Goldberg Mark S, Labrèche France, Weichenthal Scott, Lavigne Eric, Valois Marie-France, Hatzopoulou Marianne, Van Ryswyk Keith, Shekarrizfard Maryam, Villeneuve Paul J, Crouse Daniel, Parent Marie-Élise
Department of Medicine, McGill University, Montreal, Canada; Division of Clinical Epidemiology, Research Institute of the McGill University Hospital Centre, Canada.
Department of Environmental and Occupational Health, School of Public Health, Université de Montréal, Montreal, Canada.
Environ Res. 2017 Oct;158:7-15. doi: 10.1016/j.envres.2017.05.038. Epub 2017 Jun 5.
There is scant information as to whether traffic-related air pollution is associated with the incidence of breast cancer. Nitrogen dioxide (NO) and ultrafine particles (UFPs, <0.1µm), are two pollutants that capture intra-urban variations in traffic-related air pollution and may also be associated with incidence.
We conducted a population-based, case-control study of street-level concentrations of NO and UFPs and incident postmenopausal breast cancer in Montreal, Canada. Incident cases were identified between 2008 and 2011 from all but one hospital that treated breast cancer in the Montreal area. Population controls were identified from provincial electoral lists of Montreal residents and frequency-matched to cases using 5-year age groups. Concentrations of NO and UFPs were estimated using two separate land-use regression models. Exposures were assigned to residential locations at the time of recruitment, and we identified residential histories of women who had lived in these residences for 10 years or more. Odds ratios (OR) and 95% confidence intervals (CI) were estimated using logistic regression models adjusting for individual-level and ecological covariates. We assessed the functional form of NO and UFP exposures using natural cubic splines.
We found that the functional form of the response functions between incident postmenopausal breast cancer and concentrations of NO and UFPs were consistent with linearity. For NO, we found increasing risks of breast cancer for all subjects combined and stronger associations when analyses were restricted to those women who had lived at their current address for 10 years or more. Specifically, the OR, adjusted for personal covariates, per increase in the interquartile range (IQR=3.75 ppb) of NO was 1.08 (95%CI: 0.92-1.27). For women living in their homes for 10 years or more, the adjusted OR was 1.17 (95%CI: 0.93-1.46; IQR=3.84 ppb); for those not living at that home 10 years before the study, it was 0.93 (95%CI: 0.64, 1.36; IQR=3.65 ppb). For UFPs, the ORs were lower than for NO, with little evidence of association in any of the models or sub-analyses and little variability in the ORs (about 1.02 for an IQR of ~3500cm). On the other hand, we found higher ORs amongst cases with positive oestrogen and progesterone receptor status; namely for NO, the OR was 1.13 (95%CI: 0.94-1.35) and for UFPs it was 1.05 (95%CI: 0.96-1.14).
Our findings suggest that exposure to ambient NO and UFPs may increase the risk of incident postmenopausal breast cancer especially amongst cases with positive oestrogen and progesterone receptor status.
关于交通相关空气污染是否与乳腺癌发病率相关的信息很少。二氧化氮（NO）和超细颗粒物（UFPs，<0.1μm）是两种能够反映城市内交通相关空气污染变化的污染物，它们也可能与发病率有关。
我们在加拿大蒙特利尔进行了一项基于人群的病例对照研究，研究街道层面的NO和UFPs浓度与绝经后乳腺癌发病情况的关系。2008年至2011年间，从蒙特利尔地区除一家以外的所有治疗乳腺癌的医院中识别出发病病例。从蒙特利尔居民的省级选举名单中识别出人群对照，并按5岁年龄组与病例进行频率匹配。使用两个独立的土地利用回归模型估算NO和UFPs的浓度。在招募时将暴露情况分配到居住地点，并确定在这些住所居住10年或更长时间的女性的居住历史。使用逻辑回归模型估计比值比（OR）和95%置信区间（CI），并对个体水平和生态协变量进行调整。我们使用自然立方样条评估NO和UFP暴露的函数形式。
我们发现绝经后乳腺癌发病与NO和UFPs浓度之间的反应函数的函数形式与线性关系一致。对于NO，我们发现所有受试者患乳腺癌的风险增加，当分析仅限于那些在当前地址居住10年或更长时间的女性时，关联更强。具体而言，经个人协变量调整后，NO每增加一个四分位数间距（IQR = 3.75 ppb），OR为1.08（95%CI：0.92 - 1.27）。对于在家居住10年或更长时间的女性，调整后的OR为1.17（95%CI：0.93 - 1.46；IQR = 3.84 ppb）；对于在研究前10年未居住在该住所的女性，OR为0.93（95%CI：0.64，1.36；IQR = 3.65 ppb）。对于UFPs，OR低于NO，在任何模型或亚分析中几乎没有关联证据，OR的变异性也很小（IQR约为3500cm时约为1.02）。另一方面，我们发现雌激素和孕激素受体状态为阳性的病例中OR较高；即对于NO，OR为1.13（95%CI：0.94 -
