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居住在石化综合体附近的居民癌症发病率增加:一项长达 12 年的回顾性队列研究。

Increased cancers among residents living in the neighborhood of a petrochemical complex: A 12-year retrospective cohort study.

机构信息

Institute of Occupational Medicine and Industrial Hygiene, College of Public Health, National Taiwan University, Taipei, Taiwan.

Institute of Occupational Medicine and Industrial Hygiene, College of Public Health, National Taiwan University, Taipei, Taiwan; Green Energy and Environment Research Laboratories, Industrial Technology Research Institute, Hsinchu, Taiwan.

出版信息

Int J Hyg Environ Health. 2018 Mar;221(2):308-314. doi: 10.1016/j.ijheh.2017.12.004. Epub 2017 Dec 14.

Abstract

This study investigates whether cancers are increased for residents living in the vicinity of a petrochemical complex with coal power plants and refineries. We recruited a residential cohort of 2388 long-term residents aged above 35 years in 2009-2012 who lived within a 40 km radius of the complex. We measured their internal exposure biomarkers of urinary carcinogenic metals and retrospectively compared cancer incidences between those who lived fewer than 10 km from the complex (high exposure, HE) and those who lived more than 10 km from the complex (low exposure, LE). Residents had lived in their respective areas for 12 years, since the complex began operating in mid-1999. This included two periods of operation: 0-9 years and 10-12 years. Crude cumulative incident rates (CIRs) of all cancers were calculated for new cancer cases (ICD-9: 140-165, 170-176, 179-208) recorded in the Taiwan Health Insurance Database over total person-years at risk in each study period. Poisson regression was applied to estimate relative risks for the CIRs of all cancers between HE and LE areas during the 10-12 years since the beginning of the complex's operation, adjusting for age, gender, body mass index, smoking, hepatitis C, and occupational exposure. We found that our study subjects in HE areas had higher urinary carcinogenic metal levels, including As, Cd, Hg, Pb, and V, and higher prevalence rates of hepatitis C than those in LE areas. After the complex had been operating for 10-12 years, SIRs per 1000 person-years for all cancers in HE and LE areas were 4.44 vs. 2.48 for all subjects, 15.2 vs. 4.86 for elder subjects aged above 60 years, and 2.94 vs. 2.71 for female subjects. Correspondingly, the adjusted relative risks of CIRs for all cancers between HE and LE areas were 1.29 (95% CI: 0.99-1.68) for all subjects, 1.52 (1.04-2.22) for elder subjects, 1.41 (1.00-1.97) for female subjects, and 1.91 (1.15-3.19) for female elderly subjects. We conclude that elder and female residents living within 10 km of a petrochemical complex had higher carcinogenic exposure and cancers than those living farther away from the complex after the complex had been operating for 10 years.

摘要

本研究旨在探讨居住在毗邻有煤化工和炼油厂的石化综合体的居民是否会增加癌症风险。我们招募了 2009-2012 年间年龄在 35 岁以上的 2388 名长期居民作为居住队列,他们居住在距离该综合体 40 公里范围内。我们测量了他们尿液中致癌金属的内暴露生物标志物,并回顾性比较了居住在距离综合体不到 10 公里(高暴露组,HE)和居住在距离综合体超过 10 公里(低暴露组,LE)的居民的癌症发病率。自综合体于 1999 年年中开始运营以来,居民已在各自的区域居住了 12 年。这包括两个运营期:0-9 年和 10-12 年。在每个研究期间,根据台湾健康保险数据库中记录的所有癌症(ICD-9:140-165、170-176、179-208)的新发癌症病例,计算出所有癌症的粗累积发病率(CIR)。应用泊松回归估计在综合体运营开始后的 10-12 年期间,HE 和 LE 地区所有癌症的 CIR 相对风险,调整因素包括年龄、性别、体重指数、吸烟、丙型肝炎和职业暴露。我们发现,与 LE 地区相比,居住在 HE 地区的研究对象尿液中致癌金属水平更高,包括砷、镉、汞、铅和钒,且丙型肝炎的患病率也更高。在综合体运营 10-12 年后,HE 和 LE 地区所有人群的每 1000 人年 SIR 分别为 4.44 和 2.48,60 岁以上老年人群的 SIR 分别为 15.2 和 4.86,女性人群的 SIR 分别为 2.94 和 2.71。相应地,HE 和 LE 地区所有癌症的 CIR 调整后相对风险分别为所有人群 1.29(95%CI:0.99-1.68)、老年人群 1.52(1.04-2.22)、女性人群 1.41(1.00-1.97)和老年女性人群 1.91(1.15-3.19)。我们的结论是,在综合体运营 10 年后,居住在距离综合体 10 公里以内的老年和女性居民的致癌暴露和癌症风险高于居住在更远距离的居民。

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