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. 2021 Apr 26;16(4):e0250377. doi: 10.1371/journal.pone.0250377

Incidence of lung cancer and mortality among civil construction industry workers: A protocol for a systematic review and meta-analysis

Rita Stella Maria Cahuana Pinto 1, Alana Castro Panzenhagen 2, Luis Felipe Silva Oliveira 1,3, José Claudio Fonseca Moreira 2,4, Carlos Eduardo Schnorr 5,*
Editor: Rakibul M Islam6
PMCID: PMC8075260  PMID: 33901220

Abstract

Background

The construction sector is one of the most stable growth industries in the world. However, many studies have suggested an association between occupational exposure in civil construction and lung cancer risk. Thus, this study aims to assess lung cancer risk in civil construction workers occupationally exposed to physical and chemical agents through a systematic review and meta-analysis.

Methods/design

Studies will be identified by searching PUBMED, Embase, SCOPUS, WEB OF SCIENCE and the reference list of included articles. Eligible study designs will be cohort, cross-sectional, and case-control studies that report occupational exposure to physical or chemical agents and lung cancer risk through mortality or incidence outcomes. A meta-analysis will be used to combine odds ratios (ORs) from case-control studies and relative risks (RR) from cohort studies. Two reviewers will independently screen articles, extract data, and assess scientific quality using standardized forms and ROBINS-E tool if available. Otherwise, the New-Castle Ottawa rating scale will be used. Any of those will also be used in combination with the GRADE approach for quality of evidence. Overall risk estimates and their corresponding 95% confidence intervals (CIs) will be obtained using the random-effects model meta-analysis. This systematic review and meta-analysis will be conducted following the Meta-analysis of Observational Studies in Epidemiology (MOOSE) guidelines. Results will be reported according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement.

Discussion

This review will identify and synthesize studies investigating the association between occupational exposure in the construction industry and lung cancer. The findings will help governmental entities and researchers with evidence-based decision-making because they will integrate and validate the evidence on construction workers’ health effects due to occupational exposure.

Systematic review registration

PROSPERO CRD42020164209

Introduction

The construction sector is one of the most stable growth industries globally and represents up to 7% of the global workforce and a 15% share of the world’s Gross Domestic Product [1]. However, construction activity is also one of the leading agents in contributing to environmental pollution despite its importance for a country’s economic growth. Indeed, in 2018 buildings and construction sectors alone were responsible for 36% of the energy consumption and 39% of carbon dioxide (CO2) emissions worldwide [2]. Additionally, occupational exposure in the construction industry puts the health of construction workers at risk as they may be exposed to physical and chemical agents. Indeed, a construction worker might be potentially exposed to more than 70 different substances, including materials related to their specific trade and of other businesses in their shared workplaces [3]. The list includes many chemicals known to have adverse health effects, such as natural and artificial mineral fibers, cement, quartz, miscellaneous powders, diesel exhaust, paints, and solvents [4, 5].

Furthermore, some exposure to several substances commonly found in the construction industry environment may also be associated with an increased risk of lung cancer [6]. For instance, asbestos, wood dust, crystalline silica, chromium (VI), lead and nickel compounds, benzene, and polycyclic aromatic hydrocarbons (PAH), are indeed classified by the International Agency of Research on Cancer as known carcinogens [7]. Additionally, several primary studies have investigated the risk of lung cancer in civil construction workers, including cohort and case-control studies. Many of these have reported consistent evidence for increased mortality. Still, others have shown no sufficient evidence for increased risk [8–16].

Moreover, specific trades in the construction industry have also been investigated. One study found that bricklayers had an increased risk of lung cancer within the SYNERGY database of case-control studies [17, 18]. Another study suggested an increased risk of lung cancer in Italian bricklayers from exposure to various carcinogens, especially crystalline silica [17, 18]. Finally, another research work found an increased risk of lung cancer for all construction occupations, except managers, engineers, and supervisors [19].

Furthermore, some systematic reviews and meta-analyses have been performed to evaluate better the association between lung cancer and occupational exposure in the construction industry. Some systematic reviews have investigated the evidence regarding specific chemical exposures and lung cancer risks, and others have included both construction and non-construction workers [20–22]. Nevertheless, none of the previous systematic reviews and metanalysis have considered the civil construction industry’s specific characteristics and workers. It seems pertinent to integrate the information on lung cancer risk associated with physical and chemical agents commonly in contact with workers of different trades and occupations. Thus, we will present a systematic review and meta-analysis protocol to synthesize and evaluate the association between occupational exposure to physical, chemical agents and lung cancer risk in construction workers. We consider this synthesis as paramount to obtain more accurate and valid estimates of lung cancer risk incidence and its effect magnitude.

Review objectives

Our systematic review and meta-analysis’s main objective will be to summarize the evidence on how working in the civil construction industry impacts lung cancer risk for workers. The questions we intend to answer are:

Are construction industry workers who have been exposed to physical and chemical agents at increased risk of lung cancer through mortality and incidence outcomes? Furthermore, if enough studies are available, quantify it through a meta-analytic approach. Are the incidence or mortality different among the workers within the many specialized and unspecialized trades in the civil construction industry? What physical or chemical agents are present in the construction industry environment associated with lung cancer risk in construction workers?

Methods/design

Protocol

The systematic review and meta-analysis will be conducted following the Meta-analysis of Observational Studies in Epidemiology (MOOSE) guidelines [23] and reported following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement [24]. This protocol has been registered within the International Prospective Register of Systematic Reviews (PROSPERO) database (registration number: CRD42020164209).

Ethics

This review does not require ethical approval as the review is entirely based on the published data of the ethically approved primary studies.

Criteria for selecting studies for this review

The following criteria will be used to identify studies to be included in this review.

Inclusion and exclusion criteria

Studies will be included if they meet the following criteria:

The study reports enough data for calculating odds ratios (OR) or relative risks (RR) and 95% confidence intervals (CI). Intervals can also be imputed when they are not available. In the case of duplicated or shared data from the same population, we will include the study with the largest sample size.

The study has a control group with limited exposure to airborne chemical pollutants at construction sites (white-collar, managers, engineers, supervisors, office workers).

Studies not meeting the inclusion criteria described above will be excluded. Further, animal studies, studies that do not assess the risk for lung cancer in humans, and studies without a proper control group will also be excluded.

Participants/population

We will include studies that investigate effects on participants (both male and female) who are construction workers, with unequivocal evidence of occupational exposure to physical and chemical agents, such as, but not limited to: carpenters, floor layers, bricklayers, painters, electricians, plumbers, welders, scaffolders, roofers, masons, sheet metal workers, rebar workers, construction laborers, machine operators, drywall installers, and insulators. No lower or upper limits will be set to the age of the participants included in the original studies.

Exposure

This review will include studies that report occupational exposure at a construction site, including short-term (up to seven days) and cumulative (for more than seven days) studies that evaluate occupational exposure with a risk matrix through operational inspection, questionnaires, or specialized measuring equipment.

Comparator(s)/control

The control group will be white-collar managers, engineers, office workers, and supervisors in the construction industry.

Outcome

The primary outcome will be lung cancer risk (through mortality and incidence outcomes) based on clinically confirmed diagnosis (death certificates, cancer registry, other national recording systems, or hospital records). The effects measured will include the odds ratios (OR), relative risks (RR), and 95% confidence intervals (CI). Other summary statistics data will be sought whenever OR or RR are not available.

Study design

Eligible studies will be comparative observational studies that report occupational exposure to physical and chemical agents in the civil construction industry and the outcome of interest (lung cancer risk through mortality and incidence outcomes). Cohort, comparative cross-sectional, and case-control studies will be included.

We will exclude studies in which lung cancer is not reported as an outcome of interest. Observational studies not presenting study-specific data (e.g., relative risks, 95% confidence intervals, numbers of cases/population, observed and expected cases) or sufficient data for an outcome measure to be calculated will also be excluded.

Search strategy

We will identify potentially relevant studies by searching multiple electronic databases and websites such as PubMed, Embase, Scopus, and Web of Science. Keywords related to construction workers, occupational exposure, physical and chemical agents, and lung cancer will be used. The search strategy will be adapted for each database. The search terms will be: ("construction workers" OR "bricklayers" OR "painters" OR "carpenters" OR "floor layers" OR "electricians" OR "plumbers" OR "scaffolders" OR "roofers" OR "masons" OR "sheet metal workers" OR "rebar workers" OR "machine operators" OR "drywall installers" OR "insulators" OR "white collar workers" OR "supervisor" OR "managers" OR "engineer") AND ("construction industry" OR "construction material" OR "construction site" OR "occupational exposure" OR "construction emission" OR "physical agent" OR "chemical agent" OR "construction dust" OR "construction activity" OR "inorganic dust construction" OR "particulate matter" OR "silica" OR "asbestos" OR "cement" OR "release agents" OR "concrete" OR "polyurethane" OR "resins" OR "paints" OR "varnishes" OR "solvents") AND ("lung cancer" OR "lung function decline" OR neoplasm OR "lung diseases" OR carcinoma OR mesothelioma OR adenocarcinoma OR "pulmonary neoplasm" OR "pulmonary cancer" OR "small cell lung cancer").

Additional studies will be identified from the reference list of included articles and relevant reviews. No date restrictions will be imposed. There will be a restriction by the language of publication, only including English- and Spanish- written reports. Searches will be conducted from inception of the databases and updated to at least six months before submitting the final manuscript.

Study selection

Study selection will be conducted in three stages. First, the resulting citations will be stored in the Rayyan platform (https://rayyan.qcri.org/) and will be screened for duplicates. Second, all titles and abstracts will be independently screened by two reviewers against the inclusion/exclusion criteria to identify potentially relevant studies. Studies that do not meet specific inclusion/exclusion criteria will be rejected at this stage, and the reason for rejection will be recorded. Third, the full-text articles of all remaining studies will be obtained and independently assessed for inclusion by two reviewers. Disagreements between the two reviewers will be resolved by discussion, with the involvement of a third reviewer. Multiple reports of the same study will be counted only once; the record containing the most outstanding amount of information (for example, the largest sample size or the most prolonged follow-up period) will be retained. A PRISMA flow diagram showing details of studies included and excluded at each stage of selection will be produced.

Data extraction

Data from all included studies will be extracted independently by two reviewers using a standardized data extraction sheet piloted on a sample of five studies and then modified, if necessary, before full data extraction begins. Any disagreements between the two reviewers at any stage will be referred to a third reviewer for the final decision. For case-control studies, we will extract the sample size of the case and control groups, the OR, and the 95% CI for lung cancer from each included study. Likewise, we will extract the number of observed deaths or cases for cohort studies, the number of expected fatalities or cases, the RR, and the 95% confidence interval (CI) for lung cancer risk. We will perform the analysis using RevMan (version 5.4.1) software. For all included studies, the following data will also be extracted where available: first author, publication year, geographic area, study type, industry type, occupation, pollutant type, total number of cases (sample size) and controls, sex, age, smoking history, measurement of exposure and assessment method (medical diagnosis, spirometry or questionnaires), the definition of occupational exposure, the period of employment/exposure, case definition, type of risk, and classification of the outcome.

Quality assessment

Two reviewers will independently screen articles, extract data, and assess scientific quality using standardized forms and a published quality assessment tool (ROBINS-E tool will be used in case it is already available at https://www.bristol.ac.uk/population-health-sciences/centres/cresyda/barr/riskofbias/robins-e/). Otherwise, the New-Castle Ottawa rating scale will be used [25, 26]. This assessment scale consists of eight items categorized into three broad perspectives: selecting the study groups, comparability of the groups, and exposures or outcomes of interest. For cohort studies, a modified version of the NOS will be used. This modified NOS was developed for assessing the quality of occupational cohort studies and included five quality components: representativeness of the exposed cohorts, exposure assessment/reporting, comparability of the exposed and non-exposed cohorts, assessment of outcome, and adequacy of follow-up [26]. Any of those methods will also be used together with the GRADE approach for quality of evidence through GRADEpro (https://gdt.gradepro.org/app/) [27].

Data synthesis

A meta-analysis will be performed when at least three studies investigating the same outcome are available. A random-effects model [28] and OR or RR effect measures will be used. A systematic narrative review will be conducted through qualitative analysis in case of lack of data or very high heterogeneity levels (> 85%). Heterogeneity among studies will be investigated using the I2 statistic and Cochran’s Q test [29]. Thresholds for the I2 statistics <25% will be taken to suggest low heterogeneity, <50% to suggest moderate heterogeneity, and >75% to suggest high heterogeneity, while the significance level for chi-squared will be set at P = 0.1. Publication bias will be investigated by visual inspection of Begg’s funnel plots, a scatter plot of the studies constructed from a meta-analysis [28]. We will also perform Egger’s regression tests if ten or more studies are included in a meta-analysis [30].

The lung cancer risk in workers may be treated separately in the outcome analysis, considering the subgroup analyses or meta-regression. The heterogeneity and the number of studies available will be considered before the decision to conduct subgroup analysis. If possible, we will use subgroup and meta-regression analyses to explain any observed between-study heterogeneity if at least ten studies are included in a meta-analysis to allow statistical power for such investigations. The covariates considered will be the geographic region, sample size, follow-up period, type of exposure, type of industry, occupation, lung cancer type, the national prevalence of cigarette smoking, and national risk rate for lung cancer.

For sensitivity analyses, we will analyze critical outcomes classified by categories of the assessed study quality variables to ascertain whether there are any relations with quality and outcome. Additionally, we will assess the individual studies’ influence on results by re-estimating the overall effect after omitting each study in turn (Jackknife method). We will also conduct a cumulative meta-analysis in order of publication year to find the starting point of risk estimate becoming statistically significant and clarify the variation tendency [28].

The meta-analysis will be performed using RevMan (version 5.4.1) software, while regression analyses and funnel plots will be generated with the R environment package meta.

Discussion

A systematic review and metanalysis will help us to identify and synthesize the evidence of the association between exposure to physical, chemical agents and lung cancer in construction workers. The systematic review findings will also help us better understand the risk differences among workers of specific trades or occupations. Indeed, construction workers are an extensive and diverse group of workers and include specialized workers, such as painters, carpenters, plumbers, electricians, roofers, and many other trades and many unspecialized workers who support the former in their activities. This means that the exposure and risk might be stratified along those various group pf workers, in which some could be more at risk than others. We will also compare our results with previous systematic reviews about specific chemical exposures or reviews that have included construction and non-construction workers [20–22]. It will allow us to evaluate how the exposure in the construction industry context is similar or different from other industrial settings or other study populations.

Additionally, systematic reviews and meta-analyses are the principal methodologies to obtain a solid and truthful synthesis of scientific evidence since systematic reviews represent the highest hierarchical level of evidence [31] given the existent literature. Moreover, a systematic review on the subject will provide data on the methodology of the different studies and the strengths of the published literature, which can help the development of new experimental designs; identify the reasons for the discrepancies or contradictions between the results of the different investigations, encouraging the redesign of the studies to improve the existing research methods; and provide a more precise estimate of the effect magnitude of scientific evidence for the subject.

The results obtained from our study will: 1) provide consistent information about the affectation to the health of construction workers by occupational exposure to physical and chemical agents; and 2) be valuable to occupational health and public health policymakers to minimize the exposure of workers to carcinogenic agents. We hope that in summarizing and thoroughly evaluating primary studies’ consistency and quality we will be contributing to better practice decision making as well as the implementation of evidence-based prophylactic measures to prevent lung cancer in specialized lines of work.

Nonetheless, our planned methods have some limitations. The principal limit is the quality and thoroughness of primary studies; for example, the methods used and exposure classification vary. It will also be essential to highlight the heterogeneity between the studies regarding the lung cancer risk result, with considerable differences in occupation, contaminating substances, type of lung cancer, duration of exposure, etc.

We plan to disseminate the results of this systematic review and metanalysis to researchers and research funders in scientific conferences and by publication in a peer-review journal relevant to the field and policymakers by the publication of print materials and personal communication.

Supporting information

S1 Checklist. PRISMA-P checklist.

(DOC)

Click here for additional data file. (63.5KB, doc)

Data Availability

All relevant data from this study are publicly available here: https://osf.io/bgz2a/ (DOI: 10.17605/OSF.IO/BGZ2A).

Funding Statement

The author(s) received no specific funding for this work.

References

  • 1.Sertyeşilışık B. Global Trends in the Construction Industry: Challenges of Employment. Handbook of Research on Unemployment and Labor Market Sustainability in the Era of Globalization. IGI Global; 2017. pp. 255–274. 10.4018/978-1-5225-2008-5.ch015 [DOI] [Google Scholar]
  • 2.UN, IEA. Global status report for buildings and construction. 2019.
  • 3.Burkhart G, Schulte PA, Robinson C, Sieber WK, Vossenas P, Ringen K. Job tasks, potential exposures, and health risks of laborers employed in the construction industry. Am J Ind Med. 1993;24: 413–425. 10.1002/ajim.4700240407 [DOI] [PubMed] [Google Scholar]
  • 4.Ortega Herrera J. Contaminantes químicos en la construcción. Consejería de Economía y Empleo, editor. Castilla y León, España: Dirección General de Trabajo y Prevención de Riesgos Laborales; 2004.
  • 5.Thienen G Van, Spee T. Health Effects of construction materials and construction products. TTA Broch NR1. 2008; 22.
  • 6.British Health and Safety Executive. Occupational Cancer statistics in Great Britain, 2020. London; 2020.
  • 7.IARC. IARC Monographs on the Identification of Carcinogenic Hazards to Humans Volume 1–125. IARC Working Group, editor. Lyon, France: WHO Press; 2020.
  • 8.Dement JM, Ringen K, Welch LS, Bingham E, Quinn P. Mortality of older construction and craft workers employed at department of energy (DOE) nuclear sites. Am J Ind Med. 2009;52: 671–682. 10.1002/ajim.20729 [DOI] [PubMed] [Google Scholar]
  • 9.Veglia F, Vineis P, Overvad K, Boeing H, Bergmann MM, Trichopoulou A, et al. Occupational Exposures, Environmental Tobacco Smoke, and Lung Cancer. Epidemiology. 2007;18: 769–775. 10.1097/ede.0b013e318142c8a1 [DOI] [PubMed] [Google Scholar]
  • 10.DONG W, VAUGHAN P, SULLIVAN K, FLETCHER T. Mortality Study of Construction Workers in the UK. Int J Epidemiol. 1995;24: 750–757. 10.1093/ije/24.4.750 [DOI] [PubMed] [Google Scholar]
  • 11.Koskinen K, Pukkala E, Martikainen R, Reijula K, Karjalainen A. Different Measures of Asbestos Exposure in Estimating Risk of Lung Cancer and Mesothelioma Among Construction Workers. J Occup Environ Med. 2002;44: 1190–1196. 10.1097/00043764-200212000-00015 [DOI] [PubMed] [Google Scholar]
  • 12.Stocks SJ, McNamee R, Carder M, Agius RM. The incidence of medically reported work-related ill health in the UK construction industry. Occup Environ Med. 2010;67: 574–576. 10.1136/oem.2009.053595 [DOI] [PubMed] [Google Scholar]
  • 13.Thuret A, Geoffroy-Perez B, Luce D, Goldberg M, Imbernon E. A 26-Year Cohort Mortality Study of French Construction Workers Aged 20 to 64 Years. J Occup Environ Med. 2007;49: 546–556. 10.1097/JOM.0b013e3180577714 [DOI] [PubMed] [Google Scholar]
  • 14.d’Errico A, Mamo C, Tomaino A, Dalmasso M, Demaria M, Costa G. Mortality of a cohort of road construction and maintenance workers with work disability compensation. Med Lav. 2002;93: 519–26. Available: http://www.ncbi.nlm.nih.gov/pubmed/12596422 [PubMed] [Google Scholar]
  • 15.Sun J. Mortality among Japanese construction workers in Mie Prefecture. Occup Environ Med. 2002;59: 512–516. 10.1136/oem.59.8.512 [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 16.Arndt V. All-cause and cause specific mortality in a cohort of 20 000 construction workers; results from a 10 year follow up. Occup Environ Med. 2004;61: 419–425. 10.1136/oem.2003.008680 [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 17.Consonni D, De Matteis S, Pesatori AC, Cattaneo A, Cavallo DM, Lubin JH, et al. Increased lung cancer risk among bricklayers in an Italian population-based case-control study. Am J Ind Med. 2012;55: 423–428. 10.1002/ajim.22017 [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 18.Consonni D, Matteis S De, Pesatori AC, Cattaneo A, Cavallo DM, Lubin JH, et al. Erratum to “Increased lung cancer risk among bricklayers in an italian population-based case-control study.” Am J Ind Med. 2013;56: 825–825. 10.1002/ajim.ERRATUM [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 19.Calvert GM, Luckhaupt S, Lee S, Cress R, Schumacher P, Shen R, et al. Lung cancer risk among construction workers in California, 1988–2007. Am J Ind Med. 2012;55: 412–422. 10.1002/ajim.22010 [DOI] [PubMed] [Google Scholar]
  • 20.Donato F, Garzaro G, Pira E, Boffetta P. Mortality and cancer morbidity among cement production workers: a meta-analysis. Int Arch Occup Environ Health. 2016;89: 1155–1168. 10.1007/s00420-016-1167-x [DOI] [PubMed] [Google Scholar]
  • 21.Alonso-Sardón M, Chamorro A-J, Hernández-García I, Iglesias-de-Sena H, Martín-Rodero H, Herrera C, et al. Association between Occupational Exposure to Wood Dust and Cancer: A Systematic Review and Meta-Analysis. Zhang Z, editor. PLoS One. 2015;10: e0133024. 10.1371/journal.pone.0133024 [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 22.Boschman JS, van der Molen HF, Sluiter JK, Frings-Dresen MHW. Occupational demands and health effects for bricklayers and construction supervisors: A systematic review. Am J Ind Med. 2011;54: 55–77. 10.1002/ajim.20899 [DOI] [PubMed] [Google Scholar]
  • 23.Stroup D F, Berlin J A, Morton S C, Olkin I, Williamson G D, Rennie D, et al. Meta-analysis of Observational Studies in Epidemiology: a proposal for reporting Meta-analysis Of Observational Studies in Epidemiology (MOOSE) group. JAMA. 2000;283: 2008. 10.1001/jama.283.15.2008 [DOI] [PubMed] [Google Scholar]
  • 24.Liberati A, Altman DG, Tetzlaff J, Mulrow C, Gotzsche PC, Ioannidis JPA, et al. The PRISMA statement for reporting systematic reviews and meta-analyses of studies that evaluate healthcare interventions: explanation and elaboration. BMJ. 2009;339: b2700–b2700. 10.1136/bmj.b2700 [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 25.GA Wells, B Shea, D O’Connell, J Peterson, V Welch, M Losos PT. The Newcastle-Ottawa Scale (NOS) for assessing the quality of nonrandomised studies in meta-analyses. Ottawa, Canada: The Ottawa Hospital Research Institute; 2000.
  • 26.Lo CK, Mertz D, Loeb M. Newcastle-Ottawa Scale: comparing reviewers’ to authors’ assessments. BMC Med Res Methodol. 2014;14: 45. 10.1186/1471-2288-14-45 [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 27.Schünemann, Holger; Brożek, Jan; Guyatt, Gordon; Oxman A. GRADE handbook for grading quality of evidence and strength of recommendations. Updated October 2013. The GRADE Working Group, editor. The Cochrane Colaboration; 2013.
  • 28.Fernandez Chinguel JE, Zafra Tanaka JH, Goicochea Lugo S, Peralta CI, Taype Rondan A. Aspectos básicos sobre la lectura de revisiones sistemáticas y la interpretación de meta-análisis. ACTA MEDICA Peru. 2019;36: 157–169. 10.35663/amp.2019.362.818 [DOI] [Google Scholar]
  • 29.Higgins JP, Green S, editors. Cochrane Handbook for Systematic Reviews of Interventions Version 5.1.0 [updated March 2011]. 2011.
  • 30.Egger M, Smith GD, Schneider M, Minder C. Bias in meta-analysis detected by a simple, graphical test. BMJ. 1997;315: 629–634. 10.1136/bmj.315.7109.629 [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 31.Ferreira González I, Urrútia G, Alonso-Coello P. Revisiones sistemáticas y metaanálisis: bases conceptuales e interpretación. Rev Española Cardiol. 2011;64: 688–696. 10.1016/j.recesp.2011.03.029 [DOI] [PubMed] [Google Scholar]

Decision Letter 0

Rakibul M Islam

9 Dec 2020

PONE-D-20-29581

Lung cancer risk in workers of the civil construction industry:  A protocol for a systematic review and meta-analysis

PLOS ONE

Dear Dr. Schnorr,

Thank you for submitting your manuscript to PLOS ONE. After careful consideration, we feel that it has merit but does not fully meet PLOS ONE’s publication criteria as it currently stands. Therefore, we invite you to submit a revised version of the manuscript that addresses the points raised during the review process.

The reviewers rightly pointed out the vagueness of the protocol objective. The review authors stated “the main objective of our systematic review and meta-analysis is to determine how does working in the civil construction industry impacts on lung cancer risk for workers” which is not clear what they intend to do. Authors’ three research questions telling exactly the same thing in different ways. They are in fact examining an association between occupational exposure in the civil construction industry and lung cancer. They need to clarify whether they are assessing lung cancer events or lung cancer mortality or both.

Electronic searches. It would be relevant to consider Medline instead of PubMed. Authors are using funnel plot to report publication bias. However, the funnel plot only provides visual impressions. So the author should use Egger's test as well for testing publication bias. Give the version of RevMan that will be used: the latest "5.3"? Discuss the dissemination of findings in the Discussion section.

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We look forward to receiving your revised manuscript.

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Rakibul M Islam

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Reviewers' comments:

Reviewer's Responses to Questions

Comments to the Author

1. Does the manuscript provide a valid rationale for the proposed study, with clearly identified and justified research questions?

The research question outlined is expected to address a valid academic problem or topic and contribute to the base of knowledge in the field.

Reviewer #1: No

Reviewer #2: Yes

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2. Is the protocol technically sound and planned in a manner that will lead to a meaningful outcome and allow testing the stated hypotheses?

The manuscript should describe the methods in sufficient detail to prevent undisclosed flexibility in the experimental procedure or analysis pipeline, including sufficient outcome-neutral conditions (e.g. necessary controls, absence of floor or ceiling effects) to test the proposed hypotheses and a statistical power analysis where applicable. As there may be aspects of the methodology and analysis which can only be refined once the work is undertaken, authors should outline potential assumptions and explicitly describe what aspects of the proposed analyses, if any, are exploratory.

Reviewer #1: Partly

Reviewer #2: Yes

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3. Is the methodology feasible and described in sufficient detail to allow the work to be replicable?

Reviewer #1: Yes

Reviewer #2: Yes

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4. Have the authors described where all data underlying the findings will be made available when the study is complete?

The PLOS Data policy requires authors to make all data underlying the findings described in their manuscript fully available without restriction, with rare exception, at the time of publication. The data should be provided as part of the manuscript or its supporting information, or deposited to a public repository. For example, in addition to summary statistics, the data points behind means, medians and variance measures should be available. If there are restrictions on publicly sharing data—e.g. participant privacy or use of data from a third party—those must be specified.

Reviewer #1: Yes

Reviewer #2: Yes

**********

5. Is the manuscript presented in an intelligible fashion and written in standard English?

PLOS ONE does not copyedit accepted manuscripts, so the language in submitted articles must be clear, correct, and unambiguous. Any typographical or grammatical errors should be corrected at revision, so please note any specific errors here.

Reviewer #1: Yes

Reviewer #2: No

**********

6. Review Comments to the Author

Please use the space provided to explain your answers to the questions above and, if applicable, provide comments about issues authors must address before this protocol can be accepted for publication. You may also include additional comments for the author, including concerns about research or publication ethics.

You may also provide optional suggestions and comments to authors that they might find helpful in planning their study.

(Please upload your review as an attachment if it exceeds 20,000 characters)

Reviewer #1: Manuscript title: Lung cancer risk in workers of the civil construction industry: A protocol for a systematic review and meta-analysis

Journal Title: PLOS ONE

A) Title

The Authors tried to address the Lung cancer risk in workers of the civil construction industry. Later, the will pool the incidence of type of lung cancer among these populations and the title should be modified in this context.

Suggestion: “Incidence of lung cancer and mortality among civil construction industry workers: A protocol for a systematic review and meta-analysis”

B) Background

The authors didn’t show the problem associated with exposure to carcinogenic substances. What are these chemicals? What have been done so far? What are the gaps identified? What this systematic review going to investigate? How this review is different from the previous studies?

The findings of previous observational studies were consistent, but the authors considered the justification as there is no systematic review on this title. Do you think absence of systematic review must be the justification to carry out systematic review? To my understanding, systematic review should be conducted if:

- The existing studies are contradicting

- Existing studies recommending

- New studies are coming out

I have tried to see some literatures on incidence of /exposure risk as you mentioned/ lung cancer associated with chemical exposure among industrial workers, but there are a couple of reviews and systematic reviews on specific chemical exposure and risk of cancer among these populations. For example; Alonso-Sandra et al: Association between Occupational Exposure to Wood Dust and Cancer: A Systematic Review and Meta-Analysis; Danato et al: Mortality and cancer morbidity among cement production workers: a meta analysis; Boschman et al: Occupational demands and health effects for bricklayers and construction supervisors: A systematic review and some others reporting the incidence of lung cancer as well.

C) Method and material

- I would like to appreciate the authors for their tremendous work on method. It was coherent, detailed and interesting methodology but I have some minor comments: PICOs seems randomized trials. You are going to include studies not participants and you don’t need to mention gender but studies conducted on certain age, gender, etc..

- Why don’t you include prospective Cohort, comparative cross-sectional and randomized trials

- Your pan of data analysis will be with review manager, but you plan to perform regression analysis, how come? Review manager can’t perform regression but R and STATA and other software can.

- Is publication bias not your issue??

- What about your pan on overall quality of evidence? You don’t use the GRADEpro?

D) Discussion

- The plan of discussion is very narrow

- How will you compare your systematic review with the existing reviews?

- What do you think will be the political and health care implication of your study?

Reviewer #2: Dear Editor,

Thank you for providing me the opportunity to review this protocol. The protocol is well devised and covers most aspects needed to answer the study question. However, I have some comments listed below:

Introduction

• Line 45 and 49: The authors should include more recent references for the statistics if available.

• Line 67: Could the authors be clear in presenting if the finding is of a primary study or a review paper?

Review Objectives

• Line 88: The protocol does not appear to state the main objective precisely. Is the object to determine "how does it impact" or "quantification of the risk if analyzed". The language of the objective might create confusion.

Methods/design

• Line 101: The authors should revise the PROSPERO protocol to match with the submitted manuscript. Please provide the dates of the planned search in the abstract at the end of line 23 as from date 'MM/YYYY' to date 'MM/YYYY' (is it until November 19, 2019?) If so, the authors should be able to provide an adapted PubMed search strategy with the number of studies retrieved alongside as an appendix.

Participants/Population

• Line 123: Age restriction is excluded in the manuscript which is inconsistent with the PROSPERO protocol. Please ensure uniformity.

Search Strategy

• Line 150: I would recommend that authors also search Embase database (as mentioned in PROSPERO protocol). Else, the search might result limited studies.

Study selection

• Line 170: Mention the reference manager "XXX" at the first use rather than below.

• Line 179: Use name "PRISMA flow diagram" rather than flow chart.

Other comments

• How will the authors evaluate the quality of evidence? Do they plan to use any tool?

• What are the criteria under which data will be synthesized? (e.g; minimum number of studies to pool the results) In line 212, authors state "extremely high heterogeneity" which is unclear. What is the level of consistency required for synthesis in this review (< 75% or <85% or something else?)

• The authors should include a sub heading Dissemination or combine Ethics and Dissemination.

Optional suggestions to authors

The manuscript appears to be comprehensive, but the authors need to improve some common errors in language which hampers the readability of the paper (e.g; use of full forms more than once, minor spelling errors).

**********

7. PLOS authors have the option to publish the peer review history of their article (what does this mean?). If published, this will include your full peer review and any attached files.

If you choose “no”, your identity will remain anonymous but your review may still be made public.

Do you want your identity to be public for this peer review? For information about this choice, including consent withdrawal, please see our Privacy Policy.

Reviewer #1: No

Reviewer #2: Yes: Pratik Pokharel

[NOTE: If reviewer comments were submitted as an attachment file, they will be attached to this email and accessible via the submission site. Please log into your account, locate the manuscript record, and check for the action link "View Attachments". If this link does not appear, there are no attachment files.]

While revising your submission, please upload your figure files to the Preflight Analysis and Conversion Engine (PACE) digital diagnostic tool, https://pacev2.apexcovantage.com/. PACE helps ensure that figures meet PLOS requirements. To use PACE, you must first register as a user. Registration is free. Then, login and navigate to the UPLOAD tab, where you will find detailed instructions on how to use the tool. If you encounter any issues or have any questions when using PACE, please email PLOS at figures@plos.org. Please note that Supporting Information files do not need this step.

PLoS One. 2021 Apr 26;16(4):e0250377. doi: 10.1371/journal.pone.0250377.r002

Author response to Decision Letter 0

30 Jan 2021

Dear Prof. Rakibul,

We shall be very much appreciated if you may consider the revised version of our paper entitled (former title) " Lung cancer risk in workers of the civil construction industry: A protocol for a systematic review and meta-analysis” by Schnorr and colleagues, suitable for publication in PLOS ONE. Please find below point-by-point responses to the referee’s comments.

We greatly appreciated the editor´s and reviewer’s comments and suggestions. In this version, we performed the revision of our manuscript according to all their requests (please, kindly find the letter below). We do hope that all the present corrections could attend the editor and reviewer’s requirements for publication in PLOS ONE.

With best regards.

Yours sincerely,

Carlos Eduardo Schnorr (on behalf of all authors)

Attachment

Submitted filename: Response to Reviewers.docx

Click here for additional data file. (25.8KB, docx)

Decision Letter 1

Rakibul M Islam

4 Mar 2021

PONE-D-20-29581R1

Incidence of lung cancer and mortality among civil construction industry workers: A protocol for a systematic review and meta-analysis

PLOS ONE

Dear Dr. Schnorr

Thank you for submitting revised version of your manuscript to PLOS ONE. The manuscript has been improved substantially after addressing reviewers' comments. However, we invite you to submit the manuscript with minor revision that addresses the points raised during the review process.

Please submit your revised manuscript by 15 March 2021. If you will need more time than this to complete your revisions, please reply to this message or contact the journal office at plosone@plos.org. When you're ready to submit your revision, log on to https://www.editorialmanager.com/pone/ and select the 'Submissions Needing Revision' folder to locate your manuscript file.

Please include the following items when submitting your revised manuscript:

  • A rebuttal letter that responds to each point raised by the academic editor and reviewer(s). You should upload this letter as a separate file labeled 'Response to Reviewers'.

  • A marked-up copy of your manuscript that highlights changes made to the original version. You should upload this as a separate file labeled 'Revised Manuscript with Track Changes'.

  • An unmarked version of your revised paper without tracked changes. You should upload this as a separate file labeled 'Manuscript'.

If you would like to make changes to your financial disclosure, please include your updated statement in your cover letter. Guidelines for resubmitting your figure files are available below the reviewer comments at the end of this letter.

If applicable, we recommend that you deposit your laboratory protocols in protocols.io to enhance the reproducibility of your results. Protocols.io assigns your protocol its own identifier (DOI) so that it can be cited independently in the future. For instructions see: http://journals.plos.org/plosone/s/submission-guidelines#loc-laboratory-protocols

We look forward to receiving your revised manuscript.

Kind regards,

Rakibul M. Islam, MPH, PhD

Academic Editor

PLOS ONE

Journal Requirements:

Please review your reference list to ensure that it is complete and correct. If you have cited papers that have been retracted, please include the rationale for doing so in the manuscript text, or remove these references and replace them with relevant current references. Any changes to the reference list should be mentioned in the rebuttal letter that accompanies your revised manuscript. If you need to cite a retracted article, indicate the article’s retracted status in the References list and also include a citation and full reference for the retraction notice.

[Note: HTML markup is below. Please do not edit.]

Reviewers' comments:

Reviewer's Responses to Questions

Comments to the Author

1. Does the manuscript provide a valid rationale for the proposed study, with clearly identified and justified research questions?

The research question outlined is expected to address a valid academic problem or topic and contribute to the base of knowledge in the field.

Reviewer #1: Yes

Reviewer #2: Yes

**********

2. Is the protocol technically sound and planned in a manner that will lead to a meaningful outcome and allow testing the stated hypotheses?

The manuscript should describe the methods in sufficient detail to prevent undisclosed flexibility in the experimental procedure or analysis pipeline, including sufficient outcome-neutral conditions (e.g. necessary controls, absence of floor or ceiling effects) to test the proposed hypotheses and a statistical power analysis where applicable. As there may be aspects of the methodology and analysis which can only be refined once the work is undertaken, authors should outline potential assumptions and explicitly describe what aspects of the proposed analyses, if any, are exploratory.

Reviewer #1: Yes

Reviewer #2: Yes

**********

3. Is the methodology feasible and described in sufficient detail to allow the work to be replicable?

Reviewer #1: Yes

Reviewer #2: Yes

**********

4. Have the authors described where all data underlying the findings will be made available when the study is complete?

The PLOS Data policy requires authors to make all data underlying the findings described in their manuscript fully available without restriction, with rare exception, at the time of publication. The data should be provided as part of the manuscript or its supporting information, or deposited to a public repository. For example, in addition to summary statistics, the data points behind means, medians and variance measures should be available. If there are restrictions on publicly sharing data—e.g. participant privacy or use of data from a third party—those must be specified.

Reviewer #1: Yes

Reviewer #2: Yes

**********

5. Is the manuscript presented in an intelligible fashion and written in standard English?

PLOS ONE does not copyedit accepted manuscripts, so the language in submitted articles must be clear, correct, and unambiguous. Any typographical or grammatical errors should be corrected at revision, so please note any specific errors here.

Reviewer #1: Yes

Reviewer #2: No

**********

6. Review Comments to the Author

Please use the space provided to explain your answers to the questions above and, if applicable, provide comments about issues authors must address before this protocol can be accepted for publication. You may also include additional comments for the author, including concerns about research or publication ethics.

You may also provide optional suggestions and comments to authors that they might find helpful in planning their study.

(Please upload your review as an attachment if it exceeds 20,000 characters)

Reviewer #1: I would appreciate the authors for their tremendous work and rigorous response on all concerns being forwarded. I have tried to see the manuscript thoroughly and it was well improved substantially.

finally, I would recommend publication in PLOS ONE

Reviewer #2: The manuscript is well revised to improve the transparency, clarity and reproducibility of the planned work. The authors have addressed the comments and the responses are clear. However, I still have some minor comments listed below.

Ethics

• I would recommend modifying the tone of Ethics statement to make it sound better. It can be toned as "This review does not require ethical approval as the review is entirely based on the published data of the ethically approved primary studies."

Study selection

• Line 190: "where agreement cannot be reached” is dispensable.

Discussion

• Improvement on discussion section is fitting. However, it feels as the authors have too many introductory statements on lung cancer evidence which is not relevant here (Line 287-295). How does the evidence provided here link up with the advantages of the paper presented thereafter as "In this way, the results obtained from our study will..."? I would recommend summarising it. Introduction section should be better for presenting the facts and statistics on the grave nature of the outcome due to the risks among construction industry workers.

• The dissemination part is well addressed and can be a separate paragraph.

**********

7. PLOS authors have the option to publish the peer review history of their article (what does this mean?). If published, this will include your full peer review and any attached files.

If you choose “no”, your identity will remain anonymous but your review may still be made public.

Do you want your identity to be public for this peer review? For information about this choice, including consent withdrawal, please see our Privacy Policy.

Reviewer #1: Yes: Semagn Mekonnen Abate

Reviewer #2: Yes: Pratik Pokharel

[NOTE: If reviewer comments were submitted as an attachment file, they will be attached to this email and accessible via the submission site. Please log into your account, locate the manuscript record, and check for the action link "View Attachments". If this link does not appear, there are no attachment files.]

While revising your submission, please upload your figure files to the Preflight Analysis and Conversion Engine (PACE) digital diagnostic tool, https://pacev2.apexcovantage.com/. PACE helps ensure that figures meet PLOS requirements. To use PACE, you must first register as a user. Registration is free. Then, login and navigate to the UPLOAD tab, where you will find detailed instructions on how to use the tool. If you encounter any issues or have any questions when using PACE, please email PLOS at figures@plos.org. Please note that Supporting Information files do not need this step.

PLoS One. 2021 Apr 26;16(4):e0250377. doi: 10.1371/journal.pone.0250377.r004

Author response to Decision Letter 1

15 Mar 2021

EDITORS' COMMENTS

Please review your reference list to ensure that it is complete and correct. If you have cited papers that have been retracted, please include the rationale for doing so in the manuscript text, or remove these references and replace them with relevant current references. Any changes to the reference list should be mentioned in the rebuttal letter that accompanies your revised manuscript. If you need to cite a retracted article, indicate the article’s retracted status in the References list and also include a citation and full reference for the retraction notice.

The authors: We have reviewed the reference list text to make sure that it is complete and correct. We doble checked each reference from the list in PubMed and Retraction Watch Database (http://retractiondatabase.org/) and found no retracted papers in our reference list. However, we found and included one erratum for the reference “Consonni D, De Matteis S, Pesatori AC, Cattaneo A, Cavallo DM, Lubin JH, et al. Increased lung cancer risk among bricklayers in an Italian population-based case-control study. Am J Ind Med. 2012 May;55(5):423–8.” Both the original and the erratum are now cited in the manuscript. We also revised the reference for the Cochrane Handbook for Systematic Reviews of Interventions. We now correctly cite the handbook as “Higgins JP, Green S, editors. Cochrane Handbook for Systematic Reviews of Interventions Version 5.1.0 [updated March 2011]. 2011. 639 p.” Finally, we found one missing reference in the manuscript (line 288) and the reference is now cited as “British Health and Safety Executive. Occupational Cancer statistics in Great Britain, 2020. London; 2020.”

REVIEWERS' COMMENTS

REVIEWER #1:

I would appreciate the authors for their tremendous work and rigorous response on all concerns being forwarded. I have tried to see the manuscript thoroughly and it was well improved substantially. Finally, I would recommend publication in PLOS ONE.

The authors: Thank you for all your previous observations and questions. They have helped us to improve the manuscript of the proposed systematic review and meta-analysis.

REVIEWER #2:

The manuscript is well revised to improve the transparency, clarity and reproducibility of the planned work. The authors have addressed the comments and the responses are clear. However, I still have some minor comments listed below:

A) Ethics

• I would recommend modifying the tone of Ethics statement to make it sound better. It can be toned as "This review does not require ethical approval as the review is entirely based on the published data of the ethically approved primary studies."

The authors: We very much appreciated the reviewer´s suggestion, and the Ethics statement has been modified to sound better. The Ethics statement changed from “The present study does not require ethical approval since the original studies must have been conducting according to each local ethics committee.” to “This review does not require ethical approval as the review is entirely based on the published data of the ethically approved primary studies.”

B) Study selection

• Line 190: "where agreement cannot be reached” is dispensable.

The authors: This has been corrected accordingly.

C) Discussion

• Improvement on discussion section is fitting. However, it feels as the authors have too many introductory statements on lung cancer evidence which is not relevant here (Line 287-295). How does the evidence provided here link up with the advantages of the paper presented thereafter as "In this way, the results obtained from our study will..."? I would recommend summarising it. Introduction section should be better for presenting the facts and statistics on the grave nature of the outcome due to the risks among construction industry workers.

The authors: Thank you for all your observations and suggestions. We concentrated the facts and statistics in the introduction section. And we have summarized the statements on lung cancer evidence in the Discussion section, to improve the section clarity and content.

• The dissemination part is well addressed and can be a separate paragraph.

The authors: This has been revised accordingly.

Attachment

Submitted filename: Response to Reviewers.docx

Click here for additional data file. (20KB, docx)

Decision Letter 2

Rakibul M Islam

6 Apr 2021

Incidence of lung cancer and mortality among civil construction industry workers: A protocol for a systematic review and meta-analysis

PONE-D-20-29581R2

Dear Dr. Schnorr, 

We’re pleased to inform you that your manuscript has been judged scientifically suitable for publication and will be formally accepted for publication once it meets all outstanding technical requirements.

Within one week, you’ll receive an e-mail detailing the required amendments. When these have been addressed, you’ll receive a formal acceptance letter and your manuscript will be scheduled for publication.

An invoice for payment will follow shortly after the formal acceptance. To ensure an efficient process, please log into Editorial Manager at http://www.editorialmanager.com/pone/, click the 'Update My Information' link at the top of the page, and double check that your user information is up-to-date. If you have any billing related questions, please contact our Author Billing department directly at authorbilling@plos.org.

If your institution or institutions have a press office, please notify them about your upcoming paper to help maximize its impact. If they’ll be preparing press materials, please inform our press team as soon as possible -- no later than 48 hours after receiving the formal acceptance. Your manuscript will remain under strict press embargo until 2 pm Eastern Time on the date of publication. For more information, please contact onepress@plos.org.

Kind regards,

Rakibul M. Islam, MPH, PhD

Academic Editor

PLOS ONE

Acceptance letter

Rakibul M Islam

14 Apr 2021

PONE-D-20-29581R2

Incidence of lung cancer and mortality among civil construction industry workers: A protocol for a systematic review and meta-analysis

Dear Dr. Schnorr:

I'm pleased to inform you that your manuscript has been deemed suitable for publication in PLOS ONE. Congratulations! Your manuscript is now with our production department.

If your institution or institutions have a press office, please let them know about your upcoming paper now to help maximize its impact. If they'll be preparing press materials, please inform our press team within the next 48 hours. Your manuscript will remain under strict press embargo until 2 pm Eastern Time on the date of publication. For more information please contact onepress@plos.org.

If we can help with anything else, please email us at plosone@plos.org.

Thank you for submitting your work to PLOS ONE and supporting open access.

Kind regards,

PLOS ONE Editorial Office Staff

on behalf of

Dr. Rakibul M. Islam

Academic Editor

PLOS ONE

Associated Data

    This section collects any data citations, data availability statements, or supplementary materials included in this article.

    Supplementary Materials

    S1 Checklist. PRISMA-P checklist.

    (DOC)

    Click here for additional data file. (63.5KB, doc)
    Attachment

    Submitted filename: Response to Reviewers.docx

    Click here for additional data file. (25.8KB, docx)
    Attachment

    Submitted filename: Response to Reviewers.docx

    Click here for additional data file. (20KB, docx)

    Data Availability Statement

    All relevant data from this study are publicly available here: https://osf.io/bgz2a/ (DOI: 10.17605/OSF.IO/BGZ2A).

    Articles from PLoS ONE are provided here courtesy of PLOS

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