Krishnadasan Anusha, Kennedy Nola, Zhao Yingxu, Morgenstern Hal, Ritz Beate
Department of Epidemiology, School of Public Health, University of California, Los Angeles, CA, USA.
Am J Ind Med. 2007 May;50(5):383-90. doi: 10.1002/ajim.20458.
To date, little is known about the potential contributions of occupational exposure to chemicals to the etiology of prostate cancer. Previous studies examining associations suffered from limitations including the reliance on mortality data and inadequate exposure assessment.
We conducted a nested case-control study of 362 cases and 1,805 matched controls to examine the association between occupational chemical exposures and prostate cancer incidence. Workers were employed between 1950 and 1992 at a nuclear energy and rocket engine-testing facility in Southern California. We obtained cancer-incidence data from the California Cancer Registry and seven other state cancer registries. Data from company records were used to construct a job exposure matrix (JEM) for occupational exposures to hydrazine, trichloroethylene (TCE), polycyclic aromatic hydrocarbons (PAHs), benzene and mineral oil. Associations between chemical exposures and prostate cancer incidence were assessed in conditional logistic regression models.
With adjustment for occupational confounders, including socioeconomic status, occupational physical activity, and exposure to the other chemicals evaluated, the odds ratio for low/moderate TCE exposure was 1.3; 95%CI = 0.8 to 2.1, and for high TCE exposure was 2.1; 95%CI = 1.2 to 3.9. Furthermore, we noted a positive trend between increasing levels of TCE exposure and prostate cancer (P-value for trend = 0.02).
Our results suggest that high levels of TCE exposure are associated with prostate cancer among workers in our study population.
迄今为止，关于职业接触化学物质对前列腺癌病因的潜在影响知之甚少。以往研究关联性的研究存在局限性，包括依赖死亡率数据以及暴露评估不充分。
我们进行了一项巢式病例对照研究，纳入362例病例和1805例匹配对照，以研究职业化学物质暴露与前列腺癌发病率之间的关联。这些工人于1950年至1992年期间受雇于南加州的一个核能和火箭发动机测试设施。我们从加利福尼亚癌症登记处和其他七个州癌症登记处获取了癌症发病率数据。公司记录中的数据用于构建职业接触肼、三氯乙烯（TCE）、多环芳烃（PAHs）、苯和矿物油的工作接触矩阵（JEM）。在条件逻辑回归模型中评估化学物质暴露与前列腺癌发病率之间的关联。
在对职业混杂因素进行调整后，包括社会经济地位、职业体力活动以及对其他评估化学物质的暴露，低/中度TCE暴露的比值比为1.3；95%置信区间=0.8至2.1，高TCE暴露的比值比为2.1；95%置信区间=1.2至3.9。此外，我们注意到TCE暴露水平升高与前列腺癌之间存在正相关趋势（趋势P值=0.02）。
我们的结果表明，在我们的研究人群中，高剂量TCE暴露与前列腺癌有关。
