住宅与排放二恶英设施的距离与 NIH-AARP 饮食与健康研究中非霍奇金淋巴瘤的风险。
Residential proximity to dioxin-emitting facilities and risk of non-Hodgkin lymphoma in the NIH-AARP Diet and Health Study.
机构信息
Occupational and Environmental Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, MD, USA.
Occupational and Environmental Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, MD, USA.
出版信息
Environ Int. 2024 Jun;188:108767. doi: 10.1016/j.envint.2024.108767. Epub 2024 May 21.
BACKGROUND
Polychlorinated dibenzo-p-dioxins and dibenzofurans (PCDD/Fs) are persistent organic pollutants emitted from industrial sources. Residential proximity to these emissions has been associated with risk of non-Hodgkin lymphoma (NHL) in a limited number of studies.
METHODS
We evaluated associations between residential proximity to PCDD/F-emitting facilities and NHL in the NIH-AARP Diet and Health Study (N = 451,410), a prospective cohort enrolled in 1995-1996 in 6 states and 2 U.S. cities. We linked enrollment addresses with a U.S. Environmental Protection Agency database of 4,478 historical PCDD/F sources with estimated toxic equivalency quotient (TEQ) emissions. We evaluated associations between NHL and exposures during a historical period prior to enrollment (1980-1995) using an average emissions index, weighted by toxicity, distance, and wind direction (AEI-W [g TEQ/km]) within 3-, 5- and 10 km of residences. We also evaluated proximity-only metrics indicating the presence/absence of one or more facilities within each distance, and metrics calculated separately for each facility type. We used Cox regression to estimate associations (hazard ratio, HR; 95 % confidence interval, 95 %CI) with NHL and major subtypes, adjusting for demographic, lifestyle, and dietary factors.
RESULTS
A total of 6,467 incident cases of NHL were diagnosed through 2011. Participants with an AEI-W ≥ 95th percentile had elevated risk of NHL compared to those unexposed at 3 km (HR = 1.16; 95 %CI = 0.89-1.52; p-trend = 0.24), 5 km (HR = 1.20;95 %CI = 0.99-1.46;p-trend = 0.05) and 10 km (HR = 1.15; 95 %CI = 0.99-1.34; p-trend = 0.04). We found a positive association at 5 km with follicular lymphoma (HR = 1.62; 95 %CI = 0.98-2.67; p-trend = 0.05) and a suggestive association for diffuse large B-cell lymphoma (HR = 1.40; 95 %CI = 0.91-2.14; p-trend = 0.11). NHL risk was also associated with high emissions from coal-fired power plants within 10 km (HR = 1.42; 95 %CI = 1.09-1.84; p-trend = 0.05).
CONCLUSIONS
Residential proximity to relatively high dioxin emissions from industrial sources may increase the risk of NHL and specific subtypes.
背景
多氯二苯并对二恶英和多氯二苯并呋喃（PCDD/Fs）是工业来源排放的持久性有机污染物。在一些有限的研究中，居住在这些排放物附近与非霍奇金淋巴瘤（NHL）的风险有关。
方法
我们评估了 NIH-AARP 饮食与健康研究（N=451410）中居住在 PCDD/F 排放设施附近与 NHL 之间的相关性，这是一项前瞻性队列研究，于 1995-1996 年在 6 个州和 2 个美国城市招募。我们将登记地址与美国环境保护署的历史 PCDD/F 源数据库（有 4478 个历史 PCDD/F 源，估计毒性等效系数（TEQ）排放量）进行了关联。我们使用加权毒性、距离和风向的平均排放指数（AEI-W[g TEQ/km]），评估了 NHL 与登记前（1980-1995 年）暴露之间的关系，暴露于居住地 3、5 和 10 公里范围内。我们还评估了仅表示存在/不存在每个距离内一个或多个设施的接近度指标，以及分别为每个设施类型计算的指标。我们使用 Cox 回归来估计 NHL 和主要亚型的关联（危险比，HR；95%置信区间，95%CI），并调整了人口统计学、生活方式和饮食因素。
结果
共有 6467 例 NHL 病例在 2011 年之前确诊。与未暴露于 3 公里处的参与者相比，AEI-W≥95 百分位的参与者 NHL 风险升高（HR=1.16；95%CI=0.89-1.52；p 趋势=0.24），5 公里（HR=1.20；95%CI=0.99-1.46；p 趋势=0.05）和 10 公里（HR=1.15；95%CI=0.99-1.34；p 趋势=0.04）。我们在 5 公里处发现滤泡性淋巴瘤呈正相关（HR=1.62；95%CI=0.98-2.67；p 趋势=0.05），弥漫性大 B 细胞淋巴瘤呈可疑关联（HR=1.40；95%CI=0.91-2.14；p 趋势=0.11）。NHL 风险也与 10 公里范围内燃煤电厂的高排放量有关（HR=1.42；95%CI=1.09-1.84；p 趋势=0.05）。
结论
居住在工业源产生的相对较高二恶英排放物附近可能会增加 NHL 和特定亚型的风险。
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