National Center of Tropical Medicine, Network Collaborative Research in Tropical Diseases (RICET), Carlos III Institute of Health, Avda. Monforte de Lemos, 5, 28029 Madrid, Spain; Department of Preventive Medicine and Public Health, School of Medicine, Autonomous University of Madrid, Calle del Arzobispo Morcillo 4, PC, 28029, Madrid, Spain.
Cancer and Environmental Epidemiology Unit, Department of Epidemiology of Chronic Diseases, National Center for Epidemiology, Carlos III Institute of Health, Avda. Monforte de Lemos, 5, 28029 Madrid, Spain; Consortium for Biomedical Research in Epidemiology & Public Health (CIBER en Epidemiología y Salud Pública - CIBERESP), Spain.
Environ Pollut. 2020 May;260:113869. doi: 10.1016/j.envpol.2019.113869. Epub 2020 Jan 3.
It is likely that pollution from chemical facilities will affect the health of any exposed population; however, the majority of scientific evidence available has focused on occupational exposure rather than environmental. Consequently, this study assessed whether there could have been an excess of cancer-related mortality associated with environmental exposure to pollution from chemical installations - for populations residing in municipalities in the vicinity of chemical industries. To this end, we designed an ecological study which assessed municipal mortality due to 32 types of cancer in the period from 1999 to 2008. The exposure to pollution was estimated using distance from the facilities to the centroid of the municipality as a proxy for exposure. In order to assess any increased cancer mortality risk in municipalities potentially exposed to chemical facilities pollution (situated at a distance of ≤5 km from a chemical installation), we employed Bayesian Hierarchical Poisson Regression Models. This included two Bayesian inference methods: Integrated Nested Laplace Approximations (INLA) and Markov Chain Monte Carlo (MCMC, for validation). The reference category consisted of municipalities beyond the 5 km limit. We found higher mortality risk (relative risk, RR; estimated by INLA, 95% credible interval, 95%CrI) for both sexes for colorectal (RR, 1.09; 95%CrI, 1.05-1.15), gallbladder (1.14; 1.03-1.27), and ovarian cancers (1.10; 1.02-1.20) associated with organic chemical installations. Notably, pleural cancer (2.27; 1.49-3.41) in both sexes was related to fertilizer facilities. Associations were found for women, specifically for ovarian (1.11; 1.01-1.22) and breast cancers (1.06; 1.00-1.13) in the proximity of explosives/pyrotechnics installations; increased breast cancer mortality risk (1.10; 1.03-1.18) was associated with proximity to inorganic chemical installations. The results suggest that environmental exposure to pollutants from some types of chemical facilities may be associated with increased mortality from several different types of cancer.
化学设施的污染可能会影响任何暴露人群的健康，但现有大多数科学证据都集中在职业暴露方面，而不是环境暴露。因此，本研究评估了在附近有化工企业的城市居民中，是否存在因环境暴露于化工设施污染而导致的癌症相关死亡率过高的情况。为此，我们设计了一项生态研究，评估了 1999 年至 2008 年期间因 32 种癌症导致的城市居民死亡率。使用距离设施中心到城市中心的距离来估计污染暴露情况，作为暴露的替代指标。为了评估潜在暴露于化学设施污染的城市（距离化工厂≤5 公里）的癌症死亡率是否增加，我们采用了贝叶斯层次泊松回归模型。该模型包括两种贝叶斯推断方法：集成嵌套拉普拉斯近似法（INLA）和马尔可夫链蒙特卡罗法（MCMC，用于验证）。参考类别包括距离 5 公里限制以外的城市。我们发现，对于两性，与有机化工设施相关的结直肠（RR，1.09；95%可信区间，95%CrI，1.05-1.15）、胆囊（1.14；1.03-1.27）和卵巢癌（1.10；1.02-1.20）的死亡率风险更高（INLA 估计值）。值得注意的是，两性的胸膜癌（2.27；1.49-3.41）与肥料设施有关。对于女性，在靠近爆炸物/烟火装置的情况下，卵巢癌（1.11；1.01-1.22）和乳腺癌（1.06；1.00-1.13）的死亡率风险更高；而在靠近无机化工设施的情况下，乳腺癌死亡率风险更高（1.10；1.03-1.18）。结果表明，环境暴露于某些类型的化学设施污染物可能与多种类型的癌症死亡率增加有关。
