Zhao Jing, Han Wei, Guo Xiao-Bo, Zhang Lu-Wen, Xue Fang, Jiang Jing-Mei
Institute of Basic Medical Sciences,Chinese Academy of Medical Sciences,Department of Epidemiology and Biostatistics, School of Basic Medicine,Peking Union Medical College,Beijing 100005,China.
Centre of Environmental and Health Sciences,CAMS and PUMC,Beijing 100005,China.
Zhongguo Yi Xue Ke Xue Yuan Xue Bao. 2024 Dec;46(6):849-861. doi: 10.3881/j.issn.1000-503X.16061.
Objective To reveal the spatial distribution patterns of key pollutants in the Huaihe River Basin and quantify the risks and burdens of non-gastrointestinal cancers by the grade of pollution,providing targets and data support for enhanced management of water pollution in the Huaihe River Basin. Methods Surface water quality data of the Huaihe River Basin were obtained from the National Surface Water Environmental Quality Monitoring Network(2021).Incidence data of seven cancers were extracted from the 2019 Annual Report of the China Cancer Registry.Random forest and SHapley Additive exPlanations were employed to select key pollutants,and pollution was graded based on the spatial analysis of the Huaihe River Basin.The cancer risks and population attributable fractions were calculated under pollution grades. Results Five key pollutants linked to cancers were identified,including total nitrogen,total phosphorus,chemical oxygen demand,biochemical oxygen demand after 5 days,and arsenic.Pollution was graded into three levels regarding the combined effects of pollutants.Compared with the low pollution areas,high pollution areas showed increased risks of lung cancer(=1.26,95%:1.06-1.50),breast cancer(female)(=1.46,95%:1.21-1.77),pancreatic cancer(=1.46,95%:1.06-2.01),brain cancer(=1.44,95%:1.05-1.98),and gallbladder cancer(=1.60,95%:1.03-2.50).The grade of pollution contributed to more than 5% of cases for most cancers above. Conclusions The potential cancer risks and burdens attributed to surface water pollution cannot be overlooked.Addressing this challenge necessitates close collaboration of various stakeholders to strengthen policy development,enhance environmental governance,and implement public health interventions.
目的 揭示淮河流域主要污染物的空间分布模式，按污染等级量化非胃肠道癌症的风险和负担，为加强淮河流域水污染治理提供目标和数据支持。方法 淮河流域地表水水质数据来自国家地表水水环境质量监测网（2021年）。七种癌症的发病数据从《中国癌症登记年报（2019年）》中提取。采用随机森林和SHapley值法选择主要污染物，并基于淮河流域的空间分析对污染进行分级。计算不同污染等级下的癌症风险和人群归因分数。结果 确定了五种与癌症相关的主要污染物，包括总氮、总磷、化学需氧量、五日生化需氧量和砷。根据污染物的综合影响将污染分为三个等级。与低污染地区相比，高污染地区肺癌（RR = 1.26，95%CI：1.06 - 1.50）、乳腺癌（女性）（RR = 1.46，95%CI：1.21 - 1.77）、胰腺癌（RR = 1.46，95%CI：1.06 - 2.01）、脑癌（RR = 1.44，95%CI：1.05 - 1.98）和胆囊癌（RR = 1.60，95%CI：1.03 - 2.50）的风险增加。上述大多数癌症中，污染等级导致的病例占比超过5%。结论 地表水环境污染所致的潜在癌症风险和负担不容忽视。应对这一挑战需要各利益相关方密切合作，加强政策制定，强化环境治理，并实施公共卫生干预措施。
