Leung Michael, Tang Ian W, Lin Joyce J Y, Mucci Lorelei, Farmer Justin G, McAlaine Kaleigh, Mangano Joseph J, Weisskopf Marc G
Department of Environmental Health, Harvard T. H. Chan School of Public Health, Boston, Massachusetts.
Department of Epidemiology, Harvard T. H. Chan School of Public Health, Boston, Massachusetts.
JAMA Netw Open. 2025 Jul 1;8(7):e2521926. doi: 10.1001/jamanetworkopen.2025.21926.
Beginning in the 1940s, radioactive waste from the effort to develop an atomic bomb was stored in the open near the St Louis, Missouri, airport, and over several decades contaminated nearby Coldwater Creek.
To evaluate whether living near Coldwater Creek in childhood was associated with self-reported cancer incidence in the St Louis Baby Tooth-Later Life Health Study (SLBT).
DESIGN, SETTING, AND PARTICIPANTS: The SLBT cohort study was centered in St Louis and included individuals who donated their baby teeth from 1958 to 1970 to assess exposure to atmospheric nuclear weapons testing. Participants for the present analysis were recruited from June 22, 2021, to September 18, 2024.
Residential proximity to Coldwater Creek (≤1, >1 to 5, >5 to 20, and >20 km) in childhood when participants donated their baby teeth.
Self-reported cancers, from which several composite outcomes were constructed: any cancer, solid cancers (all except leukemias and lymphomas), known radiosensitive cancers (thyroid, breast, leukemia, and basal cell), and nonradiosensitive cancers (all except thyroid, breast, leukemia, and basal cell). Odds ratios (OR) and 95% CIs between living near Coldwater Creek and several self-reported cancer outcomes were estimated, adjusting for sociodemographic characteristics and neighborhood median income.
There were 4209 eligible SLBT participants, of whom 2369 (56.3%) were female. The mean age at enrollment was 63 (range, 55-77) years. The background risk of any form of cancer was 24%. The OR was 1.44 (95% CI, 0.96-2.14) for any form of cancer comparing participants living 1 km or nearer with those living further than 20 km. There was a significant association for radiosensitive cancers (OR, 1.85; 95% CI, 1.21-2.81) but not for nonradiosensitive cancers (OR, 1.41; 95% CI, 0.86-2.30) for participants living 1 km or nearer vs further than 20 km. There was evidence of a dose-response association, where cancer risks were still elevated (albeit smaller) for those living in buffers of greater than 1 to 5 km and greater than 5 to 20 km. Despite imprecision in some of the site-specific estimates, clear signals for some organs, such as the thyroid, were still detected (OR for living ≤1 vs >20 km, 5.00; 95% CI, 1.23-20.32).
In this cohort study of baby teeth donors from the Greater St Louis area, evidence suggested a positive association between living near Coldwater Creek in childhood and risk of cancer.
从20世纪40年代开始，为研制原子弹所产生的放射性废物被露天存放在密苏里州圣路易斯机场附近，几十年间污染了附近的冷水溪。
在圣路易斯乳牙-晚年健康研究（SLBT）中，评估童年时期居住在冷水溪附近是否与自我报告的癌症发病率相关。
设计、地点和参与者：SLBT队列研究以圣路易斯为中心，纳入了1958年至1970年间捐赠乳牙以评估大气核武器试验暴露情况的个体。本分析的参与者于2021年6月22日至2024年9月18日招募。
参与者捐赠乳牙时，童年时期居住距离冷水溪的远近（≤1公里、>1至5公里、>5至20公里和>20公里）。
自我报告的癌症，由此构建了几个综合结局：任何癌症、实体癌（除白血病和淋巴瘤外的所有癌症）、已知的放射敏感癌（甲状腺癌、乳腺癌、白血病和基底细胞癌）和非放射敏感癌（除甲状腺癌、乳腺癌、白血病和基底细胞癌外的所有癌症）。估计了居住在冷水溪附近与几种自我报告的癌症结局之间的比值比（OR）和95%置信区间，并对社会人口学特征和邻里收入中位数进行了调整。
有4209名符合条件的SLBT参与者，其中2369名（56.3%）为女性。入组时的平均年龄为63岁（范围55 - 77岁）。任何形式癌症的背景风险为24%。将居住在1公里及以内的参与者与居住在20公里以外的参与者相比，任何形式癌症的OR为1.44（95%置信区间，0.96 - 2.14）。居住在1公里及以内与居住在20公里以外的参与者相比，放射敏感癌存在显著关联（OR，1.85；95%置信区间，1.21 - 2.81），而非放射敏感癌则无显著关联（OR，1.41；95%置信区间，0.86 - 2.30）。有剂量反应关联的证据，即居住在大于1至5公里和大于5至20公里缓冲区内的人群癌症风险仍然升高（尽管较小）。尽管某些特定部位的估计存在不精确性，但仍检测到一些器官的明显信号，如甲状腺（居住≤1公里与>20公里相比的OR为5.00；95%置信区间，1.23 - 20.32）。
在这项对大圣路易斯地区乳牙捐赠者的队列研究中，有证据表明童年时期居住在冷水溪附近与癌症风险之间存在正相关。
