Epidemiology Research Group, American Cancer Society, Atlanta, GA.
McLaughlin Centre for Population Health Risk Assessment, University of Ottawa, Ottawa, ON, Canada.
Int J Cancer. 2019 Nov 15;145(10):2647-2660. doi: 10.1002/ijc.32202. Epub 2019 Feb 27.
Benzene is considered a carcinogen, mostly based on evidence of causality for myeloid leukemia from high levels of exposure in occupational studies. We used United States Environmental Protection Agency National Ambient Toxics Assessment (NATA) estimates of low-level ambient benzene to examine potential associations for the general public between benzene exposure and risk of hematologic cancers. Exposure was estimated by linking participants' residential address to the NATA benzene estimates for that census tract. Among 115,996 American Cancer Society Cancer Prevention Study-II Nutrition cohort participants (52,554 men, 63,442 women), 2,595 were diagnosed with incident hematologic cancer between 1997 and 2013. Extended Cox regression modeling was used to estimate hazard ratios (HR) and 95% confidence intervals (CI). Among all participants, ambient benzene was positively associated with myelodysplastic syndromes (HR = 1.16, 95% CI: 1.01-1.33 per μg/m ) and T-cell lymphoma (HR = 1.29, 95% CI: 1.08-1.53 per μg/m ). Among men, ambient benzene was also positively associated with any hematologic malignancy (HR = 1.07, 95% CI: 1.01-1.15 per μg/m ) and follicular lymphoma (HR = 1.28, 95% CI: 1.09-1.50 per μg/m ). No significant associations were observed for women only, but associations were suggestive for MDS and T-cell lymphoma. It is possible that the NATA ambient benzene estimates are a better proxy for benzene exposure for men than women in this cohort. The results of this study support an association between ambient benzene and risk of hematologic malignancies, particularly MDS, T-cell lymphoma and follicular lymphoma. More research in large scale or pooled studies is needed to further explore these associations.
苯被认为是一种致癌物质，主要基于职业暴露研究中高水平暴露导致骨髓性白血病的因果关系证据。我们使用美国环保署国家环境毒物评估（NATA）对低水平环境苯的估计值，研究普通公众暴露于苯与血液癌症风险之间的潜在关联。通过将参与者的居住地址与该普查区的 NATA 苯估计值联系起来，来估计暴露情况。在 115996 名美国癌症协会癌症预防研究-II 营养队列参与者（52554 名男性，63442 名女性）中，有 2595 人在 1997 年至 2013 年间被诊断出患有血液癌。使用扩展 Cox 回归模型来估计危险比（HR）和 95%置信区间（CI）。在所有参与者中，环境苯与骨髓增生异常综合征（HR=1.16，95%CI：每 μg/m 为 1.01-1.33）和 T 细胞淋巴瘤（HR=1.29，95%CI：每 μg/m 为 1.08-1.53）呈正相关。在男性中，环境苯也与任何血液恶性肿瘤（HR=1.07，95%CI：每 μg/m 为 1.01-1.15）和滤泡性淋巴瘤（HR=1.28，95%CI：每 μg/m 为 1.09-1.50）呈正相关。仅在女性中未观察到显著相关性，但对 MDS 和 T 细胞淋巴瘤的相关性具有提示性。在该队列中，NATA 环境苯估计值可能比女性更能代表男性的苯暴露情况。本研究结果支持环境苯与血液恶性肿瘤风险之间的关联，特别是 MDS、T 细胞淋巴瘤和滤泡性淋巴瘤。需要在大规模或汇总研究中进行更多研究，以进一步探讨这些关联。
