Gammon M D, Wolff M S, Neugut A I, Terry M B, Papadopoulos K, Levin B, Wang Q, Santella R M
Divisions of Epidemiology, Columbia School of Public Health, New York, New York 10032, USA.
Cancer Epidemiol Biomarkers Prev. 1997 May;6(5):327-32.
Chlorinated hydrocarbons may increase breast cancer risk. Most epidemiological studies addressing this possibility have used one biological sample to measure a subject's cumulative exposure to these compounds. Little is known about short-term temporal variation in organochlorines, particularly in individuals with low levels. Thus, the reliability of using one sample to assess blood levels of chlorinated hydrocarbons in an epidemiological study is unknown. To better understand the temporal changes in blood measures among women with nonoccupational exposures to these compounds, we collected two 5-ml blood samples, an average of 2 months apart, from each of 31 nonfasting healthy women, ages 45-81 years. Samples were assayed for 1,1-dichloro-2,2-bis(p-chlorophenyl)ethylene (DDE), polychlorinated biphenyls (PCBs), and trans-nonachlor in blinded, matched pairs. Results were adjusted for estimated total plasma lipids. The correlations between the two blood samples were high for DDE and PCBs (lipid-adjusted, r = 0.96 and r = 0.89, respectively). For trans-nonachlor, the correlation was relatively poor (lipid-adjusted r = 0.57); however, with the removal of one outlier, the correlation improved substantially (lipid-adjusted, r = 0.90). The mean difference between the two blood samples in unadjusted [-0.36 ng/ml, 95% confidence interval (CI), -0.97, 0.24 ng/ml, P = 0.23] and lipid-adjusted (-0.035 microgram/g lipid; 95% CI, -0.124, 0.055; P = 0.44) DDE levels was small. Similarly, there was little change in the mean difference for unadjusted (-0.14 ng/ml; 95% CI, -0.53, 0.25 ng/ml; P = 0.47) and lipid-adjusted (0.006 microgram/g lipid; 95% CI, -0.050, 0.062; P = 0.82) PCB levels. The mean differences in trans-nonachlor levels between the two blood draws were also small: unadjusted (-0.03 ng/ml; 95% CI, -0.07, 0.02 ng/ml; P = 0.20) and lipid-adjusted (-0.003 microgram/g lipid; 95% CI, -0.010, 0.004; P = 0.33). These data suggest that temporal changes in organochlorine levels within a 1 to 3-month period are minimal for noncancer patients and that a single measure for estimating exposure is highly reliable for DDE and PCB. For trans-nonachlor, however, where the correlation between blood draws was lower, three samples would be needed for estimating exposure; if an outlier is removed from our data, however, then we can conclude that only a single measure is sufficient. These data, therefore, offer no clear conclusion for the use of a single measurement for trans-nonachlor.
氯代烃可能会增加患乳腺癌的风险。大多数针对这种可能性的流行病学研究都使用一种生物样本,来测量受试者对这些化合物的累积暴露量。对于有机氯的短期时间变化,尤其是低水平有机氯的个体,人们了解甚少。因此,在流行病学研究中,使用一个样本评估氯代烃血液水平的可靠性尚不清楚。为了更好地了解非职业性接触这些化合物的女性血液指标的时间变化,我们从31名年龄在45至81岁之间的非空腹健康女性中,每人采集了两份5毫升血液样本,平均间隔2个月。对样本进行双盲、配对检测,以测定1,1-二氯-2,2-双(对氯苯基)乙烯(DDE)、多氯联苯(PCBs)和反式九氯的含量。结果对估计的总血浆脂质进行了校正。两份血液样本中DDE和PCBs的相关性很高(脂质校正后,r分别为0.96和0.89)。对于反式九氯,相关性相对较差(脂质校正后r = 0.57);然而,去除一个异常值后,相关性显著提高(脂质校正后r = 0.90)。两份血液样本中未校正的DDE水平平均差异较小[-0.36 ng/ml,95%置信区间(CI),-0.97,0.24 ng/ml,P = 0.23],脂质校正后的差异也较小(-0.035微克/克脂质;95% CI,-0.124,0.055;P = 0.44)。同样,未校正的PCBs水平平均差异(-0.14 ng/ml;95% CI,-0.53,0.25 ng/ml;P = 0.47)和脂质校正后的差异(0.006微克/克脂质;95% CI,-0.050,0.062;P = 0.82)变化也不大。两次采血之间反式九氯水平的平均差异也较小:未校正的(-0.03 ng/ml;95% CI,-0.07,0.02 ng/ml;P = 0.20)和脂质校正后的(-0.003微克/克脂质;95% CI,-0.010,0.004;P = 0.33)。这些数据表明,在1至3个月内,非癌症患者体内有机氯水平的时间变化很小,对于DDE和PCBs,单次测量暴露量具有高度可靠性。然而,对于反式九氯,两次采血之间的相关性较低,估计暴露量需要三个样本;但是,如果从我们的数据中去除一个异常值,那么我们可以得出结论,单次测量就足够了。因此,这些数据对于使用单次测量反式九氯没有明确的结论。