评估暴露于美国海军陆战队勒琼营污染饮用水的海军陆战队员、海军人员和平民工人的死亡率：一项队列研究。

Evaluation of mortality among Marines, Navy personnel, and civilian workers exposed to contaminated drinking water at USMC base Camp Lejeune: a cohort study.

机构信息

Office of Community Health and Hazard Assessment, Health Studies Section, Agency for Toxic Substances and Disease Registry (ATSDR)/CDC, 6558 Parkside Way, Chamblee, GA, 30084, USA.

Health Research and Analytics Division, Battelle Memorial Institute, Charlottesville, VA, USA.

出版信息

Environ Health. 2024 Jul 3;23(1):61. doi: 10.1186/s12940-024-01099-7.

DOI:10.1186/s12940-024-01099-7

PMID:38961410

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11221020/

Abstract

BACKGROUND

Drinking water at U.S. Marine Corps Base (MCB) Camp Lejeune, North Carolina was contaminated with trichloroethylene and other industrial solvents from 1953 to 1985.

METHODS

A cohort mortality study was conducted of Marines/Navy personnel who, between 1975 and 1985, began service and were stationed at Camp Lejeune (N = 159,128) or MCB Camp Pendleton, California (N = 168,406), and civilian workers employed at Camp Lejeune (N = 7,332) or Camp Pendleton (N = 6,677) between October 1972 and December 1985. Camp Pendleton's drinking water was not contaminated with industrial solvents. Mortality follow-up was between 1979 and 2018. Proportional hazards regression was used to calculate adjusted hazard ratios (aHRs) comparing mortality rates between Camp Lejeune and Camp Pendleton cohorts. The ratio of upper and lower 95% confidence interval (CI) limits, or CIR, was used to evaluate the precision of aHRs. The study focused on underlying causes of death with aHRs ≥ 1.20 and CIRs ≤ 3.

RESULTS

Deaths among Camp Lejeune and Camp Pendleton Marines/Navy personnel totaled 19,250 and 21,134, respectively. Deaths among Camp Lejeune and Camp Pendleton civilian workers totaled 3,055 and 3,280, respectively. Compared to Camp Pendleton Marines/Navy personnel, Camp Lejeune had aHRs ≥ 1.20 with CIRs ≤ 3 for cancers of the kidney (aHR = 1.21, 95% CI: 0.95, 1.54), esophagus (aHR = 1.24, 95% CI: 1.00, 1.54) and female breast (aHR = 1.20, 95% CI: 0.73, 1.98). Causes of death with aHRs ≥ 1.20 and CIR > 3, included Parkinson disease, myelodysplastic syndrome and cancers of the testes, cervix and ovary. Compared to Camp Pendleton civilian workers, Camp Lejeune had aHRs ≥ 1.20 with CIRs ≤ 3 for chronic kidney disease (aHR = 1.88, 95% CI: 1.13, 3.11) and Parkinson disease (aHR = 1.21, 95% CI: 0.72, 2.04). Female breast cancer had an aHR of 1.19 (95% CI: 0.76, 1.88), and aHRs ≥ 1.20 with CIRs > 3 were observed for kidney and pharyngeal cancers, melanoma, Hodgkin lymphoma, and chronic myeloid leukemia. Quantitative bias analyses indicated that confounding due to smoking and alcohol consumption would not appreciably impact the findings.

CONCLUSION

Marines/Navy personnel and civilian workers likely exposed to contaminated drinking water at Camp Lejeune had increased hazard ratios for several causes of death compared to Camp Pendleton.

摘要

背景

1953 年至 1985 年，美国北卡罗来纳州勒琼营的饮用水受到三氯乙烯和其他工业溶剂的污染。

方法

对 1975 年至 1985 年间在勒琼营（N=159128）或加利福尼亚州彭德尔顿营（N=168406）服役并驻扎的海军陆战队/海军人员以及在勒琼营（N=7332）或彭德尔顿营（N=6677）工作的文职人员进行了队列死亡率研究。彭德尔顿营的饮用水没有受到工业溶剂的污染。死亡率随访时间为 1979 年至 2018 年。使用比例风险回归计算勒琼营和彭德尔顿营队列死亡率之间的调整后的危险比（aHR）。上限和下限 95%置信区间（CI）限值的比值（CIR）用于评估 aHR 的精度。该研究主要关注死亡率 aHR≥1.20 和 CIR≤3 的根本原因。

结果

勒琼营和彭德尔顿营的海军陆战队/海军人员死亡人数分别为 19250 人和 21134 人。勒琼营和彭德尔顿营的文职人员死亡人数分别为 3055 人和 3280 人。与彭德尔顿营的海军陆战队/海军人员相比，勒琼营的肾脏癌（aHR=1.21，95%CI：0.95，1.54）、食管癌（aHR=1.24，95%CI：1.00，1.54）和女性乳腺癌（aHR=1.20，95%CI：0.73，1.98）的 aHR≥1.20，CIR≤3。aHR≥1.20，CIR>3 的死因包括帕金森病、骨髓增生异常综合征和睾丸癌、宫颈癌和卵巢癌。与彭德尔顿营的文职人员相比，勒琼营的慢性肾病（aHR=1.88，95%CI：1.13，3.11）和帕金森病（aHR=1.21，95%CI：0.72，2.04）的 aHR≥1.20，CIR≤3。女性乳腺癌的 aHR 为 1.19（95%CI：0.76，1.88），肾脏癌和咽癌、黑素瘤、霍奇金淋巴瘤和慢性髓性白血病的 aHR≥1.20，CIR>3。定量偏倚分析表明，吸烟和饮酒引起的混杂因素不太可能显著影响研究结果。