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住宅内氡暴露与癌症预防研究 II 营养队列中血液系统恶性肿瘤发病风险的关系。

Residential radon exposure and risk of incident hematologic malignancies in the Cancer Prevention Study-II Nutrition Cohort.

机构信息

Epidemiology Research Program, American Cancer Society, Atlanta, GA, USA.

Epidemiology Research Program, American Cancer Society, Atlanta, GA, USA.

出版信息

Environ Res. 2016 Jul;148:46-54. doi: 10.1016/j.envres.2016.03.002. Epub 2016 Mar 23.

Abstract

Dosimetric models show that radon, an established cause of lung cancer, delivers a non-negligible dose of alpha radiation to the bone marrow, as well as to lymphocytes in the tracheobronchial epithelium, and therefore could be related to risk of hematologic cancers. Studies of radon and hematologic cancer risk, however, have produced inconsistent results. To date there is no published prospective, population-based study of residential radon exposure and hematologic malignancy incidence. We used data from the American Cancer Society Cancer Prevention Study-II Nutrition Cohort established in 1992, to examine the association between county-level residential radon exposure and risk of hematologic cancer. The analytic cohort included 140,652 participants (66,572 men, 74,080 women) among which 3019 incident hematologic cancer cases (1711 men, 1308 women) were identified during 19 years of follow-up. Cox proportional hazard regression was used to calculate multivariable-adjusted hazard ratios (HRs) and corresponding 95% confidence intervals (CIs) for radon exposure and hematologic cancer risk. Women living in counties with the highest mean radon concentrations (>148Bq/m(3)) had a statistically significant higher risk of hematologic cancer compared to those living in counties with the lowest (<74Bq/m(3)) radon levels (HR=1.63, 95% CI:1.23-2.18), and there was evidence of a dose-response relationship (HRcontinuous=1.38, 95% CI:1.15-1.65 per 100Bq/m(3); p-trend=0.001). There was no association between county-level radon and hematologic cancer risk among men. The findings of this large, prospective study suggest residential radon may be a risk factor for lymphoid malignancies among women. Further study is needed to confirm these findings.

摘要

剂量学模型表明,氡是肺癌的一个已确定病因,它会向骨髓以及气管支气管上皮中的淋巴细胞输送不可忽视的α辐射剂量,因此可能与血液癌症的风险有关。然而,氡与血液癌症风险的研究结果并不一致。迄今为止,还没有关于住宅氡暴露与血液恶性肿瘤发病率的已发表的前瞻性、基于人群的研究。我们利用美国癌症协会癌症预防研究-II 营养队列(1992 年建立)的数据,研究了县一级住宅氡暴露与血液恶性肿瘤风险之间的关系。分析队列包括 140652 名参与者(66572 名男性,74080 名女性),其中 19 年随访期间发现 3019 例血液癌症病例(1711 名男性,1308 名女性)。使用 Cox 比例风险回归计算了氡暴露与血液癌症风险之间的多变量调整后的危险比(HR)和相应的 95%置信区间(CI)。与生活在氡水平最低(<74Bq/m3)的县的女性相比,生活在氡浓度最高(>148Bq/m3)的县的女性血液癌症风险显著升高(HR=1.63,95%CI:1.23-2.18),且存在剂量-反应关系(HRcontinuous=1.38,95%CI:每 100Bq/m3 增加 1.15-1.65;p 趋势=0.001)。男性的县一级氡与血液癌症风险之间没有关联。这项大型前瞻性研究的结果表明,住宅氡可能是女性淋巴细胞恶性肿瘤的一个危险因素。需要进一步的研究来证实这些发现。

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