Kettles M K, Browning S R, Prince T S, Horstman S W
Department of Preventive Medicine and Environmental Health, University of Kentucky College of Medicine, Lexington, KY 40504-9842, USA.
Environ Health Perspect. 1997 Nov;105(11):1222-7. doi: 10.1289/ehp.971051222.
The incidence of breast cancer in the United States has steadily increased for the past three decades. Exposure to excess estrogen, in both natural and synthetic forms, has been implicated as a risk factor for the development of this disease. Considerable interest has been focused on organochlorines, such as the triazine herbicides, and their possible role in the initiation or promotion of human breast cancer. To explore this relationship, an ecologic study of Kentucky counties was designed. Exposure to triazines was estimated by use of water contamination data, corn crop production, and pesticide use data. A summary index of triazine herbicide exposure was developed to classify counties into low, medium, or high exposure levels. Data on county breast cancer rates were obtained from the state registry. A Poisson regression analysis was performed, controlling for age, race, age at first live birth, income, and level of education. Results revealed a statistically significant increase in breast cancer risk with medium and high levels of triazine exposure [odds ratio (OR) = 1.14,p<0.0001 and OR = 1.2, p<0.0001, respectively]. The results suggest a relationship between exposure to triazine herbicides and increased breast cancer risk, but conclusions concerning causality cannot be drawn, due to the limitations inherent in ecologic study design.
在过去三十年中,美国乳腺癌的发病率一直在稳步上升。接触天然和合成形式的过量雌激素被认为是这种疾病发展的一个风险因素。人们对有机氯化合物,如三嗪类除草剂,及其在人类乳腺癌发生或发展中的可能作用给予了相当大的关注。为了探究这种关系,设计了一项对肯塔基州各县的生态学研究。通过使用水污染数据、玉米作物产量和农药使用数据来估计三嗪类除草剂的接触情况。制定了一个三嗪类除草剂接触情况的综合指数,将各县分为低、中、高接触水平。各县乳腺癌发病率的数据来自州登记处。进行了泊松回归分析,控制了年龄、种族、首次生育年龄、收入和教育水平。结果显示,三嗪类除草剂接触水平为中、高时,乳腺癌风险有统计学意义的增加[优势比(OR)分别为1.14,p<0.0001和OR = 1.2,p<0.0001]。结果表明三嗪类除草剂接触与乳腺癌风险增加之间存在关联,但由于生态学研究设计固有的局限性,无法得出因果关系的结论。