Occupational and Environmental Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Department of Health and Human Services, Rockville, MD, USA.
Occupational and Environmental Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Department of Health and Human Services, Rockville, MD, USA.
Environ Int. 2024 Sep;191:108985. doi: 10.1016/j.envint.2024.108985. Epub 2024 Aug 24.
Chemicals emitted from industrial facilities include known or suspected mammary carcinogens and endocrine disruptors, but epidemiologic studies are limited. We evaluated associations between air emissions of multiple carcinogenic chemicals and postmenopausal breast cancer risk in a large prospective U.S.
We used the U.S. Environmental Protection Agency's Toxics Release Inventory to estimate historical airborne emissions (1987-1995) of 19 known and probable carcinogens for participants enrolled (1995-1996) in the NIH-AARP Diet and Health Study. Among 170,402 women, 15,124 breast cancers were diagnosed through 2018. We constructed inverse distance- and wind-weighted average emissions metrics within 1, 2, 5, and 10 km of the enrollment address for each chemical. We estimated multivariable adjusted HRs and 95 % CIs for categories (quartiles, tertiles, medians) of each chemical in association with breast cancer overall and separately by type (invasive, ductal carcinoma in situ) and estrogen receptor (ER) status.
We observed an association between benzene emissions and breast cancer risk that was strongest at 1 km (HR vs. non-exposed = 2.06, 95 %CI: 1.34-3.17; p-trend = 0.001). The magnitude of the association weakened with increasing distance (2 km HR vs. non-exposed = 1.17, 95 %CI=0.92-1.49; p-trend = 0.19; 5 km HR vs. non-exposed = 1.05, 95 %CI=0.94-1.16; p-trend = 0.37; 10 km HR vs. non-exposed = 0.95, 95 %CI=0.89-1.02; p-trend = 0.19) and appeared to be most relevant for invasive rather than intraductal disease. Overall risk was also elevated for vinyl chloride at 5 km (HR vs. non-exposed = 1.20, 95 %CI=1.01-1.43; p-trend = 0.04), but not 2 km or 10 km. We observed suggestive associations for asbestos, trichloroethylene, and styrene in different subgroup analyses, but risk patterns were not clear across distances. Associations with other chemicals were generally null, with limited evidence of heterogeneity by disease type or ER status.
An increased risk of breast cancer associated with relatively high levels of industrial benzene emissions warrants additional study, particularly among participants with diverse sociodemographic characteristics that live in areas with higher density of industrial facilities.
工业设施排放的化学物质包括已知或疑似的乳腺致癌物和内分泌干扰物，但流行病学研究有限。我们评估了美国一项大型前瞻性研究中，多种致癌化学物质的空气排放与绝经后乳腺癌风险之间的关联。
我们使用美国环境保护署的有毒物质释放清单来估计参与者（1995-1996 年）登记时（1987-1995 年）的 19 种已知和可能致癌化学物质的历史空气排放。在 170402 名女性中，通过 2018 年诊断出 15124 例乳腺癌。我们为每个化学物质在登记地址的 1、2、5 和 10 公里范围内构建了逆距离加权平均排放指标。我们估计了每个化学物质的类别（四分位数、三分位数、中位数）与乳腺癌整体的多变量调整 HRs 和 95%CI，并按类型（浸润性、导管原位癌）和雌激素受体（ER）状态分别进行了估计。
我们观察到苯排放与乳腺癌风险之间存在关联，在 1 公里处最强（暴露与非暴露的 HR = 2.06，95%CI：1.34-3.17；p 趋势= 0.001）。随着距离的增加，关联的强度减弱（暴露与非暴露的 2 公里 HR = 1.17，95%CI=0.92-1.49；p 趋势= 0.19；暴露与非暴露的 5 公里 HR = 1.05，95%CI=0.94-1.16；p 趋势= 0.37；暴露与非暴露的 10 公里 HR = 0.95，95%CI=0.89-1.02；p 趋势= 0.19），并且似乎与浸润性而非导管内疾病最相关。总体风险也在氯乙烯的 5 公里处升高（暴露与非暴露的 HR = 1.20，95%CI=1.01-1.43；p 趋势= 0.04），但在 2 公里或 10 公里处没有升高。在不同的亚组分析中，我们观察到石棉、三氯乙烯和苯乙烯的提示性关联，但距离之间的风险模式并不清楚。与其他化学物质的关联通常为零，疾病类型或 ER 状态的异质性证据有限。
与工业苯排放水平较高相关的乳腺癌风险增加值得进一步研究，特别是在具有不同社会人口特征且居住在工业设施密度较高地区的参与者中。
