University at Albany, Rensselaer, NY, USA (Department of Environmental Health Sciences, School of Public Health).
University of Brasília, Brasília, Brazil (Department of Statistics).
Int J Occup Med Environ Health. 2022 Aug 1;35(4):459-471. doi: 10.13075/ijomeh.1896.01886. Epub 2022 Jul 25.
The etiology of exocrine pancreatic cancer (EPC) remains unknown except for family history and smoking. Despite recent medical advances, rates of pancreatic cancer incidence and mortality are increasing. Although existing evidence suggests a potentially causal relationship between environmental chemical exposures and pancreatic cancer, whether residential exposure impacts pancreatic cancer rates remains unknown.
The authors identified 28 941 patients diagnosed with exocrine pancreatic cancer in New York State exclusive of New York City for the years 1996-2013. Descriptive statistics and negative binomial regression were used in this ecological study to compare pancreatic cancer hospitalization rates among patients who lived in zip codes with hazardous waste sites (HWSs) containing persistent organic pollutants (POPs) and volatile organic pollutants (VOCs) compared with clean zip codes with no identified hazardous waste sites. The authors assessed the effect of selected known and suspected human carcinogens on the EPC hospitalization rates by subgroup analyses.
Compared with the clean sites, the pancreatic cancer hospital discharge rate in the "VOCs without POPs" and "VOCs and POPs" sites, after adjustment for potential confounders were 1.06 (95% CI: 1.03-1.09) and 1.05 (95% CI: 1.01-1.08), respectively. In the analysis by specific chemicals, rate ratios (RR) for the benzene (RR = 1.12) and ethylbenzene (RR = 1.34) in the non-chlorinated VOCs group, trichloroethylene (RR = 1.07) and tetrachloroethylene (RR = 1.11) in the chlorinated VOCs group, chlorinated pesticides (RR = 1.11) and PCBs (RR = 1.05) in the POPs groups were statistically significant (p-values <0.05) compared with clean sites.
Compared with the clean sites, the pancreatic cancer hospital discharge rate in the "VOCs without POPs" and "VOCs and POPs" sites, after adjustment for potential confounders were 1.06 (95% CI: 1.03-1.09) and 1.05 (95% CI: 1.01-1.08), respectively. In the analysis by specific chemicals, rate ratios (RR) for the benzene (RR = 1.12) and ethylbenzene (RR = 1.34) in the non-chlorinated VOCs group, trichloroethylene (RR = 1.07) and tetrachloroethylene (RR = 1.11) in the chlorinated VOCs group, chlorinated pesticides (RR = 1.11) and PCBs (RR = 1.05) in the POPs groups were statistically significant (p-values <0.05) compared with clean sites. Int J Occup Med Environ Health. 2022;35(4):459-71.
除家族史和吸烟外，外分泌胰腺（EPC）的病因仍不清楚。尽管最近取得了医学进展，但胰腺癌的发病率和死亡率仍在上升。尽管现有证据表明环境化学暴露与胰腺癌之间存在潜在的因果关系，但居住环境是否会影响胰腺癌的发病率尚不清楚。
作者在纽约州（不包括纽约市）确定了 1996 年至 2013 年间 28941 名患有外分泌胰腺的患者。本生态研究采用描述性统计和负二项式回归，比较了居住在含有持久性有机污染物（POPs）和挥发性有机污染物（VOCs）的危险废物场所（HWS）的邮政编码与无危险废物场所（无已识别的危险废物场所）的邮政编码的胰腺癌住院率。作者通过亚组分析评估了选定的已知和可疑人类致癌物对 EPC 住院率的影响。
与清洁场所相比，在调整了潜在混杂因素后，“无 POPs 的 VOCs”和“VOCs 和 POPs”场所的胰腺癌出院率分别为 1.06（95%CI：1.03-1.09）和 1.05（95%CI：1.01-1.08）。在特定化学物质的分析中，非氯化 VOC 组中的苯（RR=1.12）和乙苯（RR=1.34）、氯化 VOC 组中的三氯乙烯（RR=1.07）和四氯乙烯（RR=1.11）、POP 组中的氯化农药（RR=1.11）和多氯联苯（RR=1.05）的比率比清洁场所高（p 值<0.05）。
与清洁场所相比，在调整了潜在混杂因素后，“无 POPs 的 VOCs”和“VOCs 和 POPs”场所的胰腺癌出院率分别为 1.06（95%CI：1.03-1.09）和 1.05（95%CI：1.01-1.08）。在特定化学物质的分析中，非氯化 VOC 组中的苯（RR=1.12）和乙苯（RR=1.34）、氯化 VOC 组中的三氯乙烯（RR=1.07）和四氯乙烯（RR=1.11）、POP 组中的氯化农药（RR=1.11）和多氯联苯（RR=1.05）的比率比清洁场所高（p 值<0.05）。国际职业医学与环境卫生杂志。2022；35（4）：459-71。
