ESCAPE项目中四个欧洲队列的环境空气污染与原发性肝癌发病率

Ambient air pollution and primary liver cancer incidence in four European cohorts within the ESCAPE project.

作者信息

Pedersen Marie, Andersen Zorana J, Stafoggia Massimo, Weinmayr Gudrun, Galassi Claudia, Sørensen Mette, Eriksen Kirsten T, Tjønneland Anne, Loft Steffen, Jaensch Andrea, Nagel Gabriele, Concin Hans, Tsai Ming-Yi, Grioni Sara, Marcon Alessandro, Krogh Vittorio, Ricceri Fulvio, Sacerdote Carlotta, Ranzi Andrea, Sokhi Ranjeet, Vermeulen Roel, Hoogh Kees de, Wang Meng, Beelen Rob, Vineis Paolo, Brunekreef Bert, Hoek Gerard, Raaschou-Nielsen Ole

机构信息

The Danish Cancer Society Research Center, Copenhagen, Denmark; Centre for Epidemiology and Screening, Department of Public Health, University of Copenhagen, Copenhagen, Denmark.

Centre for Epidemiology and Screening, Department of Public Health, University of Copenhagen, Copenhagen, Denmark.

出版信息

Environ Res. 2017 Apr;154:226-233. doi: 10.1016/j.envres.2017.01.006. Epub 2017 Jan 17.

DOI:10.1016/j.envres.2017.01.006

PMID:28107740

Abstract

BACKGROUND

Tobacco smoke exposure increases the risk of cancer in the liver, but little is known about the possible risk associated with exposure to ambient air pollution.

OBJECTIVES

We evaluated the association between residential exposure to air pollution and primary liver cancer incidence.

METHODS

We obtained data from four cohorts with enrolment during 1985-2005 in Denmark, Austria and Italy. Exposure to nitrogen oxides (NO and NO), particulate matter (PM) with diameter of less than 10µm (PM), less than 2.5µm (PM), between 2.5 and 10µm (PM) and PM (soot) at baseline home addresses were estimated using land-use regression models from the ESCAPE project. We also investigated traffic density on the nearest road. We used Cox proportional-hazards models with adjustment for potential confounders for cohort-specific analyses and random-effects meta-analyses to estimate summary hazard ratios (HRs) and 95% confidence intervals (CIs).

RESULTS

Out of 174,770 included participants, 279 liver cancer cases were diagnosed during a mean follow-up of 17 years. In each cohort, HRs above one were observed for all exposures with exception of PM and traffic density. In the meta-analysis, all exposures were associated with elevated HRs, but none of the associations reached statistical significance. The summary HR associated with a 10-μg/m increase in NO was 1.10 (95% confidence interval (CI): 0.93, 1.30) and 1.34 (95% CI: 0.76, 2.35) for a 5-μg/m increase in PM.

CONCLUSIONS

The results provide suggestive evidence that ambient air pollution may increase the risk of liver cancer. Confidence intervals for associations with NO and NO were narrower than for the other exposures.

摘要

背景

接触烟草烟雾会增加患肝癌的风险，但对于接触环境空气污染可能带来的风险却知之甚少。

目的

我们评估了居住环境空气污染与原发性肝癌发病率之间的关联。

方法

我们获取了1985年至2005年期间在丹麦、奥地利和意大利招募的四个队列的数据。使用来自ESCAPE项目的土地利用回归模型估算了基线家庭住址处的氮氧化物（NO和NO₂）、直径小于10微米的颗粒物（PM₁₀）、小于2.5微米的颗粒物（PM₂.₅）、2.5至10微米之间的颗粒物（PM₂.₅₋₁₀）以及PM₁（烟尘）的暴露情况。我们还调查了最近道路的交通密度。我们使用Cox比例风险模型，并针对特定队列分析调整潜在混杂因素，同时进行随机效应荟萃分析以估算汇总风险比（HR）和95%置信区间（CI）。

结果

在纳入的174,770名参与者中，在平均17年的随访期间诊断出279例肝癌病例。在每个队列中，除了PM₂.₅和交通密度外，所有暴露的HR均高于1。在荟萃分析中，所有暴露均与HR升高相关，但没有一种关联达到统计学显著性。与NO每增加10μg/m³相关的汇总HR为1.10（95%置信区间（CI）：0.93，1.30），与PM₂.₅每增加5μg/m³相关的汇总HR为1.34（95%CI：0.76，2.35）。