Pedersen Julie Elbaek, Strandberg-Larsen Katrine, Andersson Michael, Hansen Johnni
Danish Cancer Society Research Center, Danish Cancer Society, Copenhagen, Denmark
Department of Public Health, University of Copenhagen, Copenhagen, Denmark.
Occup Environ Med. 2020 Oct 22. doi: 10.1136/oemed-2020-106865.
To explore associations between occupational exposure to four specific organic solvents, respectively, and female breast cancer, including subtypes.
Using the Danish Cancer Registry, we identified 38 375 women under age 70 years with primary breast cancer. Five randomly selected breast-cancer-free controls per case matched on year of birth were retrieved from the Danish Civil Registration System . A nationwide pension fund was used to retrieve full employment history, and exposure to 1,1,1-trichloroethane, trichloroethylene (TCE), benzene and toluene was assessed using a job exposure matrix. ORs were estimated using conditional logistic regression with adjustment for reproductive factors and socioeconomic status.
Overall results indicated no noteworthy associations between the specific organic solvents and breast cancer before and after age 50 years, except for a small increased risk after age 50 in women exposed to TCE (OR=1.15, 95% CI: 0.97-1.36). After age 50 years, exposure to TCE was associated with a small increased risk in women with over 20 years of latency (OR=1.26, 95% CI: 1.02-1.56). Further, an increased risk of oestrogen receptor positive (ER+) tumours was also observed (OR=1.21, 95% CI: 1.01-1.47), and high cumulative exposure and longer latency also increased the risk of this subtype.
This study provides limited evidence supporting the association between occupational exposure to each of the four organic solvents and breast cancer. The risk of ER+ breast tumours after age 50 years may be increased in women with TCE exposure, and this possible association therefore needs further attention in future studies.
分别探讨职业接触四种特定有机溶剂与女性乳腺癌(包括各亚型)之间的关联。
利用丹麦癌症登记处的数据,我们确定了38375名70岁以下的原发性乳腺癌女性患者。从丹麦民事登记系统中为每个病例随机选取5名年龄匹配的无乳腺癌对照者。利用全国性养老金基金获取完整的就业史,并使用工作暴露矩阵评估1,1,1 - 三氯乙烷、三氯乙烯(TCE)、苯和甲苯的暴露情况。采用条件逻辑回归估计比值比(OR),并对生殖因素和社会经济状况进行调整。
总体结果表明,特定有机溶剂与50岁前后的乳腺癌之间无显著关联,但50岁后接触TCE的女性患癌风险略有增加(OR = 1.15,95%CI:0.97 - 1.36)。50岁后,潜伏期超过20年的女性接触TCE与患癌风险略有增加相关(OR = 1.26,95%CI:1.02 - 1.56)。此外,还观察到雌激素受体阳性(ER +)肿瘤风险增加(OR = 1.21,95%CI:1.01 - 1.47),高累积暴露和较长潜伏期也增加了该亚型的风险。
本研究提供的证据有限,支持职业接触四种有机溶剂中的每一种与乳腺癌之间的关联。50岁后接触TCE 的女性患ER +乳腺肿瘤的风险可能增加,因此这种可能的关联在未来研究中需要进一步关注。