Aschengrau A, Paulu C, Ozonoff D
Department of Epidemiology, University School of Public Health, Boston, Massachusetts, USA.
Environ Health Perspect. 1998 Aug;106 Suppl 4(Suppl 4):947-53. doi: 10.1289/ehp.98106s4947.
We conducted a population-based case-control study to evaluate the relationship between cases of breast cancer and exposure to tetrachloroethylene (PCE) from public drinking water ( n = 258 cases and 686 controls). Women were exposed to PCE when it leached from the vinyl lining of water distribution pipes. The relative delivered dose was estimated using an algorithm that accounted for residential history, water flow, and pipe characteristics. Only small increases in breast cancer risk were seen among ever-exposed women either when latency was ignored or when 5 to 15 years of latency was considered. No or small increases were seen among highly exposed women either when latency was ignored or when 5 years of latency was considered. However, the adjusted odds ratios (ORs) were more increased for highly exposed women when 7 and 9 years of latency, respectively, were considered (OR 1.5 95% CI 0.5-4.7 and OR 2.3, 95% CI 0.6-8.8 for the 75th percentile, and OR 2.7, 95% CI 0.4-15.8 and OR 7.6, 95% CI 0.9-161.3 for the 90th percentile). The number of highly exposed women was too small for meaningful analysis when more years of latency were considered. Because firm conclusions from these data are limited, we recently undertook a new study with a large number of more recently diagnosed cases.
我们开展了一项基于人群的病例对照研究,以评估乳腺癌病例与公共饮用水中四氯乙烯(PCE)暴露之间的关系(258例病例和686名对照)。当PCE从配水管道的乙烯基衬里中渗出时,女性会接触到PCE。使用一种考虑居住史、水流和管道特征的算法来估计相对输送剂量。无论是否忽略潜伏期,还是考虑5至15年的潜伏期,既往接触过PCE的女性中仅观察到乳腺癌风险有小幅增加。无论是否忽略潜伏期,还是考虑5年的潜伏期,高暴露女性中均未观察到或仅有小幅增加。然而,分别考虑7年和9年潜伏期时,高暴露女性的调整优势比(OR)增加得更多(第75百分位数时,OR为1.5,95%可信区间为0.5 - 4.7;第90百分位数时,OR为2.3,95%可信区间为0.6 - 8.8;第90百分位数时,OR为2.7,95%可信区间为0.4 - 15.8;OR为7.6,95%可信区间为0.9 - 161.3)。考虑更长潜伏期时,高暴露女性的数量过少,无法进行有意义的分析。由于这些数据得出的确切结论有限,我们最近开展了一项新的研究,纳入了大量近期诊断的病例。