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安大略省青少年饮用水中的镭与骨癌死亡风险

Radium in drinking water and the risk of death from bone cancer among Ontario youths.

作者信息

Finkelstein M M

机构信息

Health and Safety Studies Unit, Ontario Ministry of Labour, Toronto.

出版信息

CMAJ. 1994 Sep 1;151(5):565-71.

Abstract

OBJECTIVE

To determine whether residents of Ontario who are exposed to radium 226 naturally occurring in drinking water are at increased risk of bone cancer.

DESIGN

A population-based case-control study of records from death and birth registries. Water samples were obtained from residences at the time of birth and of death.

SETTING

Ontario.

PARTICIPANTS

All Ontario-born people under the age of 26 years who died of bone cancer between 1950 and 1983. Control subjects were those who died of any other disease matched by age, sex and year of death.

OUTCOME MEASURES

Radium exposure distributions and estimation of risk.

RESULTS

An association was found between death from bone cancer and exposure to radium at the birthplace residence in concentrations of 7.0 mBq/L or more (odds ratio 1.58, 90% confidence interval [CI] 1.01 to 2.50; p = 0.047). There was a statistically significant exposure-response relation (p = 0.045). The increase in risk was similar for the main types of childhood bone cancer: osteosarcoma, Ewing's sarcoma and chondrosarcoma.

CONCLUSIONS

The estimated risk at these exposure levels is much higher than would be predicted. The association may be spurious, the point estimates of risk may be too high, or risk factors derived from other exposure circumstances may not be valid for exposure to radium beginning in the prenatal period. Should the findings be confirmed, consideration might be given to removing radium from drinking-water sources.

摘要

目的

确定安大略省饮用水中天然存在的镭 - 226 暴露人群患骨癌的风险是否增加。

设计

一项基于人群的病例对照研究,数据来自死亡和出生登记记录。在出生和死亡时采集住所的水样。

地点

安大略省。

参与者

1950 年至 1983 年间死于骨癌的所有 26 岁以下安大略省出生的人。对照对象为死于其他任何疾病且年龄、性别和死亡年份相匹配的人。

观察指标

镭暴露分布及风险估计。

结果

发现骨癌死亡与出生地住所镭暴露浓度在 7.0 毫贝克勒尔/升及以上之间存在关联(优势比 1.58,90% 置信区间 [CI] 1.01 至 2.50;p = 0.047)。存在统计学显著的暴露 - 反应关系(p = 0.045)。儿童期骨癌的主要类型(骨肉瘤、尤因肉瘤和软骨肉瘤)的风险增加相似。

结论

这些暴露水平下的估计风险远高于预期。这种关联可能是虚假的,风险的点估计可能过高,或者从其他暴露情况得出的风险因素可能不适用于产前开始的镭暴露。如果这些发现得到证实,可能需要考虑从饮用水源中去除镭。

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本文引用的文献

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Health Phys. 1983;44 Suppl 1:15-31. doi: 10.1097/00004032-198306001-00001.
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Health Phys. 1985 May;48(5):635-47. doi: 10.1097/00004032-198505000-00005.
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Bone sarcomas linked to radiotherapy and chemotherapy in children.儿童中与放疗和化疗相关的骨肉瘤
N Engl J Med. 1987 Sep 3;317(10):588-93. doi: 10.1056/NEJM198709033171002.
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Oncogenes and tumor-suppressing genes.癌基因与肿瘤抑制基因。
N Engl J Med. 1988 Mar 10;318(10):618-22. doi: 10.1056/NEJM198803103181007.

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