Department of Public Health, Experimental and Forensic Medicine, University of Pavia, Pavia, Italy.
Am J Ind Med. 2013 Sep;56(9):1051-62. doi: 10.1002/ajim.22205. Epub 2013 May 30.
The role of occupational exposures in breast cancer development is still uncertain and, to our knowledge, no studies have been recently carried out in Italy to provide a comprehensive estimation of this possible risk.
Based on administrative data, a case-control study was carried out recruiting all incident cases of female breast cancer in the period 2002-2009, aged between 35 and 69 years, residing in Lombardy, Italy. Controls were randomly sampled from all women residing in Lombardy as of December 31, 2005. Occupational histories, including blue-collar status, were available from 1974 through record linkage with a social security pension database, and were obtained for 11,188 cases and 25,329 controls. Adjusted odds ratios (ORs) and corresponding 90% confidence intervals (CIs) were calculated using multiple unconditional logistic regression models, including terms for sectors of longest employment and for duration of employment. Multiple comparisons were accounted for according to the Benjamini-Hochberg method.
The ORs for female breast cancer were modestly but significantly increased for employment in electrical manufacturing (OR 1.12, 90%CI 1.04-1.21), textile (OR 1.08, 90%CI 1.02-1.15), paper (OR 1.25, 90%CI 1.06-1.46) and rubber (OR 1.26, 90%CI 1.03-1.54) industries. Analysis by duration of employment within sectors showed significantly increased ORs for electrical manufacturing and rubber industries. After adjustment for multiple comparisons no estimates remained statistically significant.
Although with several limitations, our results point to a possible role of exposures in electrical manufacturing, textile, paper and rubber industries in the process leading to breast cancer. An in-dept study for the electrical manufacturing industry has been already planned.
职业暴露在乳腺癌发展中的作用仍不确定,据我们所知,意大利最近没有进行过研究来全面评估这种可能的风险。
基于行政数据,我们开展了一项病例对照研究,在 2002 年至 2009 年期间招募了所有女性乳腺癌的新发病例,年龄在 35 至 69 岁之间,居住在意大利伦巴第地区。对照随机抽取于 2005 年 12 月 31 日居住在伦巴第地区的所有女性。职业史,包括蓝领身份,可通过与社会保险养老金数据库的记录链接从 1974 年获得,并获得了 11188 例病例和 25329 例对照。使用包含最长就业部门和就业时间的多个无条件逻辑回归模型计算调整后的比值比(OR)和相应的 90%置信区间(CI)。根据 Benjamini-Hochberg 方法考虑了多重比较。
女性乳腺癌的 OR 对于电器制造(OR 1.12,90%CI 1.04-1.21)、纺织(OR 1.08,90%CI 1.02-1.15)、造纸(OR 1.25,90%CI 1.06-1.46)和橡胶(OR 1.26,90%CI 1.03-1.54)行业的就业呈适度但显著增加。对部门内就业时间的分析显示,电器制造和橡胶行业的 OR 显著增加。在进行多重比较调整后,没有估计值具有统计学意义。
尽管存在一些局限性,但我们的结果表明,电器制造、纺织、造纸和橡胶行业的暴露可能在乳腺癌的发生过程中起作用。已经计划对电器制造行业进行深入研究。