Law H D, Armstrong B K, D'este C, Hosking R, Smurthwaite K S, Trevenar S, Lucas R M, Lazarevic N, Kirk M D, Korda R J
National Centre for Epidemiology and Population Health, Australian National University, Australia.
School of Population and Global Health, The University of Western Australia, Australia.
Cancer Epidemiol. 2023 Feb;82:102296. doi: 10.1016/j.canep.2022.102296. Epub 2022 Dec 9.
Per- and polyfluoroalkyl substances (PFAS) are environmental contaminants that are potentially harmful to health. We examined if rates of selected cancers and causes of deaths were elevated in three Australian communities with local environmental contamination caused by firefighting foams containing PFAS. The affected Australian communities were Katherine in Northern Territory, Oakey in Queensland and Williamtown in New South Wales.
All residents identified in the Medicare Enrolment File (1983-2019)-a consumer directory for Australia's universal healthcare-who ever lived in an exposure area (Katherine, Oakey and Williamtown), and a sample of those who ever lived in selected comparison areas, were linked to the Australian Cancer Database (1982-2017) and National Death Index (1980-2019). We estimated standardised incidence ratios (SIRs) for 23 cancer outcomes, four causes of death and three control outcomes, adjusting for sex, age and calendar time of diagnosis.
We observed higher rates of prostate cancer (SIR=1·76, 95 % confidence interval (CI) 1·36-2·24) in Katherine; laryngeal cancer (SIR=2·71, 95 % CI 1·30-4·98), kidney cancer (SIR=1·82, 95 % CI 1·04-2·96) and coronary heart disease (CHD) mortality (SIR=1·81, 95 % CI 1·46-2·33) in Oakey; and lung cancer (SIR=1·83, 95 % CI 1·39-2·38) and CHD mortality (SIR=1·22, 95 % CI 1·01-1·47) in Williamtown. We also saw elevated SIRs for control outcomes. SIRs for all other outcomes and overall cancer were similar across exposure and comparison areas.
There was limited evidence to support an association between living in a PFAS exposure area and risks of cancers or cause-specific deaths.
全氟和多氟烷基物质（PFAS）是环境污染物，可能对健康有害。我们调查了澳大利亚三个因含PFAS的消防泡沫导致当地环境污染的社区中，特定癌症发病率和死亡率是否有所上升。受影响的澳大利亚社区分别是北领地的凯瑟琳、昆士兰的奥基和新南威尔士的威廉敦。
在医疗保险注册文件（1983 - 2019年）中确定的所有居民——澳大利亚全民医保的用户目录，这些居民曾居住在暴露区域（凯瑟琳、奥基和威廉敦），以及曾居住在选定对照区域的居民样本，与澳大利亚癌症数据库（1982 - 2017年）和国家死亡指数（1980 - 2019年）相关联。我们估计了23种癌症结局、四种死因和三种对照结局的标准化发病率（SIR），并对性别、年龄和诊断时间进行了调整。
我们观察到，在凯瑟琳，前列腺癌发病率较高（SIR = 1·76，95%置信区间（CI）1·36 - 2·24）；在奥基，喉癌（SIR = 2·71，95% CI 1·30 - 4·98）、肾癌（SIR = 1·82，95% CI 1·04 - 2·96）和冠心病（CHD）死亡率（SIR = 1·81，95% CI 1·46 - 2·33）较高；在威廉敦，肺癌（SIR = 1·83，95% CI 1·39 - 2·38）和冠心病死亡率（SIR = 1·22，95% CI 1·01 - 1·47）较高。我们还观察到对照结局的SIR有所升高。所有其他结局和总体癌症的SIR在暴露区域和对照区域相似。
支持居住在PFAS暴露区域与癌症风险或特定病因死亡之间存在关联的证据有限。
