Residential proximity to agricultural pesticide use and incidence of breast cancer in California, 1988-1997

California is the largest agricultural state in the United States and home to some of the world's highest breast cancer rates. The objective of our study was to evaluate whether California breast cancer rates were elevated in areas with recent high agricultural pesticide use. We identified population-based invasive breast cancer cases from the California Cancer Registry for 1988-1997. We used California's pesticide use reporting data to select pesticides for analysis based on use volume, carcinogenic potential, and exposure potential. Using 1990 and 2000 U.S. Census data, we derived age- and race-specific population counts for the time period of interest. We used a geographic information system to aggregate cases, population counts, and pesticide use data for all block groups in the state. To evaluate whether breast cancer rates were related to recent agricultural pesticide use, we computed rate ratios and 95% confidence intervals using Poisson regression models, adjusting for age, race/ethnicity, and neighborhood socioeconomic status and urbanization. This ecologic (aggregative) analysis included 176,302 invasive breast cancer cases and 70,968,598 person-years of observation. The rate ratios did not significantly differ from 1 for any of the selected pesticide categories or individual agents. The results from this study provide no evidence that California women living in areas of recent, high agricultural pesticide use experience higher rates of breast cancer.     

Residential proximity to agricultural pesticide applications and childhood acute lymphoblastic leukemia

Ambient exposure from residential proximity to applications of agricultural pesticides may contribute to the risk of childhood acute lymphoblastic leukemia (ALL). Using residential histories collected from the families of 213 ALL cases and 268 matched controls enrolled in the Northern California Childhood Leukemia Study, the authors assessed residential proximity within a half-mile (804.5 m) of pesticide applications by linking address histories with reports of agricultural pesticide use. Proximity was ascertained during different time windows of exposure, including the first year of life and the child's lifetime through the date of diagnosis for cases or reference for controls. Agricultural pesticides were categorized a priori into groups based on similarities in toxicological effects, physicochemical properties, and target pests or uses. The effects of moderate and high exposure for each group of pesticides were estimated using conditional logistic regression. Elevated ALL risk was associated with lifetime moderate exposure, but not high exposure, to certain physicochemical categories of pesticides, including organophosphates, chlorinated phenols, and triazines, and with pesticides classified as insecticides or fumigants. A similar pattern was also observed for several toxicological groups of pesticides. These findings suggest future directions for the identification of specific pesticides that may play a role in the etiology of childhood leukemia.     

Risk of contralateral breast cancer after tamoxifen use among Danish women

PurposeTamoxifen reduces the risk of contralateral breast cancer (CBC), but little is known about the long-term risk.MethodsFrom the database under the Danish Breast Cancer Cooperative Group (DBCG), we identified 15,863 users and 21,670 nonusers of tamoxifen among women diagnosed with breast cancer during 1977 to 2007. Information on CBC was obtained from the Danish Cancer Registry and the Danish Breast Cancer Cooperative Group database. Cox regression analyses were carried out with estimation of hazard ratios (HRs) of CBC. We also estimated the HRs of current and past use of tamoxifen.ResultsCurrent use of tamoxifen was associated with reduced HRs of CBC independently of menopausal status and calendar-period. The HRs associated with past use of tamoxifen, however, varied among postmenopausal users from 1.50 (95% confidence interval [CI], 1.20–1.87) among users in 1977 to 1989 to 0.87 (95% CI, 0.70–1.06) and 1.05 (95% CI, 0.68–1.63) among users in 1990 to 1998 and 1999 to 2007, respectively. No excesses or deficits of CBC were found 10 or more years since the last use in postmenopausal women in any calendar-period.ConclusionsOur study confirms that tamoxifen protects against CBC while being treated. The effect of tamoxifen after cessation of treatment was not clear because of the inconsistency in results by calendar-period.     

炎性因子与乳腺癌发病风险的前瞻性队列研究

目的  在大型前瞻性队列研究基础上,探讨高敏C-反应蛋白(high sensitivity C-reactive protein,hsCRP)和中性粒细胞(neutrophil,NE)与女性乳腺癌发病风险的关联性。 方法  收集2006-2007年开滦研究队列女性人群体检数据和hsCRP及NE检测结果等基线信息。采用多因素Cox风险模型分析基线hsCRP水平及NE水平与女性乳腺癌发病风险比(HR)和95%可信区间(95%CI)。 结果  队列共纳入18 866例女性,末次随访至2015年12月31日,随访期间共收集新发乳腺癌183例。其中,hsCRP < 1 mg/L组、1~3 mg/L组和>3 mg/L组新发乳腺癌9年累积发病率分别为829/10万、1 211/10万和1 495/10万,差异有统计学意义(χ²=12.08,P=0.002)。Cox分析显示：hsCRP>3 mg/L组乳腺癌发病风险是hsCRP < 1 mg/L组的1.71(95%CI：1.18~2.47,P=0.005)倍,差异有统计学意义。NE水平(< 3.70×10⁹/L和≥ 3.70×10⁹/L)差异与乳腺癌发病风险无统计学意义(P>0.05)。 结论  基线hsCRP水平升高可能增加乳腺癌发病风险。     

Regression analysis of pesticide use and breast cancer incidence in California Latinas

An evaluation of pesticide use data and breast cancer incidence rates in California Hispanic females was conducted via a regression analysis. The analysis used 1988-2000 data from the California Cancer Registry, the population-based cancer registry that monitors cancer incidence and mortality in California. It also used pesticide use data from 1970-1988 from the California Department of Pesticide Regulation. California is the leading agricultural state in the United States, and more than a quarter of all pesticides in the United States are applied there. Hispanic (Latina) females are commonly employed in agricultural operations. The authors performed regression analysis of county-level specific pesticide use data (pounds of active ingredients applied) for two classes of pesticides, organochlorines and triazine herbicides, against the breast cancer incidence rates among Latinas, controlling for age, socioeconomic status, and fertility rates, using negative binomial regression models. A total of 23,513 Latinas were diagnosed with breast cancer in California during the years 1988-1999. Risk of breast cancer was positively and significantly associated with age and socioeconomic status, and inversely and significantly associated with fertility levels. With respect to pesticides, breast cancer was positively associated with pounds of the organochlorines methoxychlor (adjusted incidence rate ratio [IRR] for highest quartile = 1.18; confidence interval [CI] = 1.03-1.35) and toxaphene (IRR = 1.16; CI = 1.01-1.34). No significant associations were found for the triazine herbicides atrazine and simazine.     

腰围与男性肺癌发病关系的前瞻性队列研究

目的 探讨腰围与男性肺癌发病风险的关系。方法 以开滦集团全体在职及离退休男性职工为调查对象,自2006年5月建立开滦集团男性动态队列并随访。基线调查时收集研究对象身高、体重、腰围等信息,并在随访时收集结局事件信息。腰围按五分位数进行分组：<80、80~、85~、90~、≥95 cm,并以腰围80~cm组为参比组,采用多因素Cox比例风险回归模型分析腰围与男性肺癌发病的风险比（HR）和95%CI。结果 截止2014年12月31日,共有105 386名研究对象进入队列,共随访739 651.13人年,平均随访7.00年,共收集肺癌新发病例707例。以80~cm组为参比组,调整年龄、文化程度、吸烟状态、累计吸烟量、饮酒情况、体育锻炼、工作环境、糖尿病史后,腰围<80及85~、90~、≥95 cm组发生肺癌的HR值（95%CI）分别为1.17（0.90~1.52）及0.96（0.74~1.23）、0.94（0.72~1.21）、0.80（0.63~1.03）,趋势检验P=0.005。按吸烟、饮酒状态分层分析显示,腰围与肺癌发病风险在吸烟（腰围≥95 cm组与80~cm组相比：HR=0.69,95%CI：0.48~0.99）、饮酒（腰围≥95 cm组与80~cm组相比：HR=0.65,95%CI：0.45~0.94）者中呈负相关。结论 腰围可能与男性肺癌的发病风险之间有负相关关系。     

代谢综合征与女性乳腺癌发病风险的前瞻性队列研究

目的研究代谢综合征(MS)与女性乳腺癌发病风险关联。方法基于“开滦女性动态队列”,于2006年5月至2015年12月,纳入25618名开滦集团在职及离退休女性职工为研究对象,并进行随访。采用问卷调查、身体测量和实验室检测的方法收集基线社会人口学特征、身高、体重、血糖、血脂、血压及肿瘤发病结局信息。采用Cox比例风险回归模型分析MS及其组分(体重指数、血压、血糖、血脂)与女性乳腺癌发病风险的关系。结果25618名研究对象年龄为(47.65±12.02)岁,中位随访时间为8.78年;乳腺癌新发病例为235例,发病密度为113.19/10万人年。调整年龄、教育程度、经济收入、吸烟状态、饮酒状态等因素后,与体重指数正常者相比,超重或肥胖者的乳腺癌发病风险较高,HR(95%CI)值为1.47(1.12~1.93);与无MS异常组分相比,具有2个MS异常组分的女性乳腺癌发病风险增加(HR=1.70,95%CI:1.16~2.50);随着MS异常组分个数的增加,乳腺癌发病风险逐渐增加(P趋势<0.05)。结论超重/肥胖、MS异常组分的个数均可增加女性乳腺癌发病风险。     

军队男性中老年人脑卒中发病和死亡的队列研究

目的：前瞻性探讨军队男性中老年人脑卒中发病及死亡的危险因素。方法：采用队列研究设计。研究对象为居住西安市22个军队干休所的1268名男性军队离退休干部。1987年基线调查的主要内容包括：年龄、体重指数(BMI)、血压、血脂、吸烟、饮酒、既往病史及家族史等。终点指标为新发脑卒中、脑卒中死亡和总死亡。结果：随访至2001年6月，观察人年为15 546。新发脑卒中113例，调整发病率为727／10万人年；脑卒中死亡45例，调整死亡率为289／10万人年。调整了年龄、血脂、吸烟、饮酒、既往心脑血管病病史及家族史等主要危险因素后，基线血压水平、BMI和既往冠心病和高脂血症病史是影响该人群脑卒中发病和死亡的主要危险因素。结论：军队男性中老年人群的脑卒中发病率和死亡率低于一般同龄人群，中老年人体重和血压水平进行监测和控制对预防中老年人群的脑卒中发病和死亡有重要意义。     

Breast cancer incidence and its possible spatial association with pesticide application in two counties of England

BACKGROUND: This study examines the spatial distribution of breast cancer incidence in Lincolnshire and Leicestershire, and its association with the application of selected pesticides. METHODS: The Black-White (BW) join-count statistic and Moran I coefficient were used to investigate the localized distribution of breast cancer. Linear regression techniques were applied to examine the association between the breast cancer incidence rate and pesticide application. RESULTS: The results from the BW join-count test and the Moran I coefficient test showed no overall evidence of localized distribution, 'clusters', of breast cancer. The regression analyses showed no sign of spatial association between breast cancer and application of pesticides in the urban areas as expected. The findings, however, did reveal a spatial association between the breast cancer incidence rates and the application of three selected pesticides [Aldicarb, Atrazine and Lindane (thought to potentially mimic oestrogen)] in rural Leicestershire. No such association was seen in Lincolnshire. CONCLUSIONS: Pesticides vary significantly in their spatial application. Overall, consistent associations between breast cancer incidence rates and the selected pesticides were not found, although the ecological study design has limitations and these are discussed. This approach is able to rule out strong associations; assessment of smaller risk would require a large and expensive study in individuals. The results of this study, although derived in the UK, have significance to the debate concerning the possibility of environmental compounds that mimic oestrogen and their consequences for human health.     

Chlorothalonil exposure and cancer incidence among pesticide applicator participants in the agricultural health study

Background

Chlorothalonil is a broad spectrum, non-systemic fungicide widely used to control diseases affecting over 50 fruit, vegetable, and agricultural crops. Despite its extensive use for over 30 years, little is known about the potential human carcinogenicity associated with the routine application of chlorothalonil. Rodent studies have shown evidence of renal tubular carcinomas and adenomas. We explored cancer incidence with chlorothalonil exposure using data from the Agricultural Health Study, a prospective cohort of licensed pesticide applicators in Iowa and North Carolina.

Methods

Licensed private and commercial pesticide applicators were recruited into this study from 1993 to 1997. Detailed information regarding pesticide use was obtained via self-administered questionnaires. Cancer incidence was followed through December 31, 2004. Chlorothalonil exposure was classified by lifetime exposure days and intensity-weighted lifetime exposure days, and then categorized into tertiles. The intensity-weighted lifetime exposure days metric was calculated based on a complex algorithm which includes pesticide application methods among other factors. This may increase or decrease exposure.

Results

Of the 47,625 pesticide applicators included in this analysis, 3657 applicators reported using chlorothalonil with a median of 3.5 application days per year. Chlorothalonil was not associated with overall cancer incidence, nor did we find any association with colon, lung, and prostate cancers—the only cancers for which we had sufficient numbers to explore associations.

Conclusion

We did not find any strong evidence for an association between chlorothalonil and the cancers investigated. Although animal studies have suggested renal cancer may be associated with chlorothalonil, we had insufficient data to evaluate this cancer.     

中国成年人糖尿病前期发病状况及其影响因素研究

目的 了解我国成年人糖尿病前期的发病状况及其影响因素。方法 基于2010年中国慢性病及其危险因素监测调查数据,从中抽取10省份,再从每省份中选择2个监测点作为随访点,于2016-2017年进行随访调查。采用非条件logistic回归模型分析糖尿病前期的影响因素。结果 本研究纳入5 578人,随访期间糖耐量受损（IGT）发生612人（男性268人,女性344人）,总计随访37 364.82人年,IGT发病率为16.4/1 000人年;空腹血糖受损（IFG）发生290人（男性128人,女性162人）,总计随访39 731.31人年,IFG发病率为7.3/1 000人年。多因素非条件logistic回归模型纳入年龄、城乡、糖尿病家族史、BMI、中心性肥胖、血脂异常、高血压以及身体活动水平,结果显示,年龄≥50岁（OR=1.60,95%CI： 1.32~1.95）、城市居民（OR=1.41,95%CI： 1.16~1.71）、肥胖（OR=1.56,95%CI： 1.12~2.19）、血脂异常（OR=1.52,95%CI： 1.25~1.83）、高血压（OR=1.32,95%CI： 1.07~1.61）以及身体活动不足（OR=1.25,95%CI： 1.04~1.50）是IGT发病的危险因素;年龄≥50岁（OR=1.31,95%CI： 1.01~1.70）、糖尿病家族史（OR=1.71,95%CI： 1.13~2.60）、超重（OR=1.41,95%CI： 1.04~1.92）、肥胖（OR=2.09,95%CI： 1.38~3.17）以及高血压（OR=1.53,95%CI： 1.18~2.00）是IFG发病的危险因素。结论 相比IFG,IGT发病率较高。年龄≥50岁者、超重/肥胖人群、高血压患者、血脂异常者、身体活动不足者以及有糖尿病家族史者易发生糖尿病前期。     

安徽省疟疾发病地理信息系统研究

目的建立疟疾发病地理信息系统模型，对疟疾发病情况进行空间分析。方法收集1950～2005年疟疾发病资料，使用EpiInfo3．3．2软件建立数据库并拟合地理信息系统模型。结果1970～1999年，疟疾发病率最高达到12156．42／10万，最低仅为1．32／10万，总体呈逐年下降趋势，平均下降速度为27．01％；2000～2005年，疫情出现回升，6年间疟疾发病率平均上升速度61．91％。结论安徽省疟疾历史上严重流行区在长江以北，重点在沿淮淮北地区；现阶段疟疾高发地区仍然徘徊在淮河流域及其以北地区，但发病范围可能有所扩大。     

Residential proximity to green spaces and breast cancer risk: The multicase-control study in Spain (MCC-Spain)

Background

Breast cancer is the main cause of cancer mortality among women. Green spaces have been recently associated with reduced cancer mortality among women. Mechanisms explaining the beneficial effect of green spaces include increased levels of physical activity and reduced exposure to air pollution, which have been both associated with cancer development.

基线高敏C-反应蛋白与吸烟人群上消化道癌发病风险的前瞻性队列研究

目的 采用大型前瞻性队列研究方法,探讨吸烟人群的高敏C-反应蛋白（high sensitivity C-reactive protein,hsCRP）和上消化道癌发病的相关性。方法 收集2006-2007年开滦集团职工体检数据和随访期内发生的上消化道癌数据,建立数据库。使用多因素Cox模型统计分析吸烟人群不同基线hsCRP水平与上消化道癌发病的关系。结果 队列最终纳入38 549人,中位随访时间8.1年,收集上消化道癌共123例。不同hsCRP水平组新发上消化道癌累积发病率（8年）分别为278/10万（hsCRP<1 mg/L组）、339/10万（1 ≤ hsCRP ≤ 3 mg/L组）和484/10万（hsCRP>3 mg/L组）,Log-rank检验显示差异有统计学意义（（口恶）²=6.48,P=0.039）。多因素Cox模型分析显示,调整性别、年龄、是否饮酒、体质指数、既往糖尿病史、工作环境和教育程度因素后,hsCRP>3 mg/L组上消化道癌发病风险是hsCRP<1 mg/L组的1.64倍（95%CI：1.05~2.56,P=0.028）。在 ≥ 45岁人群中,hsCRP>3 mg/L组上消化道癌发病风险是hsCRP<1 mg/L组的1.71倍（95%CI：1.08~2.70,P=0.022）。结论 基线hsCRP水平升高可能增加上消化道癌发病风险。     

2005-2013年中国女性乳腺癌发病及死亡趋势分析

目的  分析《中国肿瘤登记年报》中2005-2013年女性乳腺癌发病率与死亡率的变化趋势,为开展乳腺癌防治提供参考。 方法  提取2005-2013年中国女性乳腺癌发病率与死亡率的全部记录;运用Joinpoint回归模型分析中国女性乳腺癌发病率与死亡率的变化趋势。 结果  2005-2013年我国城市女性乳腺癌发病率水平高于农村,城市发病率变化趋势平稳（t=-0.2,P=0.828）,农村发病率呈现上升趋势（t=7.8,P<0.001）;城市和农村发病率高峰分别为50~岁、45~岁年龄组。2005-2013年我国城市女性乳腺癌死亡率水平高于农村,城市死亡率变化趋势平稳（t=0.8,P=0.458）,农村死亡率上升趋势明显（t=3.3,P=0.014）;城市女性死亡率在30岁之后开始上升,75岁之后加速上升,农村女性死亡率在30岁之后开始上升,55~69岁变化趋于平稳,70岁后又开始上升。 结论  2005-2013年我国城市女性乳腺癌发病率及死亡率均高于农村女性,农村女性乳腺癌发病率与死亡率上升趋势明显,应积极制定并完善乳腺癌防治措施。     

Residential proximity to waste sites and industrial facilities and chromosomal anomalies in offspring

A few studies have found chromosomal anomalies in offspring associated with a maternal residence near waste sites, but did not examine the effect of living near industrial facilities, and most combined specific anomalies into heterogeneous groups. With a case–control study design, we investigated whether maternal residential proximity to hazardous waste sites or industrial facilities with chemical air emissions was associated with chromosomal anomalies in births. Maternal residences of 2099 Texas births with chromosomal anomalies and 4368 control births without documented malformations were related to boundaries of hazardous waste sites and street addresses of industrial facilities through geographic information systems. With adjustment for maternal age, race/ethnicity, and education, maternal residence within 1 mile of a hazardous waste site (relative to farther away) was not associated with chromosomal anomalies in offspring except for Klinefelter variants among Hispanic births (odds ratios (OR) 7.9, 95% confidence interval (CI) 1.1–42.4). Women 35 years or older who lived within 1 mile of industries with emissions of heavy metals were two times more likely (95% CI 1.1–4.1) than women living farther away to have offspring with chromosomal anomalies including trisomies 13, 18, or 21 or sex chromosome abnormalities. Among women 40 years or older, maternal residence within a mile of industries with solvent emissions was associated with chromosomal anomalies in births (OR 4.8, 95% CI 1.2–42.8). Study findings suggest some relation between residential proximity to industries with emissions of solvents or heavy metals and chromosomal anomalies in births to older mothers.     

中国人群饮酒与代谢综合征发病关系的前瞻性研究

目的研究我国成年人饮酒状况对代谢综合征（MS）发病的影响。方法本项目为前瞻性队列研究。2007至2008年对分别于1998和2000年基线调查的中国心血管病流行病学多中心协作研究35～74岁的27020例队列人群开展随访调查。结果基线14572例非MS人群经8年随访,共发生MS2362例。在调整了年龄、南北方、城乡、受教育程度、体力活动、吸烟、体质指数以及MS组分数后,和不饮酒者相比,男性饮酒者发生MS的相对危险度（RR）为1．24（95％CI：1．06～1．45）,人群归因危险度为10．13％;每日摄入酒精量10．1～20g,20．1—40g,〉40g组的RR分别为1．36（95％CI：1．02～1．82）,1．34（95％CI：1．03—1．74）和1．41（95％CI：1．13,～1．77）;每周饮酒2～5次和／〉6次的RR分别为1．25（95％CI：1．01～1．55）和1．26（95％CI：1．04～1．52）;只喝啤酒组、只喝白酒组和混合饮酒组的RR分别为1．60（95％CI：1．05～2．45）、1．30（95％CI：1．02～1．65）和1．27（95％CI：1．06～1．52）。女性每日摄入酒精量在10．1～20g组和〉20g组RR分别为2．67（95％CI：1．26—5．65）和2．38（95％CI：1．35—4．22）。结论在全人群中,每13摄入酒精量〉10g就会显著增加MS发病风险,在女性中尤为明显。男性每周饮酒≥2次以及只饮啤酒、只饮白酒和混合饮酒者均明显升高MS的发病风险。为减少MS的流行,应提倡限制酒精过量摄入,尤其女性更应限制酒精摄入量（≤10g／d）。     

江苏省海门市1999-2016年成年女性乳腺癌发病及死亡趋势分析

目的  分析海门市1999-2016年成年女性乳腺癌发病及死亡率情况。 方法  利用海门市肿瘤登记报告系统中1999-2016年女性乳腺癌患者的发病及死亡资料, 计算粗发病率、粗死亡率、标化率、年龄别率、变化百分比(percent change, PC)和年度变化百分比(annual percentage change, APC)等指标。 结果  海门市1999-2016年成年女性乳腺癌新发病例2 977人, 粗发病率、中标发病率分别为39.29/10万、20.65/10万; APC分别为5.87%、4.71%。因乳腺癌死亡病例938人, 粗死亡率、中标死亡率分别为12.38/10万、6.07/10万; APC分别为3.87%、2.43%。乳腺癌年龄别发病率随年龄递增, 30~岁发病迅速攀升, 发病高峰出现在55~岁(65.05/10万)及70~岁(60.77/10万); 乳腺癌年龄别死亡率随年龄呈缓慢递增, 直至80岁出现死亡高峰(29.68/10万)。 结论  海门市乳腺癌发病率和死亡率总体呈现逐年上升趋势, 且随年龄增长而递增。世标发病率及世标死亡率均高于全省及全国水平。应加强本地区乳腺癌的防治工作。     

A review of pesticide exposure and cancer incidence in the agricultural health study cohort

We reviewed epidemiologic evidence related to occupational pesticide exposures and cancer incidence in the Agricultural Health Study (AHS) cohort. Studies were identified from the AHS publication list available on a Medline/PubMed database search in March 2009. Findings related to lifetime-days and/or intensity-weighted lifetime-days of pesticide use are the primary focus of this review, because these measures allow for the evaluation of potential exposure-response relationships. Most of the 32 pesticides examined were not strongly associated with cancer incidence in pesticide applicators. Increased rate ratios and positive exposure-response patterns were reported for 12 pesticides currently registered in Canada and/or the United States. Exposure misclassification is also a concern in the AHS and may limit the analysis of exposure-response patterns. Epidemiologic evidence outside the AHS remains limited with respect to most of the observed associations, but animal toxicity data support the biological plausibility of relationships observed six pesticides. Continued follow-up is needed to clarify associations reported to date. In particular, further evaluation of registered pesticides is warranted.