Westra Sydney, Goldberg Mark S, Labrèche France, Baumgartner Jill, Ho Vikki
Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montréal, Québec, Canada.
Department of Medicine, McGill University, Montréal, Québec, Canada.
Am J Ind Med. 2023 Nov;66(11):911-927. doi: 10.1002/ajim.23525. Epub 2023 Aug 11.
Breast cancer is the most diagnosed cancer among women and recognized risk factors explain 25%-47% of cases. Organic solvents are used widely in the workplace and exposure may increase the risk of developing breast cancer, yet there are insufficient data to confirm this hypothesis. We sought to determine whether past occupational exposures to selected organic solvents were associated with the incidence of invasive breast cancer in postmenopausal women in Montréal, Canada.
From a population-based case-control study (2008-2011), using in-depth interviews we elicited information on risk factors and lifetime occupational histories. Industrial hygienists and chemists translated job descriptions into specific chemical and physical exposures. We assessed 11 individual solvents and four solvent groups. Unconditional logistic regression was used to estimate adjusted odds ratios (ORs) and 95% confidence intervals (CIs) for metrics of past exposures to selected solvents. Exposure metrics included any previous exposure, average frequency in hours per week, duration in years, and average cumulative concentration weighted by hours per workweek exposed.
We enrolled 695 cases and 608 controls. We found increased ORs for average cumulative concentration of exposure to mononuclear aromatic hydrocarbons (OR: 1.52, 95% CI: 1.04, 2.28), chlorinated alkanes (OR: 2.42, 95% CI: 1.23, 5.68), toluene (OR: 1.59, 95% CI: 1.02, 2.59), and a group of organic solvents with reactive metabolites (OR: 1.53, 95% CI: 1.08, 2.24). Positive associations were found across all exposure metrics and were higher among women with estrogen-positive/progesterone-negative tumors.
Our findings suggest occupational exposure to certain organic solvents may increase the risk of incident postmenopausal breast cancer.
乳腺癌是女性中诊断出最多的癌症，已知的风险因素可解释25%-47%的病例。有机溶剂在工作场所广泛使用，接触有机溶剂可能会增加患乳腺癌的风险，但尚无足够数据证实这一假设。我们试图确定过去职业性接触特定有机溶剂是否与加拿大蒙特利尔绝经后妇女浸润性乳腺癌的发病率相关。
在一项基于人群的病例对照研究（2008-2011年）中，我们通过深入访谈获取了风险因素和终生职业史信息。工业卫生学家和化学家将工作描述转化为特定的化学和物理接触情况。我们评估了11种单一溶剂和4组溶剂。采用无条件逻辑回归来估计选定溶剂过去接触指标的调整比值比（OR）和95%置信区间（CI）。接触指标包括既往任何接触、每周平均接触小时数、接触年限以及按每周工作小时数加权的平均累积浓度。
我们纳入了695例病例和608例对照。我们发现，接触单环芳烃的平均累积浓度（OR：1.52，95%CI：1.04，2.28）、氯代烷烃（OR：2.42，95%CI：1.23，5.68）、甲苯（OR：1.59，95%CI：1.02，2.59）以及一组具有反应性代谢产物的有机溶剂（OR：1.53，95%CI：1.08，2.24）的OR值升高。在所有接触指标中均发现了正相关，且在雌激素阳性/孕激素阴性肿瘤的女性中更高。
我们的研究结果表明，职业性接触某些有机溶剂可能会增加绝经后乳腺癌的发病风险。
