Division of Toxicology, China Medical University Hospital, Taichung, Taiwan.
Department of Emergency Medicine, China Medical University Hospital, Taichung, Taiwan.
PLoS One. 2020 Dec 29;15(12):e0243922. doi: 10.1371/journal.pone.0243922. eCollection 2020.
Habits such as smoking and alcohol drinking and existing esophageal malfunction are considered the main risk factors for esophageal carcinogenesis. Caustic ingestion of acidic or alkaline agents or strong irritants can induce severe esophageal corrosive injury and increase esophageal cancer risk. We studied the relationship between esophageal carcinoma and acute detergent or pesticide poisoning by using nationwide health insurance data. Methodology/Principle findings: We compared a pesticide/detergent intoxication cohort (N = 21,840) and an age- and gender-matched control cohort (N = 21,840) identified from the National Health Insurance Research Database between 2000 and 2011. We used the multivariable Cox proportional model to determine esophageal carcinoma risk. The overall incidence density of esophageal cancer was 1.66 per 10,000 person-years in the comparison cohort and 4.36 per 10,000 person-years in the pesticide/detergent intoxication cohort. The corresponding adjusted hazard ratio (HR) for esophageal cancer was 2.33 (95% confidence interval [CI] = 1.41-3.86) in the pesticide/detergent intoxication cohort compared with the control cohort. Patients with corrosive and detergent intoxication did not have a higher risk of esophageal cancer (adjusted HR = 0.98, 95% CI = 0.29-3.33) than those without pesticide/detergent intoxication. However, patients with pesticide intoxication had a significantly higher risk of esophageal cancer (adjusted HR = 2.52, 95% CI = 1.52-4.18) than those without pesticide/detergent intoxication. Conclusion: In the present study, after adjusting for conventional risk factors, we observed that pesticide intoxication could exert substantial effects through increased esophageal cancer risk. However, patients with detergent intoxication may not have an increased risk of esophageal cancer.
吸烟、饮酒和现有的食管功能障碍等习惯被认为是食管癌发生的主要危险因素。酸或碱性腐蚀性物质或强刺激性物质的腐蚀性摄入可导致严重的食管腐蚀性损伤，并增加食管癌的风险。我们使用全民健康保险数据研究了食管癌与急性洗涤剂或农药中毒之间的关系。方法/原理结果：我们比较了 2000 年至 2011 年从国家健康保险研究数据库中确定的农药/洗涤剂中毒队列（N=21840）和年龄及性别匹配的对照组（N=21840）。我们使用多变量 Cox 比例模型来确定食管癌的风险。在比较队列中，食管癌的总发生率密度为 1.66/10000 人年，而在农药/洗涤剂中毒队列中为 4.36/10000 人年。农药/洗涤剂中毒队列的食管癌调整后危险比（HR）为 2.33（95%置信区间[CI]为 1.41-3.86）。与对照组相比，腐蚀性和洗涤剂中毒患者的食管癌风险没有更高（调整后 HR=0.98，95%CI=0.29-3.33）。然而，与无农药/洗涤剂中毒的患者相比，农药中毒患者的食管癌风险显著更高（调整后 HR=2.52，95%CI=1.52-4.18）。结论：在本研究中，在调整了常规危险因素后，我们观察到农药中毒可通过增加食管癌风险产生实质性影响。然而，洗涤剂中毒患者可能没有增加食管癌的风险。
