Edwards R, Pless-Mulloli T, Howel D, Chadwick T, Bhopal R, Harrison R, Gribbin H
Department of Public Health, Wellington School of Medicine and Health Sciences, University of Otago, Wellington, New Zealand.
Thorax. 2006 Dec;61(12):1076-82. doi: 10.1136/thx.2005.057620. Epub 2006 Oct 13.
The incidence of lung cancer among women is high in the highly industrialised area of Teesside in north-east England. Previous research has implicated industrial pollution as a possible cause. A study was undertaken to investigate whether prolonged residence close to heavy industry is associated with lung cancer among women in Teesside.
Two hundred and four women aged <80 years with incident primary lung cancer and 339 age matched community controls were recruited to a population based case-control study. Life course residential, occupational, and active and passive smoking histories were obtained using an interviewer administered questionnaire.
The age adjusted odds ratio (OR) for lung cancer among people living >25 years v 0 years near (within 0-5 km) heavy industry in Teesside was 2.13 (95% CI 1.34 to 3.38). After adjustment for confounding factors the OR was 1.83 (95% CI 0.82 to 4.08) for >25 years or 1.10 (95% CI 0.96 to 1.26) for an additional 10 years living near industry. ORs were similar after residence near heavy industry outside Teesside was also included, and when latency was allowed for by disregarding residential exposures within the last 20 years. Adjustment for active smoking had the greatest effect on the OR.
This population based study using life grid interviews for life course exposure assessment has addressed many deficiencies in the design of previous studies. The findings support those in most of the international literature of a modestly raised risk of lung cancer with prolonged residence close to heavy industry, although the confidence intervals were wide. The effect of air pollution on the incidence of lung cancer merits continued study.
在英格兰东北部蒂斯河畔高度工业化的地区,女性肺癌发病率很高。先前的研究认为工业污染可能是一个原因。开展了一项研究,以调查在蒂斯河畔长期居住在重工业附近是否与女性肺癌有关。
招募了204名年龄小于80岁的原发性肺癌初发女性患者以及339名年龄匹配的社区对照者,进行一项基于人群的病例对照研究。通过访员管理的问卷获取生活历程中的居住、职业以及主动和被动吸烟史。
在蒂斯河畔,居住在重工业附近(0 - 5公里范围内)超过25年与居住0年的人群相比,年龄调整后的肺癌优势比(OR)为2.13(95%可信区间1.34至3.38)。在调整混杂因素后,居住超过25年的OR为1.83(95%可信区间0.82至4.08),在工业附近额外居住10年的OR为1.10(95%可信区间0.96至1.26)。纳入蒂斯河畔以外重工业附近的居住情况,以及通过忽略过去20年内的居住暴露情况来考虑潜伏期后,OR值相似。对主动吸烟进行调整对OR的影响最大。
这项基于人群的研究使用生活网格访谈来评估生活历程暴露,解决了先前研究设计中的许多缺陷。研究结果支持了大多数国际文献中的观点,即长期居住在重工业附近会使肺癌风险略有升高,尽管可信区间较宽。空气污染对肺癌发病率的影响值得继续研究。