Cancer and Environmental Epidemiology Unit, National Center for Epidemiology, Carlos III Institute of Health, Avda. Monforte de Lemos, 5, 28029 Madrid, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Spain.
Cancer and Environmental Epidemiology Unit, National Center for Epidemiology, Carlos III Institute of Health, Avda. Monforte de Lemos, 5, 28029 Madrid, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Spain; Molecular Epidemiology of Cancer Unit, University Institute of Oncology, University of Oviedo, C/Fernando Bongera, s/n, 33006 Oviedo, Spain.
Environ Int. 2012 Apr;40:116-127. doi: 10.1016/j.envint.2011.07.002. Epub 2011 Jul 29.
Population exposure to emissions from multiple industrial sources, though little studied, is an aspect of great interest from an epidemiologic standpoint.
To investigate whether risk of dying due to tumors of the digestive system in populations residing in the vicinity of Spanish metal production and processing installations increases with proximity to a greater number of industrial facilities.
An ecologic study was designed to ascertain municipal mortality due to malignant tumors of the digestive system (oral cavity and pharynx, esophagus, stomach, pancreas, liver, gallbladder and colon-rectum) during the period 1994-2003, in Spanish regions with the presence of multiple industrial sources in the metal sector. Population exposure to pollution was estimated on the basis of distance from town of residence to pollution source. Using Poisson regression models, we analyzed: the increased risk of dying of cancer with proximity to a given number of sources; and excess mortality in the vicinity of specific industrial clusters.
The tumor responsible for the greatest number of regions with increased risk in both sexes was liver cancer (78% of the regions, being statistically significant in Valencia (p-value for trend (p trend)=0.001 in both sexes), Madrid (p trend=0.011 in women) and the Basque Country (p trend=0.002 in men)), followed by colorectal and pancreatic cancers (56% of the regions, being statistically significant in both sexes in Valencia (p trend=0.001) and Zaragoza (p trend=0.018) for colorectal cancer; and Valladolid (p trend=0.019 in men) and Barcelona (p trend=0.049 in women) for pancreatic cancer). Valencia was the province that displayed increased risk with the proximity to metal industries for all tumors studied, while the Basque Country was the Autonomous Region that registered a rising risk trend for liver, stomach and colorectal tumors with proximity (≤5 km) to a greater number of sources.
The results could support the hypothesis that mortality due to certain tumors of the digestive system increases with proximity (≤5 km) to a greater number of metal industry sources. Nevertheless, in this type of ecologic study, conclusions cannot be obtained in terms of cause and effect, nor can individual inferences be made from grouped data.
人群暴露于多种工业来源的排放物中，尽管研究甚少，但从流行病学角度来看，这是一个非常有趣的方面。
研究居住在西班牙金属生产和加工设施附近的人群，其因消化系统肿瘤而死亡的风险是否会随着与更多工业设施的接近而增加。
设计了一项生态研究，以确定 1994 年至 2003 年期间西班牙多个金属行业存在工业污染源的地区，居民因消化系统恶性肿瘤（口腔和咽、食管、胃、胰腺、肝、胆囊和结肠-直肠）导致的城市死亡率。根据居住地与污染源的距离来估计人群对污染的暴露情况。使用泊松回归模型，我们分析了：与给定数量的污染源接近时，癌症死亡风险增加的情况；以及特定工业集群附近的超额死亡率。
在两性中，导致风险增加的地区数量最多的肿瘤是肝癌（78%的地区，在瓦伦西亚（男女 p 趋势值均为 0.001）、马德里（女性 p 趋势值为 0.011）和巴斯克地区（男性 p 趋势值为 0.002）有统计学意义），其次是结直肠癌和胰腺癌（56%的地区，在瓦伦西亚（男女 p 趋势值均为 0.001）和萨拉戈萨（女性 p 趋势值为 0.018）对结直肠癌；以及巴利亚多利德（男性 p 趋势值为 0.019）和巴塞罗那（女性 p 趋势值为 0.049）对胰腺癌）有统计学意义。瓦伦西亚是所有研究肿瘤中因接近金属工业而显示出风险增加的省份，而巴斯克地区则是因接近（≤5 公里）更多金属工业源而导致肝癌、胃癌和结直肠癌风险上升的自治区。
结果可能支持这样的假设，即某些消化系统肿瘤的死亡率随着接近（≤5 公里）更多金属工业源而增加。然而，在这种生态研究中，不能得出因果关系的结论，也不能从分组数据中得出个体推论。
