Carton Matthieu, Barul Christine, Menvielle Gwenn, Cyr Diane, Sanchez Marie, Pilorget Corinne, Trétarre Brigitte, Stücker Isabelle, Luce Danièle
Population-based Epidemiologic Cohorts Unit, Inserm, Villejuif, France.
University of Versailles St-Quentin, Villejuif, France.
BMJ Open. 2017 Jan 9;7(1):e012833. doi: 10.1136/bmjopen-2016-012833.
Our objective was to investigate the association between head and neck cancer and occupational exposure to chlorinated, oxygenated and petroleum solvents in women.
Investigation of occupational and environmental CAuses of REspiratory cancers (ICARE), a French population-based case-control study, included 296 squamous cell carcinomas of the head and neck (HNSCC) in women and 775 female controls. Lifelong occupational history was collected. Job-exposure matrices allowed to assess exposure to 5 chlorinated solvents (carbon tetrachloride; chloroform; methylene chloride; perchloroethylene; trichloroethylene), 5 petroleum solvents (benzene; special petroleum product; gasoline; white spirits and other light aromatic mixtures; diesel, fuels and kerosene) and 5 oxygenated solvents (alcohols; ketones and esters; ethylene glycol; diethyl ether; tetrahydrofuran). OR and 95% CIs, adjusted for smoking, alcohol drinking, age and geographical area, were estimated with logistic models.
Elevated ORs were observed among women ever exposed to perchloroethylene (OR=2.97, 95% CI 1.05 to 8.45) and trichloroethylene (OR=2.15, 95% CI 1.21 to 3.81). These ORs increased with exposure duration (OR=3.75, 95% CI 0.64 to 21.9 and OR=4.44, 95% CI 1.56 to 12.6 for 10 years or more, respectively). No significantly increased risk of HNSCC was found for occupational exposure to the other chlorinated, petroleum or oxygenated solvents.
These findings suggest that exposure to perchloroethylene or trichloroethylene may increase the risk of HNSCC in women. In our study, there is no clear evidence that the other studied solvents are risk factors for HNSCC.
我们的目的是调查女性头颈癌与职业性接触氯化溶剂、含氧溶剂和石油溶剂之间的关联。
法国一项基于人群的病例对照研究——呼吸道癌症职业与环境病因调查(ICARE),纳入了296例女性头颈鳞状细胞癌(HNSCC)患者和775名女性对照。收集了终生职业史。工作暴露矩阵用于评估对5种氯化溶剂(四氯化碳;氯仿;二氯甲烷;全氯乙烯;三氯乙烯)、5种石油溶剂(苯;特殊石油产品;汽油;白酒精和其他轻质芳烃混合物;柴油、燃料和煤油)以及5种含氧溶剂(醇类;酮类和酯类;乙二醇;乙醚;四氢呋喃)的暴露情况。采用逻辑模型估计经吸烟、饮酒、年龄和地理区域调整后的比值比(OR)及95%置信区间(CI)。
曾接触全氯乙烯的女性(OR = 2.97,95% CI 为1.05至8.45)和三氯乙烯的女性(OR = 2.15,95% CI 为1.21至3.81)的OR值升高。这些OR值随暴露持续时间增加(暴露10年或更长时间时,OR分别为3.75,95% CI 为0.64至21.9和4.44,95% CI 为1.56至12.6)。未发现职业性接触其他氯化、石油或含氧溶剂会显著增加患HNSCC的风险。
这些发现表明,接触全氯乙烯或三氯乙烯可能会增加女性患HNSCC的风险。在我们的研究中,没有明确证据表明其他所研究的溶剂是HNSCC的危险因素。