From the Department of Epidemiology, Biostatistics, and Occupational Health, McGill University, Montreal, Canada.
Air Health Science Division, Health Canada, Ottawa, Canada.
Epidemiology. 2020 Mar;31(2):177-183. doi: 10.1097/EDE.0000000000001137.
Ambient ultrafine particles (UFPs, <0.1 µm) can reach the human brain, but to our knowledge, epidemiologic studies have yet to evaluate the relation between UFPs and incident brain tumors.
We conducted a cohort study of within-city spatial variations in ambient UFPs across Montreal and Toronto, Canada, among 1.9 million adults included in multiple cycles of the Canadian Census Health and Environment Cohorts (1991, 1996, 2001, and 2006). UFP exposures (3-year moving averages) were assigned to residential locations using land-use regression models with exposures updated to account for residential mobility within and between cities. We followed cohort members for malignant brain tumors (ICD-10 codes C71.0-C71.9) between 2001 and 2016; Cox proportional hazards models (stratified by age, sex, immigration status, and census cycle) were used to estimate hazard ratios (HRs) adjusting for fine particle mass concentrations (PM2.5), nitrogen dioxide (NO2), and various sociodemographic factors.
In total, we identified 1,400 incident brain tumors during the follow-up period. Each 10,000/cm increase in UFPs was positively associated with brain tumor incidence (HR = 1.112, 95% CI = 1.042, 1.188) after adjusting for PM2.5, NO2, and sociodemographic factors. Applying an indirect adjustment for cigarette smoking and body mass index strengthened this relation (HR = 1.133, 95% CI = 1.032, 1.245). PM2.5 and NO2 were not associated with an increased incidence of brain tumors.
Ambient UFPs may represent a previously unrecognized risk factor for incident brain tumors in adults. Future studies should aim to replicate these results given the high prevalence of UFP exposures in urban areas.
环境中超细颗粒物(UFPs,<0.1 µm)可以到达人体大脑,但据我们所知,流行病学研究尚未评估 UFPs 与脑肿瘤之间的关系。
我们在加拿大蒙特利尔和多伦多进行了一项城市内空间 UFPs 变化的队列研究,纳入了加拿大人口普查健康与环境队列(1991 年、1996 年、2001 年和 2006 年)的 190 万成年人。使用基于土地利用的回归模型将 UFPs 暴露(3 年移动平均值)分配给居住地点,同时更新暴露以考虑城市内和城市间的居住迁移。我们在 2001 年至 2016 年期间随访队列成员恶性脑肿瘤(ICD-10 编码 C71.0-C71.9);使用 Cox 比例风险模型(按年龄、性别、移民状况和人口普查周期分层),在调整细颗粒物质量浓度(PM2.5)、二氧化氮(NO2)和各种社会人口因素后,估计危险比(HRs)。
在随访期间,我们共确定了 1400 例脑肿瘤发病。在调整 PM2.5、NO2 和社会人口因素后,UFPs 每增加 10000/cm,脑肿瘤发病率呈正相关(HR=1.112,95%CI=1.042,1.188)。应用间接调整吸烟和体重指数会加强这种关系(HR=1.133,95%CI=1.032,1.245)。PM2.5 和 NO2 与脑肿瘤发病率的增加无关。
环境 UFPs 可能是成年人脑肿瘤发病的一个以前未被认识的危险因素。鉴于城市地区 UFPs 暴露的高患病率,未来的研究应旨在复制这些结果。