Department of Preventive Medicine, Public Health and Microbiology, Universidad Autónoma de Madrid (UAM), Madrid, Spain.
Cancer and Environmental Epidemiology Unit, Department of Epidemiology of Chronic Diseases, National Center for Epidemiology, Carlos III Institute of Health, Madrid, Spain; Consortium for Biomedical Research in Epidemiology & Public Health, CIBERESP, Madrid, Spain.
Environ Res. 2021 Apr;195:110816. doi: 10.1016/j.envres.2021.110816. Epub 2021 Jan 30.
Mammographic density (MD), the proportion of radiologically dense breast tissue, is a strong risk factor for breast cancer. Our objective is to investigate the influence of occupations and occupational exposure to physical, chemical, and microbiological agents on MD in Spanish premenopausal women.
This is a cross-sectional study based on 1362 premenopausal workers, aged 39-50, who attended a gynecological screening in a breast radiodiagnosis unit of Madrid City Council. The work history was compiled through a personal interview. Exposure to occupational agents was evaluated using the Spanish job-exposure matrix MatEmESp. MD percentage was assessed using the validated semi-automated computer tool DM-Scan. The association between occupation, occupational exposures, and MD was quantified using multiple linear regression models, adjusted for age, educational level, body mass index, parity, previous breast biopsies, family history of breast cancer, energy intake, use of oral contraceptives, smoking, and alcohol consumption.
Although no occupation was statistically significantly associated with MD, a borderline significant inverse association was mainly observed in orchard, greenhouse, nursery, and garden workers (β = -6.60; 95% confidence interval (95%CI) = -14.27; 1.07) and information and communication technology technicians (β = -7.27; 95%CI = -15.37; 0.84). On the contrary, a positive association was found among technicians in art galleries, museums, and libraries (β = 8.47; 95%CI = -0.65; 17.60). Women occupationally exposed to fungicides, herbicides, and insecticides tended to have lower MD. The percentage of density decreased by almost 2% for every 5 years spent in occupations exposed to the mentioned agents.
Although our findings point to a lack of association with the occupations and exposures analyzed, this study supports a deeper exploration of the role of certain occupational agents in MD, such as pesticides.
乳腺密度（MD）是指乳腺组织中存在的射线致密部分的比例，是乳腺癌的一个重要危险因素。本研究旨在调查职业和职业暴露于物理、化学和微生物因素对西班牙绝经前女性 MD 的影响。
这是一项基于马德里市议会乳腺放射诊断单位进行妇科筛查的 1362 名绝经前女性的横断面研究。通过个人访谈收集工作史。使用西班牙职业暴露矩阵 MatEmESp 评估职业暴露情况。使用经过验证的半自动计算机工具 DM-Scan 评估 MD 百分比。使用多线性回归模型调整年龄、教育程度、体重指数、生育次数、既往乳腺活检、乳腺癌家族史、能量摄入、口服避孕药使用、吸烟和饮酒情况后，定量评估职业、职业暴露与 MD 之间的关系。
虽然没有任何职业与 MD 存在统计学上的显著相关性，但主要观察到果园、温室、苗圃和花园工人（β=-6.60；95%置信区间（95%CI）=-14.27；1.07）和信息和通信技术技术员（β=-7.27；95%CI=-15.37；0.84）存在边缘显著的负相关关系。相反，在美术馆、博物馆和图书馆的技术人员中发现了正相关关系（β=8.47；95%CI=-0.65；17.60）。职业暴露于杀菌剂、除草剂和杀虫剂的女性倾向于 MD 水平较低。在接触上述药物的职业中每工作 5 年，MD 百分比会降低近 2%。
尽管我们的研究结果表明与分析的职业和暴露没有关联，但本研究支持更深入地探讨某些职业因素（如农药）在 MD 中的作用。
