Weiderpass E, Pukkala E, Kauppinen T, Mutanen P, Paakkulainen H, Vasama-Neuvonen K, Boffetta P, Partanen T
Department of Medical Epidemiology, Karolinska Institutet, Stockholm, Sweden.
Am J Ind Med. 1999 Jul;36(1):48-53. doi: 10.1002/(sici)1097-0274(199907)36:1<48::aid-ajim7>3.0.co;2-2.
The etiology of breast cancer is not fully understood. Environmental and occupational exposures may contribute to breast cancer risk.
We linked 324 job titles from the 1970 census of 892,591 Finnish women with incidence of breast cancer (23,638 cases) during 1971-1995. We converted job titles to 31 chemical and two ergonomic agents through a measurement-based, period-specific, national job-exposure matrix. Poisson regression models were fit to the data, with adjustment for birth cohort, follow-up period, socioeconomic status, mean number of children, mean age at first delivery, and turnover rate.
For premenopausal breast cancer, medium/high level of occupational exposure to ionizing radiation was associated with a standardized incidence ratio (SIR) of 1.3 (95% confidence interval (CI) 0.7-2.5; trend P = 0.03). For postmenopausal breast cancer, we found on SIR of 1.2 (1.1-1.3) for low level and 1.4 (1.1-1.8) for medium/high level of ionizing radiation (trend P = 0.001); and an SIR 1.3 (1.1-1.7) for medium/high levels of both asbestos and man-made vitreous fibers. Aromatic hydrocarbon solvents showed a significant trend for a modest excess of postmenopausal breast cancer.
Our study indicates that occupational exposure to ionizing radiation may be associated with an increased risk of female breast cancer. High-quality studies on environmental and occupational etiology of breast cancer are needed for further elucidation of risk factors.
乳腺癌的病因尚未完全明确。环境和职业暴露可能会增加患乳腺癌的风险。
我们将1970年芬兰892,591名女性人口普查中的324种职业与1971 - 1995年期间的乳腺癌发病率(23,638例)进行了关联。通过基于测量的、特定时期的全国职业暴露矩阵,我们将职业转换为31种化学物质和两种工效学因素。对数据拟合泊松回归模型,并对出生队列、随访期、社会经济地位、子女平均数量、首次生育时的平均年龄和人员更替率进行了调整。
对于绝经前乳腺癌,职业性中等/高水平电离辐射暴露的标准化发病比(SIR)为1.3(95%置信区间(CI)0.7 - 2.5;趋势P = 0.03)。对于绝经后乳腺癌,我们发现低水平电离辐射的SIR为1.2(1.1 - 1.3),中等/高水平电离辐射的SIR为1.4(1.1 - 1.8)(趋势P = 0.001);石棉和人造玻璃纤维中等/高水平暴露的SIR为1.3(1.1 - 1.7)。芳烃溶剂显示出绝经后乳腺癌略有过量的显著趋势。
我们的研究表明,职业性电离辐射暴露可能与女性乳腺癌风险增加有关。需要高质量的关于乳腺癌环境和职业病因的研究来进一步阐明风险因素。