Cancer and Environmental Epidemiology Unit, National Center for Epidemiology, Carlos III Institute of Health, Madrid, Spain.
Consortium for Biomedical Research in Epidemiology and Public Health (CIBER Epidemiología y Salud Pública - CIBERESP), Madrid, Spain.
Occup Environ Med. 2018 Feb;75(2):124-131. doi: 10.1136/oemed-2017-104580. Epub 2017 Oct 26.
The association between occupational exposures and mammographic density (MD), a marker of breast cancer risk, has not been previously explored. Our objective was to investigate the influence of occupational exposure to chemical, physical and microbiological agents on MD in adult women.
This is a population-based cross-sectional study based on 1476 female workers aged 45-65 years from seven Spanish breast cancer screening programmes. Occupational history was surveyed by trained staff. Exposure to occupational agents was assessed using the Spanish job-exposure matrix MatEmESp. Percentage of MD was measured by two radiologists using a semiautomatic computer tool. The association was estimated using mixed log-linear regression models adjusting for age, education, body mass index, menopausal status, parity, smoking, alcohol intake, type of mammography, family history of breast cancer and hormonal therapy use, and including screening centre and professional reader as random effects terms.
Although no association was found with most of the agents, women occupationally exposed to perchloroethylene (e=1.51; 95% CI 1.04 to 2.19), ionising radiation (e=1.23; 95% CI 0.99 to 1.52) and mould spores (e=1.44; 95% CI 1.01 to 2.04) tended to have higher MD. The percentage of density increased 12% for every 5 years exposure to perchloroethylene or mould spores, 11% for every 5 years exposure to aliphatic/alicyclic hydrocarbon solvents and 3% for each 5 years exposure to ionising radiation.
Exposure to perchloroethylene, ionising radiation, mould spores or aliphatic/alicyclic hydrocarbon solvents in occupational settings could be associated with higher MD. Further studies are needed to clarify the accuracy and the reasons for these findings.
职业暴露与乳房密度(MD)之间的关联尚未被研究过,MD 是乳腺癌风险的一个标志物。我们的目的是研究职业接触化学、物理和微生物因素对成年女性 MD 的影响。
这是一项基于西班牙七个乳腺癌筛查项目的 1476 名 45-65 岁女性工人的基于人群的横断面研究。职业史由经过培训的工作人员进行调查。使用西班牙职业暴露矩阵 MatEmESp 评估职业暴露情况。两位放射科医生使用半自动计算机工具测量 MD 的百分比。使用混合对数线性回归模型调整年龄、教育程度、体重指数、绝经状态、产次、吸烟、饮酒、乳腺摄影类型、乳腺癌家族史和激素治疗使用情况来估计关联,并包括筛查中心和专业读者作为随机效应项。
尽管大多数因素与 MD 无关联,但职业性接触过全氯乙烯(e=1.51;95%置信区间 1.04 至 2.19)、电离辐射(e=1.23;95%置信区间 0.99 至 1.52)和霉菌孢子(e=1.44;95%置信区间 1.01 至 2.04)的女性倾向于有更高的 MD。每接触 5 年全氯乙烯或霉菌孢子,MD 增加 12%;每接触 5 年脂肪族/环烷烃溶剂,MD 增加 11%;每接触 5 年电离辐射,MD 增加 3%。
职业接触全氯乙烯、电离辐射、霉菌孢子或脂肪族/环烷烃溶剂可能与更高的 MD 有关。需要进一步的研究来阐明这些发现的准确性和原因。