Department of Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, Guangdong, China.
Department of Preventive Medicine, School of Public Health, Guangzhou Medical University, Guangzhou, Guangdong, China.
Chemosphere. 2023 Nov;340:139800. doi: 10.1016/j.chemosphere.2023.139800. Epub 2023 Aug 11.
The association of ambient fine particulate matter (PM) exposure with cancer mortality was controversial, which may ascribe to the difference in PM constituents. Polycyclic aromatic hydrocarbons (PAHs) are carcinogenic constituents in PM, which are suspected to account for PM-induced cancer mortality but are yet to be investigated. We aimed to assess the association between long-term exposure to PM-bound PAHs and cancer mortality and estimate the attributable mortality. A difference-in-differences approach was used to investigate the causal effect of long-term exposure to PM-bound PAHs on cancer mortality. We divided Jiangsu province, China into 53 spatial units and summarized the annual number of cancer deaths in each spatial unit during 2016-2020. Annual population-weighted exposure to PM-bound PAHs of each spatial unit was assessed by an inverse distance weighting method. The association between PM-bound PAHs exposures and cancer mortality was evaluated by controlling spatial differences, temporal trends, PM mass exposures, temperatures, and socioeconomic status. Records of 793,269 cancer deaths were identified among 84.7 million population. Each ln-unit increase of exposure to total benzo[a]pyrene equivalents (∑BaPeq), total carcinogenic PAHs (∑PAH7c), and total PAHs (∑PAHs) was significantly associated with a 3.21%, 3.48%, and 2.64% increased risk of cancer mortality, respectively; the risk increased monotonically at low-level exposures but attenuated or flattened afterward (all p for nonlinearity <0.05). Similar exposure-response associations were identified for specific PAHs except that the associations for both fluoranthene and benzo[a]anthracene were linear. We estimated that exposure to ∑BaPeq, ∑PAH7c, and ∑PAHs contributed to 5.73%, 8.73%, and 7.33% of cancer deaths, respectively. In conclusion, long-term exposure to PM-bound PAHs was associated with an increased risk of cancer mortality and contributed to substantial cancer deaths. Our findings highlight the importance to prevent deaths from cancer by reducing PM-bound PAHs exposures and the necessity to take into consideration specific constituents in particulate pollution management in future.
大气细颗粒物（PM）暴露与癌症死亡率之间的关联存在争议，这可能归因于 PM 成分的差异。多环芳烃（PAHs）是 PM 中的致癌成分，据推测，它们是导致 PM 引起的癌症死亡率的原因，但尚未得到证实。我们旨在评估长期暴露于 PM 结合的 PAHs 与癌症死亡率之间的关联，并估计归因于 PM 结合的 PAHs 的死亡率。采用差异中的差异方法来研究长期暴露于 PM 结合的 PAHs 对癌症死亡率的因果影响。我们将中国江苏省分为 53 个空间单元，并总结了 2016-2020 年期间每个空间单元的癌症死亡人数。通过反距离加权法评估每个空间单元的 PM 结合的 PAHs 的年度人口加权暴露量。通过控制空间差异、时间趋势、PM 质量暴露、温度和社会经济地位来评估 PM 结合的 PAHs 暴露与癌症死亡率之间的关联。在 8470 万人中发现了 793269 例癌症死亡记录。暴露于总苯并[a]芘等效物（∑BaPeq）、总致癌 PAHs（∑PAH7c）和总 PAHs（∑PAHs）的每 ln 单位增加与癌症死亡率分别增加 3.21%、3.48%和 2.64%相关；在低水平暴露时风险呈单调增加，但随后减弱或变平（所有非线性 p 值<0.05）。除了荧蒽和苯并[a]蒽的关联呈线性外，对于特定的 PAHs 也存在类似的暴露反应关联。我们估计，暴露于∑BaPeq、∑PAH7c 和∑PAHs 分别导致 5.73%、8.73%和 7.33%的癌症死亡。总之，长期暴露于 PM 结合的 PAHs 与癌症死亡率的增加风险相关，并导致大量癌症死亡。我们的研究结果强调了通过减少 PM 结合的 PAHs 暴露来预防癌症死亡的重要性，并且在未来的颗粒物污染管理中需要考虑特定成分。
