Lev Bar-Or Ruth, Twig Gilad, Broday David M, Keinan-Boker Lital, Paltiel Ora, Sinnreich Ronit, Tzur Dorit, Derazne Estela, Raz Raanan
Braun School of Public Health and Community Medicine, The Hebrew University of Jerusalem-Hadassah, Jerusalem 9112102, Israel.
Faculty of Civil and Environmental Engineering, Technion Israel Institute of Technology, Haifa 32000, Israel.
Environ Health (Wash). 2023 Jun 21;1(1):53-62. doi: 10.1021/envhealth.3c00030. eCollection 2023 Jul 21.
There is substantial public concern about the health risks of proximity to petrochemical industries. In the Haifa Bay Area (HBA), which contains Israel's densest industrial area, these concerns have been strengthened by elevated cancer mortality rates since the late 1960s. We studied the association between adolescent exposure to industrial air pollution in the HBA and adult-onset cancer. This is a historical cohort study. The study population comprised 2,187,317 subjects, using the Israeli medical corps data linked to the Israel National Cancer Registry with follow-up of up to 45 years. Exposure assessments were estimated by a spatial kriging interpolation model of SO, serving as a marker for the dispersion of air pollution emitted from the complex during the study period. We found increased crude (HR = 1.23, 95%CI= 1.17 to 1.29) and adjusted (HR = 1.16, 95%CI = 1.10 to 1.21) risk of cancer with increased exposure to air pollution in HBA. The associations remained robust in analyses stratified by decade and socio-economic status. We found evidence of monotonically increased risk in five of 13 cancer categories (leukemia, melanoma, female breast, central nervous system, and thyroid tumors). Our findings strengthen the hypothesis that this exposure posed a carcinogenic risk during the study period.
公众对靠近石化行业所带来的健康风险极为关注。在海法湾地区（HBA），这里是以色列工业最密集的区域，自20世纪60年代末以来，癌症死亡率不断上升，进一步加剧了这些担忧。我们研究了HBA地区青少年暴露于工业空气污染与成年后患癌之间的关联。这是一项历史性队列研究。研究人群包括2187317名受试者，利用与以色列国家癌症登记处相关联的以色列医疗队数据，随访时间长达45年。暴露评估通过二氧化硫的空间克里金插值模型进行估算，二氧化硫作为研究期间该综合设施排放的空气污染扩散的一个指标。我们发现，随着HBA地区空气污染暴露的增加，患癌的粗风险（风险比=1.23，95%置信区间=1.17至1.29）和调整后风险（风险比=1.16，95%置信区间=1.10至1.21）均有所增加。在按十年和社会经济地位分层的分析中，这种关联依然显著。我们发现，在13种癌症类型中的5种（白血病、黑色素瘤、女性乳腺癌、中枢神经系统肿瘤和甲状腺肿瘤）存在风险单调增加的证据。我们的研究结果强化了这样一种假设，即在研究期间这种暴露构成了致癌风险。
