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长期暴露于颗粒物与儿童癌症之间的关联:一项回顾性队列研究。

Association between long-term exposure to particulate matter and childhood cancer: A retrospective cohort study.

作者信息

Lee Jae Min, Lee Tae-Hee, Kim Soontae, Song Minkyo, Bae Sanghyuk

机构信息

Department of Pediatrics, College of Medicine, Yeungnam University, Daegu, South Korea.

Department of Statistics and Data Science, Yonsei University, Seoul, South Korea.

出版信息

Environ Res. 2022 Apr 1;205:112418. doi: 10.1016/j.envres.2021.112418. Epub 2021 Nov 25.

Abstract

BACKGROUND

Although particulate matter is a known carcinogen, its association with childhood cancer is inconclusive. The present study aimed to examine the association between long-term exposure to particulate matter and childhood cancer.

METHODS

A retrospective cohort was constructed from the claims database of the Korea National Health Insurance Service, including children born in seven metropolitan cities in Korea between 2002 and 2012. Monthly mean concentrations of particulate matter with aerodynamic diameter <10 μm (PM) and other air pollutants (NO, SO, CO, and O) were calculated using data from the AirKorea. Monthly mean concentrations of particulate matter with aerodynamic diameter <2.5 μm (PM) were estimated based on a data fusion approach. Cumulative exposure was assessed by averaging the monthly concentrations accounting for the residential mobility of the children. The occurrence of cancer was identified by the appearance of diagnosis codes in the claims database. Hazard ratios (HR) and 95% confidence intervals (95% CI) were calculated using Cox proportional regression, adjusting for potential confounders and O concentrations.

RESULTS

During the study period, 1,725 patients were newly diagnosed with cancer among 1,261,855 children. HR of all cancers per 10 μg/m increment in annual mean concentrations of PM and PM were 3.02 (95% CI: 1.63, 5.59) and 1.04 (0.74, 1.45), respectively.

CONCLUSION

PM exposure was positively associated with childhood cancer in a large retrospective cohort with exposure assessment accounting for residential mobility.

摘要

背景

尽管颗粒物是一种已知的致癌物,但其与儿童癌症之间的关联尚无定论。本研究旨在探讨长期暴露于颗粒物与儿童癌症之间的关联。

方法

从韩国国民健康保险服务的理赔数据库中构建了一个回顾性队列,包括2002年至2012年在韩国七个大城市出生的儿童。使用来自韩国空气监测网的数据计算空气动力学直径<10μm的颗粒物(PM)和其他空气污染物(NO、SO、CO和O)的月平均浓度。基于数据融合方法估算空气动力学直径<2.5μm的颗粒物(PM)的月平均浓度。通过对考虑儿童居住流动性的月浓度进行平均来评估累积暴露。通过理赔数据库中诊断代码的出现来确定癌症的发生情况。使用Cox比例回归计算风险比(HR)和95%置信区间(95%CI),并对潜在混杂因素和O浓度进行调整。

结果

在研究期间,1261855名儿童中有1725名患者被新诊断为癌症。PM和PM的年平均浓度每增加10μg/m³时所有癌症的HR分别为3.02(95%CI:1.63,5.59)和1.04(0.74,1.45)。

结论

在一个考虑居住流动性进行暴露评估的大型回顾性队列中,PM暴露与儿童癌症呈正相关。

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