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职业、行业与前列腺癌风险:加拿大蒙特利尔的一项病例对照研究

Occupation, industry, and the risk of prostate cancer: a case-control study in Montréal, Canada.

作者信息

Sauvé Jean-François, Lavoué Jérôme, Parent Marie-Élise

机构信息

School of Public Health, Department of environmental and occupational health, Université de Montréal, C.P. 6128 Succursale Centre-Ville, Montréal, Québec, H3C 3J7, Canada.

Centre de recherche du CHUM, 850 rue Saint-Denis, Montréal, Québec, H2X 0A9, Canada.

出版信息

Environ Health. 2016 Oct 21;15(1):100. doi: 10.1186/s12940-016-0185-1.

Abstract

BACKGROUND

Age, family history and ancestry are the only recognized risk factors for prostate cancer (PCa) but a role for environmental factors is suspected. Due to the lack of knowledge on the etiological factors for PCa, studies that are both hypothesis-generating and confirmatory are still needed. This study explores relationships between employment, by occupation and industry, and PCa risk.

METHODS

Cases were 1937 men aged ≤75 years with incident PCa diagnosed across Montreal French hospitals in 2005-2009. Controls were 1994 men recruited concurrently from electoral lists of French-speaking Montreal residents, frequency-matched to cases by age. In-person interviews elicited occupational histories. Unconditional logistic regression estimated odds ratios (OR) and 95 % confidence intervals (CI) for the association between employment across 696 occupations and 613 industries and PCa risk, adjusting for potential confounders. Multinomial logistic models assessed risks by PCa grade. Semi-Bayes (SB) adjustment accounted for the large number of associations evaluated.

RESULTS

Consistently positive associations-and generally robust to SB adjustment-were found for occupations in forestry and logging (OR 1.9, 95 % CI: 1.2-3.0), social sciences (OR 1.6, 95 % CI: 1.1-2.2) and for police officers and detectives (OR: 1.8, 95 % CI 1.1-2.9). Occupations where elevated risk of high grade PCa was found included gasoline station attendants (OR 4.3, 95 % CI 1.8-10.4) and textile processing occupations (OR 1.8, 95 % CI 1.1-3.2). Aside from logging, industries with elevated PCa risk included provincial government and financial institutions. Occupations with reduced risk included farmers (OR 0.6, 95 % CI 0.4-1.0) and aircraft maintenance workers (OR 0.1, 95 % CI 0.0-0.7).

CONCLUSIONS

Excess PCa risks were observed across several occupations, including predominantly white collar workers. Further analyses will focus on specific occupational exposures.

摘要

背景

年龄、家族史和血统是目前公认的前列腺癌(PCa)仅有的风险因素,但环境因素的作用也受到怀疑。由于对PCa病因因素缺乏了解,仍需要进行假设生成和验证性的研究。本研究探讨了按职业和行业划分的就业情况与PCa风险之间的关系。

方法

病例为2005 - 2009年在蒙特利尔法语医院确诊的1937名年龄≤75岁的新发PCa男性患者。对照为从说法语的蒙特利尔居民选举名单中同时招募的1994名男性,按年龄与病例进行频率匹配。通过面对面访谈获取职业史。无条件逻辑回归估计了696种职业和613个行业的就业情况与PCa风险之间关联的比值比(OR)和95%置信区间(CI),并对潜在混杂因素进行了调整。多项逻辑模型按PCa分级评估风险。半贝叶斯(SB)调整考虑了大量评估的关联。

结果

在林业和伐木行业(OR 1.9,95% CI:1.2 - 3.0)、社会科学领域(OR 1.6,95% CI:1.1 - 2.2)以及警察和侦探职业(OR:1.8,95% CI 1.1 - 2.9)中发现了一致的正向关联,并且总体上对SB调整具有稳健性。发现高级别PCa风险升高的职业包括加油站服务员(OR 4.3,95% CI 1.8 - 10.4)和纺织加工职业(OR 1.8,95% CI 1.1 - 3.2)。除伐木行业外,PCa风险升高的行业包括省政府和金融机构。风险降低的职业包括农民(OR 0.6,95% CI 0.4 - 1.0)和飞机维修工人(OR 0.1,95% CI 0.0 - 0.7)。

结论

在多个职业中观察到PCa风险增加,其中主要是白领职业。进一步的分析将集中在特定的职业暴露上。

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