review and meta-analysis

Am J Ind Med. 2019 May;62(5):367-384. doi: 10.1002/ajim.22959. Epub 2019 Feb 18.

Abstract

Background: Non-malignant respiratory disease (NMRD) cases have occurred among rubber manufacturing workers. We examined exposure to rubber manufacturing emissions as a risk factor for NMRD.

Methods: From a systematic literature review, we identified case reports and assessed cross-sectional and mortality studies for strength of evidence of positive association (strong, intermediate, non-significant positive association, none) between exposure to rubber manufacturing emissions and NMRD-related morbidity and mortality, and conducted two meta-analyses.

Results: We analyzed 62 articles. We identified 11 cases of NMRD. Nine (30%) of 30 cross-sectional studies and one (4%) of 26 mortality studies had strong evidence. The summary odds ratio and SMR for the cross-sectional and mortality meta-analyses were 3.83 (95% confidence interval [CI], 2.28-6.51) and 0.90 (95%CI, 0.82-0.99), respectively.

Conclusion: Available evidence supports rubber manufacturing emissions as a potential risk factor for NMRD-related morbidity. Further investigations with longer follow-up periods and inclusion of short-tenured workers could further define risks for NMRD and identify prevention strategies.

Keywords: chronic bronchitis; chronic obstructive pulmonary diseases; emphysema; eosinophilia; non-malignant respiratory disease; occupational asthma; occupational lung disease; rubber.

Publication types

  • Meta-Analysis
  • Research Support, U.S. Gov't, P.H.S.
  • Systematic Review

MeSH terms

  • Humans
  • Manufacturing Industry*
  • Occupational Diseases / chemically induced*
  • Occupational Diseases / mortality*
  • Occupational Exposure
  • Respiration Disorders / chemically induced*
  • Respiration Disorders / mortality*
  • Rubber / adverse effects*

Substances

  • Rubber