Kristbjornsdottir Adalbjorg, Rafnsson Vilhjalmur
The Centre of Public Health Sciences, Faculty of Medicine, University of Iceland , Reykjavik , Iceland.
Acta Oncol. 2015 Jan;54(1):115-23. doi: 10.3109/0284186X.2014.923113. Epub 2014 Jun 9.
Residents of geothermal areas have increased incidence of non-Hodgkin's lymphoma, breast, prostate, and kidney cancers. The aim was to study whether this is also reflected in cancer mortality among the population using geothermal hot water for space heating, washing, and showering.
The follow-up was from 1981 to 2009. Personal identifier of those 5-64 years of age was used in record linkage with nationwide death registry. Thus, vital and emigration status was ascertained. The exposed population was defined as inhabitants of communities with district heating generated from geothermal wells since 1972. Reference populations were inhabitants of other areas with different degrees of volcanic/geothermal activity. Hazard ratio (HR) and 95% confidence intervals (CI) were adjusted for age, gender, education, housing, reproductive factors and smoking habits.
Among those using geothermal water, the HR for all causes of death was 0.98 (95% CI 0.91-1.05) as compared with cold reference area. The HR for breast cancer was 1.53 (1.04-2.24), prostate cancer 1.74 (1.21-2.52), kidney cancer 1.78 (1.03-3.07), and for non-Hodgkin's lymphoma 2.01 (1.05-3.38). HR for influenza was 3.36 (1.32-8.58) and for suicide 1.49 (1.03-2.17).
The significant excess mortality risk of breast and prostate cancers, and non-Hodgkin's lymphoma confirmed the results of similarly designed studies in Iceland on cancer incidence among populations from high-temperature geothermal areas and users of geothermal hot water. The risk is not confined to cancers with good prognosis, but also concerns fatal cancers. Further studies are needed on the chemical and physical content of the water and the environment emissions in geothermal areas.
地热地区居民患非霍奇金淋巴瘤、乳腺癌、前列腺癌和肾癌的发病率有所增加。目的是研究在使用地热水进行空间供暖、洗涤和淋浴的人群中,这是否也反映在癌症死亡率上。
随访时间为1981年至2009年。使用5至64岁人群的个人标识符与全国死亡登记处进行记录链接。由此确定生命和移民状态。暴露人群定义为自1972年以来使用地热井进行区域供暖的社区居民。参照人群为其他具有不同程度火山/地热活动地区的居民。对年龄、性别、教育程度、住房、生殖因素和吸烟习惯进行了风险比(HR)和95%置信区间(CI)的调整。
与寒冷参照地区相比,使用地热水的人群中,全因死亡的HR为0.98(95%CI 0.91 - 1.05)。乳腺癌的HR为1.53(1.04 - 2.24),前列腺癌为1.74(1.21 - 2.52),肾癌为1.78(1.03 - 3.07),非霍奇金淋巴瘤为2.01(1.05 - 3.38)。流感的HR为3.36(1.32 - 8.58),自杀的HR为1.49(1.03 - 2.17)。
乳腺癌、前列腺癌和非霍奇金淋巴瘤显著的超额死亡风险证实了冰岛类似设计研究中关于高温地热地区人群和地热水使用者癌症发病率的结果。该风险不仅限于预后良好的癌症,也涉及致命癌症。需要进一步研究地热地区水的化学和物理成分以及环境排放。