Pan Xue-lei, Day Howard W, Wang Wei, Beckett Laurel A, Schenker Marc B
Department of Public Health Sciences, University of California at Davis, Davis, CA 95616-8638, USA.
Am J Respir Crit Care Med. 2005 Oct 15;172(8):1019-25. doi: 10.1164/rccm.200412-1731OC. Epub 2005 Jun 23.
Little is known about environmental exposure to low levels of naturally occurring asbestos (NOA) and malignant mesothelioma (MM) risk.
To conduct a cancer registry-based case control study of residential proximity to NOA with MM in California.
Incident MM cases (n = 2,908) aged 35 yr or more, diagnosed between 1988 and 1997, were selected from the California Cancer Registry and frequency matched to control subjects with pancreatic cancer (n = 2,908) by 5-yr age group and sex. Control subjects were selected by stratified random sampling from 28,123 incident pancreatic cancers in the same time period. We located 93.7% of subjects at the house or street level at initial diagnosis. Individual occupational exposure to asbestos was derived from the longest held occupation, available for 74% of MM cases and 63% of pancreatic cancers. Occupational exposure to asbestos was determined by a priori classification and confirmed by association with mesothelioma.
The adjusted odds ratios and 95% confidence interval for low, medium, and high probabilities of occupational exposures to asbestos were 1.71 (1.32-2.21), 2.51 (1.91-3.30), and 14.94 (8.37-26.67), respectively. Logistic regression analysis from a subset of 1,133 mesothelioma cases and 890 control subjects with pancreatic cancer showed that the odds of mesothelioma decreased approximately 6.3% for every 10 km farther from the nearest asbestos source, an odds ratio of 0.937 (95% confidence interval = 0.895-0.982), adjusted for age, sex, and occupational exposure to asbestos.
These data support the hypothesis that residential proximity to NOA is significantly associated with increased risk of MM in California.
关于低水平天然存在的石棉(NOA)的环境暴露与恶性间皮瘤(MM)风险的了解甚少。
在加利福尼亚州开展一项基于癌症登记处的病例对照研究,以探究居住环境与NOA的距离和MM发病风险之间的关系。
选取1988年至1997年间确诊的年龄在35岁及以上的新发MM病例(n = 2908),这些病例来自加利福尼亚癌症登记处,并按5岁年龄组和性别与胰腺癌对照对象(n = 2908)进行频数匹配。对照对象通过分层随机抽样从同一时期的28123例新发胰腺癌病例中选取。在初次诊断时,我们找到了93.7%的研究对象的家庭住址或街道位置。个体职业性石棉暴露情况来自其从事时间最长的职业,74%的MM病例和63%的胰腺癌病例有此项信息。职业性石棉暴露通过预先设定的分类来确定,并通过与间皮瘤的相关性进行确认。
职业性接触石棉的低、中、高概率的调整比值比及95%置信区间分别为1.71(1.32 - 2.21)、2.51(1.91 - 3.30)和14.94(8.37 - 26.67)。对1133例间皮瘤病例和890例胰腺癌对照对象的子集进行逻辑回归分析显示,每远离最近的石棉源10公里,间皮瘤的发病几率约降低6.3%,调整年龄、性别和职业性石棉暴露后,比值比为0.937(95%置信区间 = 0.895 - 0.982)。
这些数据支持这样的假设,即在加利福尼亚州,居住环境与NOA的距离与MM发病风险的增加显著相关。