Poulsen Aslak Harbo, Sørensen Mette, Andersen Zorana J, Ketzel Matthias, Raaschou-Nielsen Ole
Danish Cancer Society Research Center, Strandboulevarden 49, 2100, Copenhagen Ø, Denmark.
Department of Public Health, Center for Epidemiology and Screening, University of Copenhagen, Copenhagen, Denmark.
Cancer Causes Control. 2016 Apr;27(4):473-80. doi: 10.1007/s10552-016-0721-x. Epub 2016 Feb 18.
Air pollution is an established lung carcinogen, and there is increasing evidence that air pollution also negatively affects the brain. We have previously reported an association between air pollution and risk of brain tumors in a cohort study based on only 95 cases. We set out to replicate that finding in a large nationwide case-control study.
We identified all 4,183 adult brain tumor cases in Denmark in the years 2000-2009 and 8,018 risk set sampled population controls matched on gender and year of birth. We extracted residential address histories and estimated mean residential nitrogen oxides (NO x ) concentrations since 1971 with a validated dispersion model. Categorical and linear odds ratios (OR) and confidence intervals (CI) were calculated with conditional logistic regression models.
The highest risk estimates for any brain cancer were observed among subjects with the highest average exposure levels (80-99 µg/m(3): OR 1.27, 95% CI 0.82-1.96; ≥100 µg/m(3): 1.40, 95 % CI 0.87-2.26 as compared to <20 µg/m(3) NO x ), but there was no increased OR at NO x levels below 80 µg/m(3) and when modeled linearly there was no significant association with risk of brain cancer (OR 1.11, 95% CI 0.84-1.46 per 100 µg/m(3) NO x ). In sub-analysis the OR associated with exposures ≥100 µg/m(3) was 2.30 (95% CI 1.15-4.59) for non-glioma and 0.89 (95% CI 0.44-1.77) for glioma.
This study did not support the relatively strong linear association between air pollution and risk of brain tumors which was found in our previous study. The suggestion of an increased brain tumor risk at high exposures merits further attention as does the differing results according to tumor morphology.
空气污染是一种已被确认的肺癌致癌物,并且越来越多的证据表明空气污染也会对大脑产生负面影响。我们之前在一项仅基于95例病例的队列研究中报告了空气污染与脑肿瘤风险之间的关联。我们着手在一项大型全国性病例对照研究中重复这一发现。
我们确定了2000年至2009年丹麦所有4183例成人大脑肿瘤病例以及8018例按性别和出生年份匹配的风险设定抽样人群对照。我们提取了居住地址历史记录,并使用经过验证的扩散模型估算了自1971年以来的平均居住氮氧化物(NOx)浓度。使用条件逻辑回归模型计算分类和线性比值比(OR)及置信区间(CI)。
在平均暴露水平最高的受试者中观察到任何脑癌的最高风险估计值(80 - 99μg/m³:OR 1.27,95%CI 0.82 - 1.96;≥100μg/m³:1.40,95%CI 0.87 - 2.26,与<20μg/m³的NOx相比), 但在NOx水平低于80μg/m³时OR没有增加,并且在线性模型中与脑癌风险没有显著关联(每100μg/m³的NOx,OR 1.11,95%CI 0.84 - 1.46)。在亚组分析中,对于非胶质瘤,与暴露≥100μg/m³相关的OR为2.30(95%CI 1.15 - 4.59),对于胶质瘤为0.89(95%CI 0.44 - 1.77)。
本研究不支持我们之前研究中发现的空气污染与脑肿瘤风险之间相对较强的线性关联。高暴露水平下脑肿瘤风险增加的提示值得进一步关注,根据肿瘤形态的不同结果也值得关注。